Anal Ulcer

Fissure in ano or anorectal fissure is largely considered as a medico surgical disoder according to modern medical science. However, allopathic line of treatment is limited to few oral pain medications, stool softeners, soothing ointments, which are all relieving a few symptoms and that too for a very short period of time. This is mainly opted for acute fissures but in chronic

ulcers though conservative conventional treatment may be tried, yet in majority of cases this treatment fails and surgical management is called for like anal dilatation, fissurectomy, excision of anal ulcer and so on. Unfortunately in most of the cases this has also been unsuccessful. Moreover, you may have trouble controlling flatulence after surgery.

At that time the patient asks IS SURGERY ONLY OPTION FOR TREATMENT OF FISSURE IN ANO? AND OUR ANSWER IS NO.

Anal fissure or anorectal fissure finds an excellent treatment with homoeopathy. Think of surgery only after a fair trial with homoeopathic medicine. Most cases get well and rarely need surgery if treated properly by a competent homoeopath.

Now you must be thinking HOW HOMOEOPATHY HELPS AVOID SURGERY? The mainstay of surgery is to produce cuts in the muscles surrounding the anus to reduce anal spasms. The same goal can be achieved without using knife.

Homoeopathic medicines are basically aimed at enhancing the healing process. They facilitate healing, improve blood circulation to affected parts, relieve the anal spasm, alleviate pain, prevent infection, relieve constipation and treat all the symptoms related to anal fissure in totallity. This goes a long way to prevent recurrence of the condition.

Usually this problem recurs following conventional treatment. But in homoeopathy therapy chances of recurrence are nil. The main reason for recurrence of this condition is tendency to constipation. While choosing medicines the cause of constipation for a particular patient is also evaluated such as sedentary habits, dietary errors, faulty feeding habits, mental stress, weakness of digestive system muscles and so on. The remedies administered encompass these factors and helps to relieve constipation tendency itself.

Timely administered homoeopathic medicines take care of acute and chronic fissures gently, effectively, and without producing any side effects. The treatment is based upon individual study and evaluation of the case.

SO WHAT CAN BE EXPECTED WITH HOMOEOPATHIC TREATMENT

Homoeoapthy has proved very effective in curing more than 80% of the fissure in ano sufferers. The results are obtained reasonably fast and are long lasting. The duration of treatment varies from patient to patient, depending upon the duration and extent of the fissures. Most patients show significant improvement in about 3 to 7 weeks of homoeopathic treatment. Some patients may need longer course of medication.

There are 87 remedies which give great relief. However, the correct choice and the resulting relief is a matter of experience and right judgment on the part of the physician. The treatment is decided after thorough case taking of the patient. Thus homoeopathic medicines of anal fissure or ulcer are designer made unlike allopathy in which all patients receive the same type of drugs and surgery.

What is Anorectal Fissure or Anal Fissure or Fissure in Ano or Anal Ulcer?

Fissure in ano or anorectal fissure is a very common and painful condition. This condition is characterized by a longitudinal crack in the skin of anus. If the skin lining of the lower end of the anus gets scratched, it may break up into a fissure.

They most commonly occur in the midline posteriorly, the least protected part of the anal canal. In males fissures usually occur in the midline posteriorly (90%) and much less common anteriorly (10%). In females fissures on the midline posteriorly are commoner than anteriorly (60:40).

Causes

Most common cause of the fissure in ano is CONSTIPATION. Chronic constipation due to any reason (such as habitual, drug induced, pregnancy and so on) leads to recurring abrasion or forceful rubbing of the anal mucosa, which leads to a fissure.

Spasm of the internal sphincter has also been incriminated to cause it.

When too much skin has been removed during operation for hemorrhoids (piles), anal stenosis may result in which anal fissure may develop when hard stool passes through such stricture.

The other less common causes are :

  • Following bout of diarrhea or following passage of bulky stools very quickly (especially in children).
  • Multiple pregnancies.
  • Chronic use of laxatives.
  • Rarely, a fissure may be the manifestation of underlying disease like Crohn’s disease, ulcerative colitis, sexually transmitted diseases, cancer and so on.
  • Surgery for piles (hemorrhoids) done imperfectly.

Symptoms

  • Pain while defecation : The lower anal canal is extremely sensitive area of skin and can produce fairly significant signals of pain if damaged. Sharp agonizing knife-like pain starts when the individual passes stool. The pain is severe and persists for an hour or so. It ceases suddenly. After the pain goes off the sufferer remains comfortable till the next action of the bowels. The individual tends to be constipated rather then go through painful ordeal. If a fissure becomes chronic and deep, dull aching kind of pain develops that starts a few minutes after the bowel movement and can persist for hours after passing stools. The chronic fissure pain is due to spasm of the internal sphincter muscle and can be quite debilitating.
  • Severe spasm of the anal sphincter.
  • Blood streaks on stool : The bleeding associated is bright red and associated with some pain or tenderness in the anus. It usually occurs as streaks on the outside of the stool, or spots noted on toilet tissue.
  • Discharge, swelling and pruritus ani (anal itching) occur especially with chronic fissures.
  • Anorectal fissures or anal fissures may present as ACUTE FISSURE of recent origin (less than 6 weeks of duration). At this stage they are superficial. Some of them may deepen to reach underlying layers and present as chronic fissure of a long duration (more than 6 weeks of duration) or recurring fissures.

Diagnosis

Clinical examination of the patient is required to diagnose this condition; no complicated procedures are required. With careful evaluation of the symptoms and a close look at the anus, a diagnosis of fissure can be confirmed.

On examination:

  • A tightly closed puckered anus is seen which the diagnostic point of this condition is.
  • A split or cut in the posterior midline of anal mucosa.
  • Lateral fissures.
  • Acute fissures are superficial with sharply demarcated edges.
  • Chronic fissures are usually deeper and may have secondary features, including hardening of the edge of the fissure, a sentinnel pile which looks like a small skin tag and hypertrophied anal papillae and so on.

Home Remedies

  • Several times a day, sit in a warm sitz bath for 20 minutes. This relaxes the anal sphincter, reducing spasms and their associated pain.
  • Prevention of anorectal fissure involves avoiding constipation and diarrhea through diet and excercise.