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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.
Fissure in Ano Causes
Most common cause of the fissure-in-ano is constipation. Chronic constipation due to any reason (such as habitual, drug-induced, 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
- 1. Following bout of diarrhea or following the passage of bulky stools very quickly (especially in children)
- 2. Multiple pregnancies
- 3. Chronic use of laxatives
- 4. Rarely, a fissure may be the manifestation of underlying disease e.g. Crohn's disease, ulcerative colitis, sexually transmitted disease, or cancer.
- 5. Incorrectly performed an operation for piles
Fissure in Ano Symptoms
1. Pain while passing stools: The lower anal canal is an exquisitely sensitive area of skin and can produce fairly significant signals of pain if damaged. Sharp agonizing knife-like pain starts when the individual passes stool. The pain is severe and persists for an hour or so. It ceases suddenly. The sufferer is comfortable until the next action of the bowel. The individual tends to be constipated rather than go through the painful ordeal. If a fissure becomes chronic (long-standing) and deep, another kind of pain can develop. It is a dull ache in the anus and pelvis that starts a few minutes after the bowel movement and can persist for hours after passing stools. This chronic fissure pain is due to spasm of the internal sphincter muscle (one of the small muscles in the anus) and can be quite debilitating.
2. Severe spasm of the anal sphincter (as a protective reflex)
3. Blood streaked stool (typically on the side of the hard stool): It is important to note that the bleeding associated with a fissure-in-ano is bright red and associated with some pain or tenderness in the anus. Dark bleeding of greater amount without any anal tenderness or pain should never be ignored and should be brought to the notice of doctor.
4. Discharge, swelling, and itching occur, especially with chronic fissures. Interestingly, homeopathy has many medicines to relieve the discomfort. Rightly chosen homeopathic medicine covers various aspects of the fissure.
Types of Fissure-in-ano
Fissure-in-ano may present as an acute fissure of recent origin (less than 6 weeks of duration). At this stage fissures are superficial. Some of them may deepen to reach underlying layers and present as a chronic fissure of a long duration (more than 6 weeks of duration) or recurring fissures.
Fissure-in-ano is largely considered as a medico-surgical disorder. However, looking at it in the light of homeopathic medicine, it is medically correctible conditions. Fortunately, in most cases, surgery can be avoided with homeopathy treatment.
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