Infection and abscess mostly arise in glands or hair roots of the skin. The infected spot initially erupts and then forms an abscess. The abscess gets opened and discharges its contents (pus) and then heals Sometimes, it opens at both sides/ends and thus becomes a tunnel or tract – namely fistula.

Anus, the exit route of faeces and it surroundings are more vulnerable to bacterial or fungal infection due to moisture and folded skins. Germs/micro organisms will also be more concentrated in that area in spite of cleanliness. Usually, infection occurs and causes boils or abscess due to lack of hygienic condition, but sometimes the causes remain unknown.

Anal fistula – Among fistula, anal fistula is the commonest and most bothersome. Most commonly it arises from perianal abscess. This anal fistula mostly connects anus / rectum to the outer skin. Sometimes, it may connect anus and vagina or anus and urethra. The fistula usually traces the drainage pathway of the abscess. It may have a single or multiple opening(s) in inner/outer aspect, depending upon the position and direction of the drainage of the abscess. The fistula having multiple opening should be seriously investigated for tuberculosis or Crohn’s disease.

Causes - Ill-treated or maltreated infection and abscess are the main causes for fistula formation, the other causes include negligence/lack in treatment of piles, anal fissures, Crohn’s disease, cancer, constipation, etc.

Symptoms – Anal fistula is mostly present with the following symptoms, when there is infection or strain or block.
Feeling of lump near the anus with stabbing/throbbing pain

• Pain will shut off immediately after letting out the pus
• Continuous or intermittent (on and off) leakage of foul pus/mucous/faecal matter from the fistula’s external opening, soiling the inner garments
• Discomfort and skin infections due to constant wetness caused by leaked fluids
• Constipation or diarrhoea
• If fistula gets blocked, again there will be abscess formation with the symptoms of swelling, fever, malaise and septicaemia.

Diagnosis – Anal fistula can be diagnosed easily by physical examination of the anus and its surroundings. Rectal examination, sigmoidoscopy and fistulography give more details about the abscess, its tracts and openings.

Management :

• Take plenty of water and fruit juices to avoid constipation
• Follow hygienic measures in cleaning and caring
• Pass stool twice a day to avoid strain to rectum and anusDon’t strain While defecating. It is better to have semisolid stool for easy
• defecation
• Sitz bath – After passing stool, sit in a shallow bath tub filled with antiseptic lotions or warm salted water for 10 minutes, to make the condition hygienic
• Hot compress can help anal abscess by enhancing blood circulation for diluting the infective toxins over there and healing faster with supply of nutrients

Preventive measures :

• Follow regular bowel habits without any strain
• Follow hygeinic measures to keep anal area clean and dry
• Treat any infections or boils immediately
• Avoid nylon underwear and use cotton ones

Homeopathic approach to fistula :

Homeopathy can abort the tendency to abscess formation and suppuration by increasing resistance Homeopathy provides this without any surgical measure. If the flow gets stopped, the pathway dries up naturally and shrinks to get close approximation for better healing.

Homeopathic medicines commonly used in cases of fistula are – Acid Nit, Apis mel, Bacilinum, Calc Flour, Calc Phos, Calc Sulf, Calendula Q, Capsicum, Carboveg, Causticum, Collinsonia, Graphites, Hamemelis, Hepasulf, Hydrastis, Hypericum, Lachesis, Lycopodium, Mag Phos, Mer cor, Merc sol, Muriatic acid, Silicea, Sulphur, Thuja, etc. These medicines should be taken under the advice and diagnosis of a qualified Homoeopath.

Fissure in ano :

A fissure literally means a cleft crack. Medically, fissure refers to linear crack in the skin. Skin cracks can arise anywhere in the body. But the cracks are most commonly seen in edges or at the junction of two different types of skins

Causes - The major causes are supposed to be,

• Physical strain -Pressure exerted while passing stool
• Defecation – Anal fissure is most commonly caused by constipation. The hard, dry stool tears the anus when it stretches the anus forcibly while defecating. It can also be caused by diarrhoea due to sudden purge or straining after enema.
• Foods – Low fibre diet, more spices, alcohol and lesser intake of water can produce hard dry stool, which needs more strain in defecation
• Weakened anus sphincter muscles – due to any diseases
• Dry skin disorders which affect lower part of anus
• Small tight anus – congenitally small or spastic tight anus

Symptoms :

• Cruel pain is the major symptom of fissure – Pain may be burning, stabbing, pricking and a feeling of glass pieces or thorns in the anus. Pain is usually aggravated after defecation. The patients used to suffer with pain for more than half-an-hour after passing stool or for the remaining whole day.
• Bleeding usually occurs at the time of defecation which appears as a streak in the stool. Usually it will be fresh and is supposed to come in drops after defecation but never passes mixed with the faeces.
• Tightness or spasms of the anus usually interrupt in passing the stool
• The fissure is always visible / felt as a swollen traingular (thickened) area with the skin tag in its lower end
• With the fear of pain, patients usually avoid the act of defecation and develop constipation from there which further worsens the condition

Diagnosis - of fissures is easy, since a simple examination with slight stretch of anus can identify the fissure. Digital examination will be very painful in all the case of fissures due to spasm and tightness of anal sphincters, so it is avoided mostly.

Management – Many fissures can be healed with simple management as follows.

• Take plenty of water and fruit juices
• Avoid non-veg and fatty diet
• Take easily digestible, simple food with plenty of vegetables
• Use Indian style toilets since squatting position will be a better position for pain and natural defecation.
• Follow hygienic measures in cleaning and caring
• Pass stool twice a day to avoid dry hard stool and strain to rectum and anus
• Never suppress an urge. Go for stool whenever there is a call since it will be easy then
• Sitz bath – Before passing stool, sit in a shallow bath tub of warm salt water for 10 – 15 minutes to relax the anal sphincter and to relieve the anal spasm. This technique usually pacifies all the painful anal conditions

Do and Don’t:

• Sporting activities, long-distance walking / travelling / cycling during healing process
• Any friction or injury
• Dry cleaning by toilet papers. Go for wash with warm water which usually soothes
• Scratching, since it may become red, sore and infected.
• Non-veg, fast foods, oily foods, etc.
• Spices and chillies
• Smoking, drinking alcohol and coffee

Prevention – It is well said that prevention is better than cure. Always follow these procedures to avoid anal sufferings

• Take plenty of water for easy defecation and to avoid constipation.
• Follow regular bowel habits
• Take hygeinic measure to keep anus clean and dry
• Treat constipation or diarrhoea immediately

Surgery - Mostly anal fissure heals without surgery, if it is cared for in its initial days itself. But if it becomes chronic and persistent, then, as a last resort, surgery can be opted.
Ahen one opts for the treatment in case of fissure. Also, surgery cannot cure all cases of fissure. Even after surgery it can recur if the root cause is not cured. So, Homeopathy treatment is the best way to root out the disease and cure fissure in ano without any side-effects.

Homeopathic medicines : commonly used in case of fissure are -Acid Nit, Bryonia, Calc Flour,

]]> http://www.drharshadraval.com/homeopathy/anal-fissula-homeopathy-treatment/feed/ 0 http://www.drharshadraval.com/homeopathy/haemorrhoid-homeopathy-treatment-piles/ http://www.drharshadraval.com/homeopathy/haemorrhoid-homeopathy-treatment-piles/#comments Wed, 06 May 2009 11:18:10 +0000 Dr. Harshad Raval (M.D. Homeopathy) http://www.drharshadraval.com/?p=59 Piles is often feared as the tumour of the anus. Actually, piles is not tumourous and not dangerous. It is a simple enlarged / engorged blood vessel(s) of the anus. It is

Incidences – Piles is very commonly seen nowadays. Women have higher incidence than men. The reason behind it is not clearly known. It is more commonly seen in adolescent age group and aged persons who all seem to be more tensed. There must be a relation between piles and tension/psychological factors. Its incidences is more common in persons who deviate more from nature in diet, living style and sitting habits. Sufferers are mostly

• Long sitting travellers
• Sedentary workers
• Alcoholics and those who suffer from liver disorders
• One who suffers often from constipation or diarrhoea

Types :- Piles is classified in two ways.

Internal piles – lies inside the anus. Usually internal piles originates from superior haemorrhoidal plexus of the upper part of anal canal and lies above the Hilton’s line..

External piles :- lies outside the anus. External piles originates from inferior haemorrhoidal plexus of the lower part of the anal canal i.e. it lies lower to the Hilton’s line. Primary piles – occurs due to hereditary reason without any causative factor or obstruction

Secondary piles  :– occurs in continuation with other diseases or obstruction to portal circulation like liver disorders, portal hypertension due to obstruction, rectal or pelvic tumours, cancer,

Prolapsed piles :–is the piles which gets descend from the place of origin, i.e. internal piles descends to get visualised as external piles.

Symptoms :– Symptoms of piles usually vary according to the type and place of origin. Piles in its initial stages is most commonly found to be without any symptoms. It is often noticed after constipation and abrasions. As said earlier internal piles are usually silent except rarely bleeding, but the external piles mostly produce a lot of suffering/symptoms. Internal piles, when get prolapsed or protruded, produce symptoms like external piles.

The most common symptoms of piles are

• Feeling a lump or discomfort in anus
• Frequent ineffectual urge for stool without passing stool or without satisfaction of complete evacuation. Even after passing stool,
• Bleeding from anus – Mostly pile mass bleed as bright red blood in drops just after defecation, Pinkish or bluish colour swellings protrudes from anus like bunch of grapes
• Pain – Piles mass will usually have a burning or stabbing or throbbing type of pain which often makes the person restless and doesn’t allow them to sit and relax. They may also have a sensation of having thorns or glass pieces in anus while sitting.
• Itching of anus.
• Mucus discharge or oozing/leakage of faecal matter from anus, since anus could not be able to close so tightly due to pain.
• Strained and frequent urination due to irritability of anus with the contact of expanding, filling bladder.
• Prolapsed or protruded piles often become thrombosed and become hard tender external mass.

Diagnosis – Piles can be easily diagnosed by examination of the anus with finger palpation and proctoscope. The prolapsed internal piles and external piles are easily visible and can be diagnosed on the spot. Sentinal piles – a natural skin tag/knot which guards the extension of fissure – is often misunderstood as pile mass by many patients.

MANAGEMENT : Take rest and avoid long walks, long distance travelling and cycling

• Take plenty of water and follow regular bowel habits to avoid constipation and strain
• Use Indian style toilets since squatting position will be a better position for pain and natural defecation
• Follow hygienic measures in cleaning and caring
• Pass stool twice a day to avoid dry hard stool and strain to rectum and anus
• * Never suppress an urge. Go for stool whenever there is a call since it is passed on easily
• Don’t strain to evacuate hard faecal matter. Take time in toilet for a natural descend or try enema or stool liquefiers. It is better to have semisolid stool for easy defecation
• Take proper treatment for cause of pile mass, if it is of secondary to any other disease
• Sitz bath – Before passing stool, sit in a shallow bath tub of warm water for 10-15 minutes to relieve the anal spasm and relaxation of anal sphincter. This method also pacifies all painful anal conditions
• Ice application is advised, when there is constant bleeding
• Take easily digestible, simple cooked foods. Avoid spices and chillies

Haemorrhoidectomy – Removal of pile mass by surgery surgery. Allopathy usually considers piles as a surgical complaint and treats it mostly with surgery even for painless piles. Patients, also with the fear of getting cancer or tumours, opt for removal..

Homeopathic : Homeopathy medicines :commonly used in case of piles are Acid Nit, Aconite, Aesculus Hip, Aloes, Apis mel, Bryonia, Calc carb, Calc Phos, Capsicum, Carboveg, Causticum, Chamomilla, Collinsonia, Graphites, Hamemelis, Hepasulf, Hypericum, Ficus.R, Ignatia, kali carb, Lachesis, Lycopodium, Mag Phos, Mer cor, Millefolium, Muriatic acid, Nat Sulp, Nux Vom, Paeonia, Phosphorus, Podophyllum, Ratahnia, Silicea, Sulphur, Thuja, etc. These medicines should be taken under the advice and diagnosis of a qualified Homoeopath.