Ayurvedic treatment for fissure.

A small tear, a great deal of pain.

An anal fissure — Parikartika in Ayurveda, from the word for “cutting” — is a small tear in the lining of the anal canal, most often caused by a hard stool. The pain it causes makes the anal muscle tighten, and that spasm reduces blood flow to the tear and stops it healing — so the next stool reopens it.

A fissure that has lasted under six weeks is called acute; one that keeps reopening for longer is chronic, and may form a small skin tag at its edge. Both are treated, but the longer a fissure has lasted, the more patient the treatment needs to be.

Common symptoms

• Sharp, burning or cutting pain during stool, which may last for minutes or hours afterwards
• A small amount of bright red blood on the stool or the paper
• Itching or irritation around the anus
• A visible crack in the skin, sometimes with a small tag beside it
• Fear of going to the toilet — which worsens constipation, and the fissure

Causes

• Hard stools and straining — constipation is the usual cause
• Repeated diarrhoea
• Childbirth
• A tight anal muscle, which keeps the tear from healing
• Very spicy or dry food, and too little water

Soften, soothe, and let it heal.

Treatment works on three things at once: the stool is softened with diet and herbal preparations so it passes without force; the pain and spasm are eased with medicines and local applications; and the tear is given the chance to heal, often helped by warm sitz baths.

A chronic fissure that will not heal with this may need more — classical Ayurvedic procedures are considered where appropriate, and the doctor explains the options after examination. Treatment aims to relieve symptoms and address the root cause; results vary from person to person.

• What to expect
• Pain relief is the first goal and usually comes early in treatment
• Healing of the tear follows, with a bowel kept soft and regular throughout
• The habits that caused the fissure are corrected, so it does not return

Acute or chronic

How long a fissure has lasted changes how it is treated.

• Acute — Less than six weeks old; usually heals with medicines, diet and care.
• Chronic — Keeps reopening for longer; may carry a skin tag and needs more patient, sometimes procedural, treatment.

Do’s and don’ts.

• Do:
• Keep the stool soft — fibre, fruit, plenty of water, and ghee in the diet as the doctor advises
• A warm sitz bath after stool, two or three times a day, as advised
• Go when the urge comes; keep regular meal and sleep times
• Gentle walking every day
• Don’t:
• Do not strain, hold the urge, or sit long on the toilet
• Avoid dry, very spicy and fried food, and excess tea and coffee
• Do not use harsh soaps or wipe hard; wash gently with water
• Do not keep applying creams for months without an examination

When to see a doctor urgently

Please do not wait if you notice:

• Pain that is unbearable or keeps you from passing stool at all
• Heavy bleeding
• Pus or discharge, or a painful swelling near the anus
• Fever along with any of the above

Frequently asked questions.

How is a fissure different from piles?

Piles are swollen blood vessels — the main sign is painless bleeding, or a lump. A fissure is a tear — the main sign is sharp pain with stool, with only a little blood. Both can occur together, which is why an examination matters.

Will it heal on its own?

A fresh fissure sometimes does, if the stool is kept soft. One that has lasted weeks usually does not, because every hard stool reopens it. Treatment breaks that cycle.

Why does my fissure keep coming back?

Almost always because constipation has come back. The diet and routine part of the treatment is what keeps it away.

Is surgery needed?

Most fissures are treated without it. Procedures are considered for chronic fissures that have not healed with medicines and care, and only after the doctor has examined you.

A note on results

Treatment aims to relieve symptoms and address the root cause. Results vary from person to person.

Pain with every stool? It can be treated.

Book a consultation, or call the clinic — the sooner a fissure is treated, the simpler the treatment.

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