Overview

The anal canal comprises the final two to three inches of the rectum, which represents the terminal section of the large intestine. An anal fissure refers to a small tear in the lining of the anal canal. This tear can potentially expose the surrounding muscle known as the anal sphincter. The resultant damage often leads to localised muscle spasms that may further separate the edges of the fissure. These spasms, in conjunction with bowel movements, can induce significant pain and impede the healing process.

An anal fissure is classified as acute when it is observed for less than six weeks. Conversely, if the fissure persists for more than six weeks or recurs frequently, it is categorised as chronic.

Causes

Anal fissures, which are characterized by tears in the anal canal, typically occur as a result of trauma or injury. The primary contributing factors include:

- Constipation or the passage of large or hard stools

- Diarrhea

- Childbirth, particularly in women

- Excessive pressure or excessive tightness in the anal sphincter muscles

Furthermore, certain risk factors are associated with the development of anal fissures, including:

- Anal cancer or leukemia

- Immunodeficiency, encompassing conditions such as sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV)

- Altered bowel conditions, including Crohn's disease and ulcerative colitis 

Understanding these causes and risk factors is essential for effective prevention and management of anal fissures.Colitis

Symptoms

Acute Conditions:

- Presence of a visible tear in the anal region

- Experience of pain during bowel movements

- Observation of blood on toilet paper after wiping the anal area

- Detection of blood on the surface of stools, manifesting as streaks of blood

- Presence of a foul discharge

Chronic Conditions:

- Experience of painful bowel movements without any bleeding

- Itching and irritation of the skin surrounding the anus

- Formation of a skin tag at the terminus of a fissure    

Ayurvedic View

Parikarthika cuts pain in the anal region. Vata dosha prakopa (increase,)mainly apana vata dosha, which settles in guda(anal region), causes mala baddha(hardening and dryness of stool,)there is kruchra mala pravruthi(passing of hard stools with difficulty and with strain),vata alone or along with other dosha and in amconditiona awastha (indigestion), results in ati parikartana vat vedana(excruciating cutting pain in anal region,basti (urinary passage)and nabi(umbilicus), this is anal fissure. Ayurveda's way of approach is to correct the jatara agni so that proper formation of mala is there, bring back doshas back to prakruta avastha(balance state) in guna(quality),sthana (place)and karma(anuloma function-easy bowel evacuation), and heal the affected area, with symptomatic relief in symptoms, correcting the root cause of this conditon in a natural way, thereby correcting the diet and lifestyle.