Anal fissure

Tear or cut to the anal region or in the anal canal called an anal fissure. An anal fissure can occur in anyone at any age. It can be caused by injury to the mucosal layer or by overstraining, etc. Small tearing in the mucosa can cause bleeding in the stool or a pricking type of pain during and after passing stool.

Causes:

1. Trauma to the anal mucosa by stretching of skin beyond its capabilities.
2. Constipation: if the stool is hard to dry and large it can cause small injury to the lining of the anal canal.
3. Prolonged diarrheic.
4. People with poor bowel habits are prone to suffer from anal fissure.
5. Trauma during delivery of the child in a woman.
6. Ulcerative colitis can cause anal fissure.
7. Anal sexual intercourse.

 Symptoms: 

1. Stitching, burning pain while passing stool and lasts for 1-2 hour after passing stool.
2. Constipation.
3. Fresh blood in the stool.
4. Visible cut in the anal region on examination.
5. Burning and itching with pain in the anal region.
6. Foul-smelling discharge from the anus.
7. Bleeding can be seen in toilet paper after wiping out.
8. Skin tag or lump next to the tear.

Risk factors:

1. Women during and after childbirth are prone to get an injury to the mucosal lining of the anus due to overstraining.
2. A person with chronic constipation may develop a fissure because dry hard stool causes injury.
3. People with a history of IBD have a higher risk to develop anal fissure.

Complications : 

1. Severe pain and discomfort.
2. Anal fistula.
3. Difficulty in passing stool.
4. Recurrence even after treatment has taken.
5. Low blood supply to the anal region can lead to ulceration that is very painful and pus formation may occur.

Diagnosis: 

1. Rectal examination: to see the tearing of injury to the anal canal.
2. sigmoidoscopy: to see the lower part of the colon if any tearing or skin tag is present inside.

Management: 

1. Avoid constipation and keep stool soft.
2. Eat lots of fibers in diet like fruits and vegetables.
3. Drink at least 2-3 liter water per day.
4. Do not eat spicy high fatty food.
5. Don’t drink and smoke.
6. Sit in warm water after passing stool it will help in relieving pain.
7. Do not strain while passing the stool.
8. Wash the anal region gently do not rub it harshly.
9. Maintain hygiene.
10. Take proper treatment of IBD or Crohn’s disease.

Homoeopathy treatment: 

1. Ratanhia Peruviana:  it is well marked in rectal symptoms. Pain in the rectum for hours after passing stool.  Fissure in anus with great burning sensation and temporary relief by cold water. Fetid thin diarrhoea and burning pain before and during passing stool. Mucus discharge from the anus.
2. Paeonia officials: it has marked symptoms of anal fissure. It acts well on swollen orifices. Burning pain with intolerable itching along with ulceration of anus with crusts. Constant burning pain and can not sit still. Offensive discharge from the anal region.
3. Nitric acid: it well is indicated in severe constipation with anal fissure.  The stool is dry and hard required great staring but passes little. Tearing type of pain while passing stool.  Stool tears the mucosal lining of the anal canal. Bleeding from the anus that is bright red.