What is Fissure-in-ano ?

Anal fissures, also medically called as Fissure-in-ano, is nothing but a painful condition where there is a longitudinal cut on the skin of the anus. Due to friction or scratch or trauma, there may be a cut or fissure formation. Males, females including adults as and children may get affected with Fissure-in-ano.

The rear part of the anus is a common spot affected due to the poor blood supply, leading two formation of the fissure and difficult healing. Some conditions such as constipation, chronic diarrhea, ulcerative colitis, Crohn's disease, etc. could trigger or lead to fissure formation.

Symptoms of Fissure-in-ano :

• Pain while passing motions: Painfulness of the anus where there is a cut, is the most common symptom. The pain typically described by the patient is as cutting, shooting, agonizing, burning or even excruciating. It may last for a few hours after passing stool due to friction, fresh trauma, inflammation, and infection. It would start soon while passing stool, at times, preventing the defecate. Children may avoid passing stool due to anticipated pain. If the patient has consumed spicy food, there could be burning while passing stool; and afterward. The pain may subside after a few minutes or a few hours; to re-appear after the next call for passing stool.
• Severe anal spasm (as a protective reflex)
• Hard stool may cause friction on the wall of anus giving blood streaked stool. There may be frank bleeding after passing stool, which is likely to be bright red in color.
• Itching, Discharge, swelling are common symptoms of chronic fissures.

Causes of Fissure-in-ano:

The most common cause of fissure-in-ano is constipation. Chronic constipation due to any reason (such as due to lifestyle, habitual, drug-induced, due to pregnancy, etc.) leads to recurring abrasion or forceful rubbing of the anal mucosa, which leads to a fissure. The current theory also suggests that sphincter spasm and accompanying ischemia; may precipitate the development of fissures and prevent them from healing in some people. The other less common causes can be

• Following a bout of diarrhea or following passage of bulky or hard stools (especially in children)
• Multiple pregnancies
• Chronic use of purgatives
• Rarely, a fissure may be the manifestation of underlying disease e.g. Crohn's disease, ulcerative colitis, sexually transmitted disease, or cancer.
• Wrongly performed an operation for piles

When choosing the homeopathic remedy for a fissure, the causative factors are always evaluated, and homeopathic medicine encompassing this cause is chosen. The remedy chosen in such a way not only heals the fissure but also does not allow the problem to recur.

Future of Fissure

Prognosis: The vast majority of acute fissures resolve entirely within a short span of time, if there is no constipation or straining for the toilet.

Complications: If acute fissures are not properly managed, they become chronic. Chronic and non-healing fissure-in-ano may present as a complicated condition, especially when it is associated with resistant constipation,

• Hemorrhoids (piles): Hemorrhoids are swollen, dilated veins of the rectum or anus. Hemorrhoids may be located at the beginning of the anal canal (internal hemorrhoids), or at the anal opening (external hemorrhoids).
• Anorectal fistula: Anorectal fistula is a hollow tract (opening) leading from the anal canal or rectum to the skin through which watery pus drains.
• Crohn's disease: Crohn s disease is a chronic inflammatory process primarily involving the intestinal tract. It most commonly affects the last part of the small intestine (ileum) and/or the large intestine (colon and rectum). Also called regional enteritis and ileitis.
• Anorectal cancer: Cancer affecting rectum and anus.
• Perianal abscess: Perianal abscess is a collection of pus outside the anus.

Chronic and recurring fissures may lead to permanent scarring or injury that prevents normal bowel movements.

Timely administered homeopathic medicines take care of acute and chronic fissures gently, effectively, and without producing any side effects.