3 Medicines for Fissure of Anus

Graphites- Graphites is affected in person having the tendency or history of eczema; anus is extremely sore and the stool are covered with mucus; constipation with no urge; the fissures are usually caused by hard and large stool; anus are sore and it smarts after passing stool; Stool large, hard, knotty, difficult and passed with extreme pain; no desire for stool for many days, it requires long time with great straining to pass the stool; Hemorrhoids may also present with fissures.

Nitric Acid- This remedy is indicated in fissures where there is a sensation as if splinters or sticks were in the anus; Fissures are extremely painful and bleeds easily during stool; pain is so severe that the patient may break in sweat and becomes anxious; blood from fissures is dark and offensive; Patient gets some relief from cold applications.

Paeonia- Paeonia has fissures with much oozing; the anus is offensively moist and sore, smarts all the time; Burning and stinging pain lasting several hours after passing stool; Patient gets some relief while walking, must walk the floor whole night to get relief.

Other medicines used in fissures are Ratanhia, Sanguinaria Nitrate, Silicea, Platina, Krameria, Calcarea Carb, Hamamelis, Muriatic Acid, Nux Vomica, Sulphur, Carbo Veg, etc.

Anal fissures?

An anal fissure is a cut or tear occurring in the anus (the opening through which stool passes out of the body) that extends upwards into the anal canal. Fissures are a common condition of the anus and anal canal and are responsible for 6-15% of the visits to a colonic and rectal (colorectal) surgeon. They affect men and women equally and both the young and the old. Fissures usually cause pain during bowel movements that often is severe. Anal fissure is the most common cause of rectal bleeding in infancy.

Anal fissures occur in the specialized tissue that lines the anus and anal canal, called anoderm. At a line just inside the anus referred to as the anal verge or intersphincteric groove, the skin of the inner buttocks changes to anoderm. Unlike skin, anoderm has no hairs, sweat glands, or sebaceous glands and contains a larger number of somatic sensory nerves that sense light touch and pain. The abundance of nerves explains why anal fissures are so painful. The hairless, gland-less, extremely sensitive anoderm continues for the entire length of the anal canal until it meets the demarcating line for the rectum, called the dentate line.

Cause:

Anal fissures are caused by trauma to the anus and anal canal. The cause of the trauma usually is a bowel movement, and many patients can remember the exact bowel movement during which their pain began. The fissure may be caused by a hard stool (constipation) or repeated episodes of diarrhea. Occasionally, the insertion of a rectal thermometer, enema tip, endoscope, or ultrasound probe (for examining the prostate gland) can result in sufficient trauma to produce a fissure. During childbirth, trauma to the perineum (the skin between the posterior vagina and the anus) may cause a tear that extends into the anoderm.

Treatment:

General Treatment:

Changes to diet and lifestyle will help to encourage healing of a fissure. The main aim is to try and avoid constipation, so that stools are smaller and softer.

This can be achieved by eating a diet that is rich in fiber, including plenty of fruit, vegetables and wholegrain cereals such as brown rice, bread and pasta. You should also aim to drink enough water-based drinks so that your urine is no darker than pale yellow.

Taking a regular supplement of bulk-forming laxative like Fybogel or a laxative that softens the stool like lactulose syrup will help the healing process and prevent further tears. Patients are advised to avoid “sharp” foods that may not be well-digested (i.e., nuts, popcorn, and tortilla chips)

Sitting in a warm bath after bowel movements, to relax the spasm, to increase the flow of blood to the anus, and to clean the anus without rubbing the irritated anoderm may also bring some relief from the discomfort.

If your fissure has not healed despite these lifestyle changes, or if you are worried about it, you should see your doctor. If you have blood in your stool (rather than some spotting on toilet paper or in the bowel) or have recently experienced altered bowel habits or have been losing weight, another problem may be responsible for your symptoms and you should seek medical advice promptly.

Medication:

Ointments containing anesthetics, steroids, nitroglycerin, and calcium channel blocking drugs are used for treating anal fissures along with conservative management.
Injections of botulinum toxin may be effective when ointments are not effective.

Surgery:

If a fissure continues to cause pain and bleeding and does not respond to conservative medical therapy, it is considered chronic and surgery may be required. Chronic fissures heal only 10% of the time without surgery. This may involve an operation to wedge out the area of the fissure and any underlying scar tissue. During the operation, one of the anal muscles is also usually cut (internal lateral sphincterotomy) or the anus forcible dilated. While these procedures sound terrible, they reduce spasm which can interfere with healing. Surgery can usually be performed without an overnight hospital stay. Although the pain often disappears a few days after surgery, full healing requires one to two months however most patients are back to normal activity within a week or two.

Useful Link: http://en.wikipedia.org/wiki/Anal_fissure