ABOUT FISSURE IN ANO AND ITS HOMOEOPATHIC REMEDIES
Longitudinal tear in the lower end of anal canal results in fissure in ano. It is the most painful condition affecting in the anal region.
Clinical Feature
Age- Commonly seen in young patient.
- Severe pain during and after defaecation, burning in nature,lasting for about 1/2hour to 1 hour because of which defaecation is postponed.
- Severe constipation is present.
- Stool are hard,pellet like and there is a drop of blood or streak of fresh blood.
- Sensible pile refers to tag of skin at the outer end of the fissure.
- In some cases, fissure may be associated with a small perianal abscess resulting in worsening of pain.
Diagnosis
- When the buttocks are spread apart,a longitudinal tear and a hypertrophied,thickened skin is seen near the lower end of fissure- Sentinel pile.
- Per rectal examination can be done(with lignocaine jelly application) and sphincter spasm can be appreciated.
- Proctoscopy is contraindicated because the condition is very painful.
Treatment
1. Conservative
- Avoid constipation- encourage fibre diet,mild laxatives, not to postpone defaecation.
- Surface Anaesthetic Cream- Lignocaine jelly.
- Sitz bath
- Metronidazole
- Antibiotics
2. Agent which decreases sphincter pressure
- Glyceryl Trinitrate topical application-Significant headache and 50% recurrence are drawbacks.
- Purified botulinum toxin injection into internal spincter- It inhibits presynaptic release of acetylcholine from cholinergic nerve endings and causes temporary paresis of striated muscle. Cost,perianal thrombosis are drawbacks.
- Calcium blockers
- Nifedipine
- Diltiazem oral (as well as topical application also have been used).
3.Surgical Treatment
- Lateral sphincterotomy
- Lord's dilatation
- Fissurectomy and local advancement flap.
Homoeopathic Medicine For Anal Fissure
- Graphitis
- Silicea
- Merc sol
- Thuja
- Phos
Graphitis
It is a deep acting constitutional remedy.
It is a great remedy for anal fissure.
Best suited to the person who is fatty ,chilly and costive with swollen lymphatic glands.
Habitually constipated.
Anus is fissured and painful with varices.
Stool hard,large lumps and knotty with mucous shreds.
very chilly patient.
Patient is stout and anaemic with a tendency to constipation.
Fissures due to chronic constipation.
Anus eruption,itching with fissure.
Stools-brown fluid,mixed with undigested substance and of an intolerance of pain.
As a result of such passage of large hardered feacal matter anus becomes fissure and varies make their appearance.
Anus is extremely sore and the patient is very much annoyed when sitting
Silicea
Rectum feels paralysed.
Chronic fistula is the result of repeated trauma to the fistula bearing area.
It is deep with exposure of the circular fibers of the internal sphinctor muscles.
A tight anal splinctor is observed in these patients,might be causing severe reflex spasm and the stool traumatises the rectal and anal tissue repeatedly.
Stools come down with difficulty,when partly expelled recede back again.
Great straining at stools, which causes irritation to sphinctor ani.
Modalitis - Aggravated in Morningm from washing the parts, uncovering, lying down, cold application.
Better by Warmth, in summer season.
Merc sol
Perineal area is almost constantly moist,excessively odorous with viscid perspiration,worse at night.
The tract of the fistula can be palpated as an indurated cord. But if the fistula is deep high and horseshoe,it can not be palpated.
This is one of the indicated remedy for ulcerative colitis, then the fistula may be secondary to the same. Thus when fistula is being diagnosed ulcerated colitis may be ruled out.
Patient has general tendency to free perspiration,but patient is not relieved thereby.
Vesicular and pustular eruptions around the anus.
Ulcers which are present at the opening of fistulous tract have irregular shape,edges are ill-defined.
Itching of the anus region worse by warmth of bed.
Copper coloured eruptions.
Rawness and soreness of the respiratory tract.
Modalitis- Aggravated at night,wet damp weather,warm room and warmth of bed.
Better by rest,washing the parts.
Thuja
Anus fissured,painful to touch with multiple warts.
An inflammatory tract with a secondary opening in the perianal skin,with a primary opening.
Skin around the anus is dirty looking.
Thick whitish yellowish discharges from the fistula which stains the clothes.
Hair around the area become dry and fall out.
Profuse perspiration of gluteal and anal region and around,with foul smelling odour.
Fissure is painful to touch.
The feel is hard globular.
On pressure squeezes out the contents of fistular tract.
Fistular originates in an abscess in the intersphincteric space of anal canal.
Chronic catarrhal condition with greenish yellowish discharge.
Ulceration,that too,non healing in the anal region,painful and tender to touch.
Trouble while sitting and while walking.
It is a sycotic disorder,fistula occasionally on left gluteal or perineal side.
Neuralgia,region is tender to touch.
Condition is associated with low grade fever with pain in thighs.
Rumbling and colicky pain in abdomen.
Sometimes patient complaints of constipation with violent rectal pain causing stools to recede back.
Piles are swollen.
Modalitis -Aggravation in night,cold,and damp weather, touch,heat of bed.
Better in open air.
Phos
Anal incontinance,with fecal impaction,or chronic constipation with prolonged laxative abuse. The sphincter muscle mechanism is intact but the large bolus of faeces distends the ampula, causing the relaxation of the internal sphincter.The about the anal opening and at the gluteal region bleed easily.They heal and break out again. These ulcer have the malignant tendency.Dry and scaly eruptions.
Very foetid stool and flatus,stools are long narrow and hard.
Stools like that of dogs,difficult to expel.
Green mucous with grain like sago.
Great weakness after defecation.
White hard stools.
The patient in general is chilly and aggravated by cold.
The patient want to be magnetised.
Indicated in tall,slender weak,feeble and anaemic persons,who grow too rapidly,with haemorrhagic tendency.
Great debility and prostration
Oversensitive.
Modalitis- Aggravated from touch, physical exertion,evening,lying on painful side
Better in dark ,cold food, open air,washing the ulcer with cold
The selection of homoeopathic remedies based on symptom similarities and doses according to the Susceptibility of patient.
Don't take homoeopathic medicine without any prescription / without any advise of physician.
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