Fissure in Ano
Fissure in Ano is a small tear in the thin ,moist tissue that lines the anus. An anal fissure is usually a result of passing hard or large stools during a bowel movement. Anal fissures causes pain and bleeding with bowel movements.
Fissure in Ano is very common in infants but can occur at any age. In most cases,the fissure heals on its own within 4-6 weeks ,but when it persists beyond 8 weeks ,it is considered as chronic.
Certain treatments like stool softners, topical pain relievers can promote healing and help to get relieve from fissures.
Symptoms –
• Pain during and after bowel movements that can last up to several hours .
• Burning or Itching in the anal region.
• A visible tear in the skin around your anus.
• A skin tag or small lump of skin ,next to the tear.
• Bright red blood on the stool or toilet paper after a bowel movement.
Causes –
• Passing large or hard stools.
• childbirth
• Anal intercourse
• Inflammatiory bowel disease such as crohn’s disease
• Chronic constipation
• Frequent diarrhoea
• Decreased blood flow to the Anorectal area.
• Overtight or spastic anal spinchter muscles
In rare cases ,an anal fissure may occur due to –
• Anal cancer
• HIV
• Syphilis
• Herpes
Complications –
• failure to heal-
If fissure doesn’t heal in 8 weeks , fissure is considered chronic and needs further treatment.
• Recurrence –
The person who once experienced a fissure is more prone for the another one.
• Extends to surrounding muscles-
Fissure may extend into the ring of muscle that holds your anus closed, making it more difficult to heal
Prevention –
• Make it a habit to change infants diapers frequently to avoid skin rashes changes into cuts.
• Clean the anal area gently with mild soap and warm water.
• Keep anal area dry.
• Whenever you have diarrhoea treat it immediately.
• Drink plenty of fluids, eat fibrous foods and exercise regularly to avoid constipation.
Diagnosis –
It can be diagnosed simply by Anorectal examination by doctor.
Some more testing may be required if the condition seems more chronic. Tests includes in it are –
• Anoscopy
• Flexible sigmoidoscopy
• Colonoscopy
Treatment –
• Using over the counter stool softners.
• Taking fiber supplements and eating more fibrous foods.
• Taking sitz bath to relieve anal muscles.
• Applying a nitroglycerin ointment to promote blood flow to the area or a hydrocortisone cream such as cortizone 10 ,to help with inflammation.
• Applying topical pain relievers such as lidocaine, to ease discomfort.
• Another treatment is Botox injections into the anal sphincter. It will prevent spasm in your anus by temporarily paralysing the muscle.
• Blood pressure medications such as nifedipine or diltiazem can help to relax the anal sphincter.
• If these treatments donot work ,a procedure called lateral internal sphincterotomy (LIS) can be done, which involves cutting a small portion of anal sphincter muscle to reduce spasm and pain and promote healing.
Ayurvedic Perspective –
In Ayurveda Fissure in Ano is described under the term Parikartika .It happens by imbalance of vata and pitta dosha. Vata causes pain like cutting feeling along with swelling.
Line of treatment –
• Avagaha sweda –
It is hot sitz bath which gives muscles relaxation and reduces swelling and itching at anal region.
• Jatyadi oil/ ghee –
It is used externally to heal wounds like fissures or cuts.
• Gugglu preparations –
1) Kaishore gugglu – It is beneficial for dermatitis ,itchiness and extreme burning sensation.
2) Triphala gugglu – It has expertise in bowel problems like constipation.
3) Shigru gugglu – It is given when swelling and discomfort increases.
4) Lakshadi gugglu – It is beneficial to stop bleeding.
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