Do you recall feeling a tearing sensation in your anal area during a difficult bowel movement episode? And ever since, every trip to the bathroom to pass stool has been a painful and dreaded moment instead of a relaxing one. To add to the horror, fresh red blood smears your stool and the toilet tissue. If you experience those things, it is likely that you are suffering from anal fissures.
The pain during and after defecation (passing stool) is the clinical hallmark of anal fissure (a cut or tear in the anus) which can be classified into:
•Primary –
Longitudinal laceration usually found in anterior or posterior midline of the anus. The cuts usually result from frequent constipation and/or explosive diarrhea. Pregnancy, difficult childbirth, trauma from excessive wiping of anus and other conditions that cause injury to anus may cause anal fissures.
•Secondary –
Also called atypical fissures. These are lateral cuts or tears in that anus that can be caused by syphilis, tuberculosis, carcinoma and other diseases. Atypical fissures usually require biopsies and cultures to determine underlying condition.
Anal fissure is a benign condition; however, if it progresses, it may lead to the following complications:
•Chronic fissure –
A tear that does not heal. Not only is this extremely painful (because of added inflammation in surrounding areas), it may also cause scar tissue formation around the area.
•Anal fistula –
The tear may develop into a hole or tunnel, which connects to the surrounding areas like the urethra (passage of urine) or bowels.
•Anal stenosis –
The scar tissue formation and spasm makes the anal canal narrower, making passage of stool more difficult that may aggravate the condition.
Anal fissures heal spontaneously or with conservative management like prevention of constipation and facilitating healing of tears. The first line of therapy includes including more fiber in the diet and increasing water intake. Fiber supplementation and laxatives (psyllium-based products) twice a day for one week prove to make defecation easier by making stools softer. Drinking two glasses of water is recommended after taking each dose of fiber supplement. Pain control can be achieved by using ointments, jelly and other analgesics. Sitz bath or sitting in a basin of warm water once or twice a day for 10 to 20 minutes may also provide relief.
An adjunct therapy is the use of Lesser Celandine (Ranunculus ficaria) to treat anal fissure. The lesser celandine is a plant in the buttercup family which is commonly found in Europe, Asia and Canada. It has been traditionally used as remedy for inflammatory conditions. It is also known by the name “pilewort” and has been used in the management of hemorrhoids, a similar anorectal condition.
Lesser Celandine (Ranunculus ficaria) to treat anal fissure greatly helps in relieving the pain associated with the condition. Its anti-inflammatory properties decrease the swelling in the surrounding area, thus making defecation a less traumatic activity. It also has an anti-spasmodic effect, which prevents the spasm of the affected anal region, thus increasing blood flow to the area. Increased blood flow hastens speedy healing of the tears.
This herbal plant is synthesized in the liver, thus patients with poor liver function are not advised to take this remedy. The safety of Lesser Celandine to pregnant and lactating women, also younger children, is still not established so avoid taking the herbal medicine, if you belong to this group, to prevent possible untoward reactions.
Please Share
