Anal Fissure:
An anal fissure is a small split or tear in the anal mucosa that may cause painful bowel movements and bleeding.
Causes, incidence, and risk factors:
Anal fissures are extremely common in young infants but may occur at any age.
Studies suggest 80% of infants will have had an anal fissure by the end of the first year.
They are equally common in men and women.
Sometimes an anal fissure and a hemorrhoid develop at the same time.
The incidence of anal fissures decreases rapidly with age.
Fissures are much less common among school-aged children than among infants.
Anal fissures are caused by vigorous stretching of the anal canal.
A fissure may develop if one is constipated and try to pass a large, hard stool;
sometimes after repeated diarrhea.
Many experts believe the most common cause is excessive tension in the two muscular rings (sphincters) controlling the anus.
The external anal sphincter is under ones conscious control.
However, the internal anal sphincter is not under ones control. This muscle remains under pressure, or tension, all the time.
A fissure may develop if the internal sphincter's resting pressure becomes too high, causing spasm and reducing blood flow to the anus.
In older adults, anal fissures may be caused by decreased blood flow to the area.
Trauma also can cause fissures.
During childbirth, 11% of women develop anal fissures.
Fissures can also be caused by digital insertion (as during an examination), foreign body insertion, or anal intercourse.
In some cases, an anal fissure may be caused by Crohn's disease, (an inflammatory bowel disease that causes bloody diarrhea, abdominal pain, fever, weight loss, and fissures or fistulas near the anus).
A low-fiber diet may play a role in the development of fissures.
Most fissures heal on their own and do not require treatment, aside from good diaper hygiene.
However, some fissures may require medical treatment.
SUMPTOMS:
An anal fissure causes a sharp, stinging, or burning pain during a bowel movement. The pain, which can be severe, may last for a few hours.
Constipation, often with painful bowel movements
Blood on the surface of stool (not mixed in with stool)
Blood on toilet tissue or wipes
A crack in the skin that is visible when the anus is stretched slightly (the fissure is almost always in the midline)
Fissures may itch. They often bleed lightly or cause a yellowish discharge.
Blood mixed with stool indicates some other condition, possibly inflammatory bowel disease (IBD) or colon cancer.
Occasionally an anal fissure may be a painless wound that won't heal and that bleeds intermittently but causes no other symptoms.
Health professionals can diagnose an anal fissure from symptoms and by looking at the anus.
Can see the fissure by gently separating the buttocks.
Most fissures occur along the midline—the top or bottom—of the anus.
May use a gloved finger (digital rectal examination) or a lighted instrument (anoscope) to examine the fissure.
However, if the fissure is extremely painful, one has to wait until it has begun to heal before performing a rectal exam or using an anoscope (anoscopy) to rule out other problems.
A topical anesthetic may be used if an immediate examination is necessary.
During an exam, one can also determine whether another condition may be causing the fissure.
If there are several fissures or have one or more in an area of the anus where fissures usually do not occur then look for another condition such as
IBD,
Syphilis,
a suppressed immune system,
Tuberculosis,
HIV infection,
Anal cancer.
Most acute fissures need some home treatment, including soaking in a shallow tub of warm water (sitz bath) several times a day,
Increasing fiber in the diet,
Try to prevent constipation, which can keep a fissure from healing.
The pain of a fissure may make one anxious about having bowel movements.
However, trying not to have bowel movements will only increase constipation and create a cycle that keeps the fissure open and painful.
Drinking lots of water or other fluids also will make stools soft and easy to pass.
HOMEOPATHIC TREATMENT:
1 acon, 1 aesc, 2 agn, 2 all-c, 1 aloe, 1 alum, 1 anac, 1 androc, 1 ant-c, 1 arg, 1 arn, 2 ars, 1 ars-s-f, 1 arum-t, 1 bcg, 1 berb, 1 calc, 1 calc-f, 2 calc-p, 1 carb-ac, 1 carb-an, 1 carc, 2 caust, 3 CHAM, 2 cund, 1 cur, 2 fl-ac, 3 GRAPH, 1 grat, 1 hep, 2 hydr, 2 ign, 1 kali-c, 1 kali-i, 1 lac-d, 2 lach, 2 led, 1 med, 2 merc, 1 merc-i-r, 1 mez, 1 morg, 1 morg-g, 1 morph, 1 mur-ac, 2 nat-m, 3 NIT-AC, 2 nux-v, 2 paeon, 2 petr, 2 phos, 2 phyt, 1 pip-n, 1 plat, 2 plb, 3 RAT, 1 rhus-t, 1 sars, 2 sed-ac, 3 SEP, 2 sil, 2 sulph, 1 syph, 1 tab, 3 THUJ, 1 tub, 1 zing
FISSURE bleeding (8)
1 ars, 1 calc, 1 graph, 1 lac-d, 1 nat-m, 1 nit-ac, 1 rhus-t, 1 syph
FISSURE bleeding stool, after (5)
1 ars, 1 calc, 1 lac-d, 1 nat-m, 2 nit-ac
FISSURE cold water amel. (1)
1 rat
FISSURE infants (1)
1 kali-i
FISSURE ointments agg. (1)
1 aloe
FISSURE oozing (4)
1 graph, 2 paeon, 1 syph, 1 tub
FISSURE painful, very (6)
1 cham, 1 graph, 1 lac-d, 1 rat, 1 syph, 1 thuj
FISSURE painless (4)
1 acon, 1 aloe, 1 carb-ac, 1 phos
FISSURE pregnancy, during (17)
1 ars, 1 caust, 1 grat, 1 ign, 1 lach, 1 mez, 1 nat-m, 1 nit-ac, 1 nux-v, 1 phos, 1 plb, 1 sep, 1 sil, 1 sulph, 1 tab, 1 thuj, 1 zing
fissures, soreness of anus, with HEMORRHOIDS(4)
1 caps, 1 cham, 2 nit-ac, 1 rat
PREVENTION:
To prevent anal fissures in infants, be sure to change diapers frequently.
To prevent fissures at any age:Keep the anal area dry .
Wipe with soft materials or a moistened cloth or cotton pad .
Promptly treat any constipation or diarrhea.
Avoid irritating the rectum.
Causes, incidence, and risk factors:
Anal fissures are extremely common in young infants but may occur at any age.
Studies suggest 80% of infants will have had an anal fissure by the end of the first year.
They are equally common in men and women.
Sometimes an anal fissure and a hemorrhoid develop at the same time.
The incidence of anal fissures decreases rapidly with age.
Fissures are much less common among school-aged children than among infants.
Anal fissures are caused by vigorous stretching of the anal canal.
A fissure may develop if one is constipated and try to pass a large, hard stool;
sometimes after repeated diarrhea.
Many experts believe the most common cause is excessive tension in the two muscular rings (sphincters) controlling the anus.
The external anal sphincter is under ones conscious control.
However, the internal anal sphincter is not under ones control. This muscle remains under pressure, or tension, all the time.
A fissure may develop if the internal sphincter's resting pressure becomes too high, causing spasm and reducing blood flow to the anus.
In older adults, anal fissures may be caused by decreased blood flow to the area.
Trauma also can cause fissures.
During childbirth, 11% of women develop anal fissures.
Fissures can also be caused by digital insertion (as during an examination), foreign body insertion, or anal intercourse.
In some cases, an anal fissure may be caused by Crohn's disease, (an inflammatory bowel disease that causes bloody diarrhea, abdominal pain, fever, weight loss, and fissures or fistulas near the anus).
A low-fiber diet may play a role in the development of fissures.
Most fissures heal on their own and do not require treatment, aside from good diaper hygiene.
However, some fissures may require medical treatment.
SUMPTOMS:
An anal fissure causes a sharp, stinging, or burning pain during a bowel movement. The pain, which can be severe, may last for a few hours.
Constipation, often with painful bowel movements
Blood on the surface of stool (not mixed in with stool)
Blood on toilet tissue or wipes
A crack in the skin that is visible when the anus is stretched slightly (the fissure is almost always in the midline)
Fissures may itch. They often bleed lightly or cause a yellowish discharge.
Blood mixed with stool indicates some other condition, possibly inflammatory bowel disease (IBD) or colon cancer.
Occasionally an anal fissure may be a painless wound that won't heal and that bleeds intermittently but causes no other symptoms.
Health professionals can diagnose an anal fissure from symptoms and by looking at the anus.
Can see the fissure by gently separating the buttocks.
Most fissures occur along the midline—the top or bottom—of the anus.
May use a gloved finger (digital rectal examination) or a lighted instrument (anoscope) to examine the fissure.
However, if the fissure is extremely painful, one has to wait until it has begun to heal before performing a rectal exam or using an anoscope (anoscopy) to rule out other problems.
A topical anesthetic may be used if an immediate examination is necessary.
During an exam, one can also determine whether another condition may be causing the fissure.
If there are several fissures or have one or more in an area of the anus where fissures usually do not occur then look for another condition such as
IBD,
Syphilis,
a suppressed immune system,
Tuberculosis,
HIV infection,
Anal cancer.
Most acute fissures need some home treatment, including soaking in a shallow tub of warm water (sitz bath) several times a day,
Increasing fiber in the diet,
Try to prevent constipation, which can keep a fissure from healing.
The pain of a fissure may make one anxious about having bowel movements.
However, trying not to have bowel movements will only increase constipation and create a cycle that keeps the fissure open and painful.
Drinking lots of water or other fluids also will make stools soft and easy to pass.
HOMEOPATHIC TREATMENT:
1 acon, 1 aesc, 2 agn, 2 all-c, 1 aloe, 1 alum, 1 anac, 1 androc, 1 ant-c, 1 arg, 1 arn, 2 ars, 1 ars-s-f, 1 arum-t, 1 bcg, 1 berb, 1 calc, 1 calc-f, 2 calc-p, 1 carb-ac, 1 carb-an, 1 carc, 2 caust, 3 CHAM, 2 cund, 1 cur, 2 fl-ac, 3 GRAPH, 1 grat, 1 hep, 2 hydr, 2 ign, 1 kali-c, 1 kali-i, 1 lac-d, 2 lach, 2 led, 1 med, 2 merc, 1 merc-i-r, 1 mez, 1 morg, 1 morg-g, 1 morph, 1 mur-ac, 2 nat-m, 3 NIT-AC, 2 nux-v, 2 paeon, 2 petr, 2 phos, 2 phyt, 1 pip-n, 1 plat, 2 plb, 3 RAT, 1 rhus-t, 1 sars, 2 sed-ac, 3 SEP, 2 sil, 2 sulph, 1 syph, 1 tab, 3 THUJ, 1 tub, 1 zing
FISSURE bleeding (8)
1 ars, 1 calc, 1 graph, 1 lac-d, 1 nat-m, 1 nit-ac, 1 rhus-t, 1 syph
FISSURE bleeding stool, after (5)
1 ars, 1 calc, 1 lac-d, 1 nat-m, 2 nit-ac
FISSURE cold water amel. (1)
1 rat
FISSURE infants (1)
1 kali-i
FISSURE ointments agg. (1)
1 aloe
FISSURE oozing (4)
1 graph, 2 paeon, 1 syph, 1 tub
FISSURE painful, very (6)
1 cham, 1 graph, 1 lac-d, 1 rat, 1 syph, 1 thuj
FISSURE painless (4)
1 acon, 1 aloe, 1 carb-ac, 1 phos
FISSURE pregnancy, during (17)
1 ars, 1 caust, 1 grat, 1 ign, 1 lach, 1 mez, 1 nat-m, 1 nit-ac, 1 nux-v, 1 phos, 1 plb, 1 sep, 1 sil, 1 sulph, 1 tab, 1 thuj, 1 zing
fissures, soreness of anus, with HEMORRHOIDS(4)
1 caps, 1 cham, 2 nit-ac, 1 rat
PREVENTION:
To prevent anal fissures in infants, be sure to change diapers frequently.
To prevent fissures at any age:Keep the anal area dry .
Wipe with soft materials or a moistened cloth or cotton pad .
Promptly treat any constipation or diarrhea.
Avoid irritating the rectum.
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