Ayurvedic treatment for Anal fissures or parikartika

Anal fissures or parikartika

Know More on Gastro Intestinal diseases

  • Definition
  • Causes
  • Symptoms
  • Diagnosis
  • Management
  • FAQS
  • References

Definition

Anal fissures or parikartika Ayurvedic treatment

Anal fissure refers to a minor or a small break in the skin of the anal opening of the body. This commonly happens because of hard stools during bowel clearance. Generally, anal fissures are known to cause pain and bleeding associated with itching sensation, during defecation. For many people this may also lead to muscular spasms in the anus.1

Although anal fissures commonly found in infants but they can be seen in any age group. Most of the time they resolve with simple measures, like increasing intake of fiber intake, adequate hygiene or sitz baths (immersing lower body in warm water). If these do not help, there may be need for medicines or surgery.1

Ayurveda describes fissure as Parikartika. This word refers to the cutting or burning nature of pain. Additionally bleeding is another vital sign of the disease.3

As per Ayurveda, poor digestion and appetite along with high consumption of dry, hot, or salty foods aggravate the Pitta and Vata dosha, thereby leading to anal fissures.4

Causes

Anal fissures or parikartika

Some common causes of anal fissure are2:

  • Having hard or large amount of stools
  • Feeling constipated and need to strain during motions
  • Diarrhea
  • Swelling and pain in and around anus
  • Recent birth of a child

 Some conditions that increase the risks for developing an anal fissures are2:

  • In infancy
  • Older age
  • Being constipated
  • Recent childbirth
  • Diseases like Crohn's disease
  • Indulging in anal intercourse

 Major complications of anal fissure in medical practice are a Failure to heal, leading to long term problems and Recurrence of the fissures.

Symptoms

Anal fissures or parikartika

Commonly seen signs and symptoms of anal fissure are2

  • Moderate to severe pain in anal area
  • Having lasting pain after passing motions
  • Observing blood after passing motions
  • Itching or irritation in the anal area
  • An extended tag of skin near the fissure

Diagnosis

Anal fissures or parikartika

Fissures are diagnosed clinically by digital rectal exam, or by use of an anoscope to inspect the anal canal.1

Usually this suffices, but doctors may recommend Flexible sigmoidoscopy or colonoscopy to rule out any underlying condition. These tests help visualizing the inside of the large intestine for any tumors etc.1

Management

Anal fissures or parikartika

Primarily treatment is provided to relieve pain and allow the fissure to heal. This is done by correcting of the imbalanced Vata and Pitta doshas - implicated in manifestation of anal fissures. 

Ayurveda has various non-invasive (medicinal) and invasive methods (surgical) for treating anal fissures. Some common non-invasive methods are aushadhi chikitsa (medicines) and Basti procedure (medicinal enema). Similarly, some of the invasive methods recommended are Kshara karma (alkalization), Ksharsutra application (alkali thread therapy) and Agnikarma (burning of a part of a body). 5

Diet Recommendations (Aahar)

Recommended diet includes cow milk, butter, buttermilk, wheat, ghee, rice, green vegetable, and regular diet. Avoid chilies, fried foods and foods that may cause constipation.6

Lifestyle changes (Vihar)

Sitz baths (immersing lower body in warm water) are beneficial.5 Avoid constant sitting and excessive straining during defecating.6 

FAQS

Anal fissures or parikartika
  1. What is GERD?

Acid reflux disease - also commonly known as Gastro-esophageal reflux disease (GERD) is condition in which acid from the stomach regurgitates or moves up into the esophagus (gullet).

  1. How are fissures caused?

An anal fissure may occur when due to passing of hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. One may experience spasms in the ring of muscle at the end of the anus (anal sphincter).

  1. Can a fissure heal completely?

With appropriate treatment and following of pathya apathya, a fissure can heal completely. Although care should be taken not to be constipated and have high amount of fiber in food.

  1. What is a kshar karma? How is it different from other surgery

Kshar karma is a specialized Ayurvedic surgical procedure that involves minimal blood loss and provides excellent relief in hemorrhoids and fistulas. It involves the applying of a sclerosing agent, such as apamarg kshar snuhi kshar etc.

It differs from conventional surgery as in it does not require anaesthesia, shows minimal blood loss and need not require inpatient admissions.

  1. What are the risk factors of developing bowel incontinence?

A number of factors can increase the risk of developing fecal incontinence. These include:

  • Age: It is more common in middle-aged and older adults.
  • Female gender: Fecal incontinence is slightly more common in women. One reason may be that fecal incontinence can be a complication of childbirth.
  • Nerve damage: People who have long-standing diabetes or multiple sclerosis — conditions that can damage nerves that help control defecation — may be at risk of fecal incontinence.
  • Dementia: Fecal incontinence is often present in late-stage Alzheimer's disease and dementia.
  • Physical disability: Being physically disabled may make it difficult to reach a toilet in time. An injury that caused a physical disability also may cause rectal nerve damage, leading to fecal incontinence. Also, inactivity can lead to constipation, resulting in fecal incontinence.
  1. What exercises can be done to have better control on the motions?

Certain asanas that help strengthen the pelvic floor (muscles around the anal opening) are recommended for better control over the anorectal area. These are -

Utkatasana                   Virabhadrasana                 Ananda Balasana             Shlabhasana

 

  1. Can celiac disease lead to anything serious?

Untreated, celiac disease can cause the following complications:

  • Malnutrition: The damage to your small intestine means it can't absorb enough nutrients. Malnutrition can lead to anemia and weight loss. In children, malnutrition can cause slow growth and short stature.
  • Calcium loss of calcium and low bone density: Malabsorption of calcium and vitamin D may lead to a softening of the bone (osteomalacia or rickets) in children and a loss of bone density (osteoporosis) in adults.
  • Infertility and miscarriage: Malabsorption of calcium and vitamin D can contribute to reproductive issues.
  • Lactose intolerance: Damage to your small intestine may cause you to experience abdominal pain and diarrhea after eating lactose-containing dairy products, even though they don't contain gluten. Once your intestine has healed, you may be able to tolerate dairy products again. However, some people continue to experience lactose intolerance despite successful management of celiac disease.
  • Cancer: People with celiac disease who don't maintain a gluten-free diet have a greater risk of developing several forms of cancer, including intestinal lymphoma and small bowel cancer.
  • Neurological problems: Some people with celiac disease may develop neurological problems such as seizures or peripheral neuropathy (disease of the nerves that lead to the hands and feet).

In children, celiac disease can also lead to failure to thrive, delayed puberty, weight loss, irritability and dental enamel defects, anemia, arthritis, and epilepsy.

  1. Who gets affected by pancreatitis?

Acute pancreatitis is more common in middle-aged and elderly people, but it can affect people of any age. Men are more likely to develop alcohol-related pancreatitis, while women are more likely to develop it as a result of gallstones.

  1. What are the common causes of developing ulcers in stomach?

Common causes of peptic ulcers include -

  • Long-term use of non steroidal anti-inflammatory drugs (NSAIDs)
  • An infection with the bacteria Helicobacter pylori (H. pylori)
  • Rare cancerous and/or noncancerous tumors in the stomach, duodenum, or pancreas

Addtionally, intake of alcohol and smoking also increase the chances of having a gastric ulcer.

  1. What causes hemorrhoids?

Swelling in the anal or rectal veins causes hemorrhoids. Several factors may cause this swelling, including -

  • Chronic constipation or diarrhea
  • Straining during bowel movements
  • Sitting on the toilet for long periods of time
  • A lack of fiber in the diet

Another cause of hemorrhoids is the weakening of the connective tissue in the rectum and anus that occurs with age.

Pregnancy can cause hemorrhoids by increasing pressure in the abdomen, which may enlarge the veins in the lower rectum and anus. For most women, hemorrhoids caused by pregnancy disappear after childbirth.

 

References

Anal fissures or parikartika
  1. Mayo Clinic. Fissures: an overview. Available at http://www.mayoclinic.org/diseases-conditions/anal-fissure/home/ovc-20168229 accessed Aug 23rd 2016
  2. Mayo Clinic. Fissures: Symptoms and causes. Available at http://www.mayoclinic.org/diseases-conditions/anal-fissure/symptoms-causes/dxc-20168232 accessed Aug 23rd 2016
  3. Bhanushali V et al. Comparative study of Ksharasutra suturing and Lord's anal dilatation in the management of Parikartika (chronic fissure-in-ano). 2014 Apr;35(2):141-7.
  4. Dudhamal TS et al. Comparative Study Of Effect Of Yashtimadhu Ghrita And Shatadhauta Ghrita Locally In The Management Of Parikartika W.S.R. To Acute Fissure-In-Ano. Int Ayur Med J. 2016; Vol. 4(08):2455-62
  5. Bhagat P, Sekhar Namburi UR et al. Pain management in Fissure-in-Ano by Invasive and Non-Invasive Methods: An Ayurvedic Review. Int J Ayur Med. 2015; 6 (2): 128-33.
  6. Mishra N, Sharma HP. Hemorrhoids–(Arsha): a Comprehensive Review on Its Causes And Treatment.  UJAHM 2013, 01 (03): Page 31-33

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