Anal Fissure

Main cause of this disease is passage of hard stool, which is tearing the delicate anal canal. This forms a wound or cut in front or back part of the anus, results in severe pain. Once damage occurs here, due to hard stool, it fails to heal. This is because daily it contaminates with stool. Further injury and bacterial contamination, un-cleanliness makes wound further worsen and fails to heal. Then it is called chronic fissure. Patient will have pain or burning sensation for months together. Though it heals with great difficulty, again passage of hard stool may again cut or injures the area and again there its formation of ulcer. This is why patient with fissure have repeated attack of symptoms. These types of attacks may last for years in some women.

Most health professionals can diagnose an anal fissure by listening to the symptoms and by looking at the anus. Usually, the health professional can see the fissure by gently separating the buttocks.

A health professional may use a gloved finger (digital rectal examination) or a lighted instrument (anoscope) to examine the fissure. However, if the fissure is extremely painful, the health professional will usually wait until it has begun to heal before performing a rectal exam or using an anoscope (anoscopy) to rule out other problems. A topical anaesthetic may be used if an immediate examination is necessary.

Taking only oral medications may helps in some patients if fissure is of recent orogin. Final and permanent remedy for this is again kshara karma. Under Suitable Anesthesia application of kshara to fissure bed. This burns the part mildly without damaging much tissue. So that fresh wound is created which heals faster. Agni karma follows this, senile pile excised and sphincterotomy is adopted to prevent recurrence. Intermittent anal dilatation to be done after the procedure in further follows up.