fissure in ano and ayurveda non surgical procedure ksharkarma
Dr Vinay Kumar (Piles, fistula, fissure, pilonidal sinus and anorectal diseases )
01 Jul 2022
FISSURE IN ANO Anal fissure is a small cut or tear in the tissue of anal opening. Symptoms in patient suffering from fissure in ano:- • Patient complaints of pain during passing stool, pain may last for hours, sometime patient may need analgesics for pain relief. • Itching. • Per rectal bleed on and off. Bleeding may present in the form of strip on stool surface or two or three drops after passing stool. Some time toilet paper stain with blood while cleaning. • In some patient there is a skin growth at the skin margin. Most of the patient misinterpret it as piles. But it is not actual piles its sentinel piles or sentinel skin tag. Classification of anal fissure:- Anal fissure can be divided into primary and secondary anal fissures based on etiology; Posterior and anterior fissures based on location and acute and chronic anal fissures based on the duration of symptoms. • Classified into two subtypes according to causative factors (etiology):- 1. Primary anal fissure- caused due to local trauma such as hard stools, prolonged diarrhea, vaginal delivery, repetitive injury or penetration. These are usually posterior and anterior in location. 2. Secondary anal fissure- caused due to previous surgical procedures in anal area, inflammatory bowel disease, tuberculosis, sarcoidosis, HIV/AIDS, syphilis, they are usually multiple and lateral in position. • Anal fissure may be classified into several types based on location: 1. Posterior anal fissures- it is most common found in 90% cases, it lies at 6 o’clock position when patient examined in lithotomy position. 2. Anterior anal fissures- it is second commonest fissure found in 10% cases, it lies at 12 o’clock position when patient examined in lithotomy position. 3. Lateral anal fissure- lateral fissure is less common causative factors are secondary like previous surgical procedures in anal area, inflammatory bowel disease, tuberculosis, sarcoidosis, HIV/AIDS, syphilis. • Based on duration of symptoms, an anal fissure may be classified as either acute or chronic fissure. 1. Acute anal fissure- an acute fissure looks like a fresh tear somewhat like a paper cut. It of lesser duration i.e. 4 weeks. 2. Chronic anal fissure- typically occurs in the midline with visible sphincter fibers at the fissure base, anal papillae, sentinel piles and indurate margins. In chronic fissure there is cycles of pain and recovery for several times. Treatment :- Diet is having significant role in fissure management, patient has to take high fiber diet with plenty of fluids intake. Also patient has do regular exercise. Fissure can be managed conservatively with diet control, analgesics, local topical application and hot sitz bath. If these measures fails Botox injection are also given to paralyze sphincter muscles temporarily which promotes healing. If this also fails lateral sphincterotomy is done it may be closed or open. Now a days laser surgery is also performed. At Arogyam Piles Clinic And Research Center we practice authentic , time tested, evidence based ayurveda. Fissures are managed with ayurvedic medication and diet. If some patient doesn’t respond to medical management, in such patient ksharkarma- non surgical procedure is performed. Kshar karma – in this procedure anal dilation is done, followed by application of kshar- alkaline paste is done on fissure bed, which slough out unhealthy tissue and fresh granulation- healing process start. Benefit of this procedure are non invasive procedure i.e. there no cut or incision, OPD procedure patient can go home after 2 hours, no need of bed rest can resume his day today activity from next day, anyone can undergo this procedure even patient having major medical illness. For more information call or whatsapp 9646764444 Or visit ARPGYAM PILES CLINIC AND RESEARCH CENTER 2nd floor above Longia sweet shop, Chandigarh- Kharar highway, Desumajra Sector 125, Greater Mohali, Punjab, 140301 Email- info@arogyampilesclinic.com Website- www.arogyampilesclinic.com