Anal Fissure
By HDr.FNAWAN
INTRODUCTION
Anal fissure is a small tear in the thin, moist tissue that lines the anus. An anal fissure may occur when you pass hard or large dry stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You may also experience spasms in the ring of muscle at the end of your anus.
SYMPTOMS
1. A visible tear in the skin around your anus.
2. A skin tag or a small lump of skin next to the tear.
3. Streaks of blood on stools or on toilet paper after wiping.
4. Sharp pain in the anal area during bowel movements.
5. Burning, swelling or itching in the anal area.
CAUSES
Common causes of anal fissure include.
1. Passing large or hard stools.
2. Constipation and straining during bowel movements.
3. Chronic diarrhea.
4. Childbirth.
5. Anal intercourse.
Less common causes of anal fissures include.
1. Crohn's disease or another inflammatory bowel disease.
2. Anal cancer.
3. HIV.
4. Tuberculosis.
5. Syphilis.
PREVENTIONS
An anal fissure cannot always be prevented, but following preventive measures can be taken to reduce the risk of getting anal fissure.
1. Drinking plenty of fluids.
2. Eating fibrous foods.
Fiber-rich foods include:
*Wheat bran
*Oat bran
*Whole grains, including brown rice, oatmeal, popcorn, and whole-grain pastas, cereals, and breads
*Peas and beans
*Seeds and nuts
*Citrus fruits
*Prunes and prune juice
3. Avoid Foods that cause constipation and aggravate fissures. These include high fat and low fiber snacks like chips and sugary doughnuts, cheesy pizza, and burger etc., if you are dealing with tummy troubles. Frozen meals, packaged foods, and convenience meat products which go through a lot of processing and are also high in sodium. They can make your bowel movement tough. If constipation problem is not treated in time, it can make your anal fissure worse.
4. Avoid Enriched or Refined flour as it is heavily processed flour that has no germ or bran and all necessary nutrients like vitamins, minerals and fiber content are lost during processing . Therefore, enriched bread, pasta, cereals and snack foods should be replaced with whole grain food items. If you maintain your daily fiber intake from 25 to 30 gm per day, you can avoid painful, thick stool and prevent constipation.
5. Avoid Added sugars as it only adds calories and contains no nutritional values. Eating too many sugary foods can disturb your digestive health. So, try to cut down on sugary items such as jellies, candies, ice-creams, sugary cereals, and sweetened drinks, etc.
6. Avoid High-fat Meats as Fatty meats like bacon, pork, beef sticks, and lamb are high in saturated fat and low in fiber. Apart from constipation, fatty foods increase your chances of developing obesity and diabetes also. So Instead of choosing a meat-rich diet you should prefer fiber-rich protein sources like chickpeas, black beans, lentils, and split peas, etc.
7. Exercising regularly to avoid constipation.
8. Treating diarrhea immediately.
9. Cleansing the anal area gently with mild soap and warm water and keeping the anal area dry.
10. Changing infants’ diapers frequently.
11. Do not strain while passing hard and dry stool. It is helpful to apply Vaseline on anal region to let stool slip easily. It is a well-known fact that coconut oil works as an excellent lubricant and also makes it easier for hard stool to pass. The medicinal properties of coconut oil help treat wounds, sores and other skin lesions. It is safe and works as a positive healing agent for fissure wounds.
12. Avoid cooking in Aluminum vessels. Long term use of Aluminum can lead to poisoning and in turn constipation.
13. Avoid Laxatives and Purgatives for treating constipation as long-time use can form a habit and when you stop taking them it may cause severe constipation.
TREATMENTS AND DRUGS
Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing.
If your symptoms persist, you'll likely need further treatment.
Nonsurgical treatments
*Externally applied nitroglycerin helps increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache.
*Steroid creams, to help relieve discomfort.
*Botulin toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms.
*Blood pressure medications which can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects.
SURGERY
If you have a chronic anal fissure that is resistant to other treatments or if your symptoms are severe, your doctor may recommend surgery. Surgery usually involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain and promote healing. Surgery has a small risk of causing incontinence.
HOMEOPATHIC TREATMENT
Some of the Homeopathic medicines used in anal fissure without having any side effects are:-
Bryonia,Alumina, Sulphur and Nat. Mure can be used to avoid constipation.
Silicea to promote healing
Belladonna
Podophyllum
Cal. Flour
Ratanhia
Phosphorus
Nitric acid
Aesculus. Hip
Paeonia
Graphites.
