Around 11 out of 100 people will experience anal fissures at some point in their lives. Anal fissures are tiny tears in the anal mucosa. These tears can affect both males and females of all ages. 

If you have anal fissures, you might feel intense pain, particularly for about one to two hours after you pass motions. This pain can feel like sharp pieces of glass poking you from inside while you defecate. You might also notice blood during and after passing stools. 

The pain from anal fissures can be so intense making you avoid passing stools for fear of the pain. Thus holding back makes your stool harder, and it further tears the lining of your anus, creating a painful cycle that’s hard to break.

Anal fissures lasting less than six weeks are called acute fissures. These acute tears are superficial and heal on their own within six weeks. However, anal fissures that persist beyond six weeks are considered chronic. These cuts are often deeper and associated with inner or outer lumps or fleshy growths. Primary anal fissures do not have a clear underlying cause. In contrast, secondary fissures are caused by some underlying condition. 

Anal fissures are usually not a life-threatening condition. However, if left untreated, it can recur, get infected, or form an abscess. Sometimes, it can lead to fecal impaction due to avoiding passing stools. Anal fissures can impact the overall quality of your life. 

You can think of homeopathy along with conventional treatment for anal fissures. Homeopathy for anal fissures can help prevent surgery. These medicines help heal the tear and treat constipation by stimulating digestion. It reduces the tendency for the recurrence of anal fissures. 

Role of homeopathy in anal fissures

Homeopathic medicines help in healing your anal fissures and relieve pain. These remedies control anal bleeding. They act by correcting your disturbed digestive system and the tendency for chronic constipation. You can start homeopathic treatment for anal fissures along with conventional medications. The best part is that homeopathic medicines use your body’s restorative processes to heal; thus, they are non-toxic and non-habit-forming.

Top five homeopathic medicines for anal fissures

Ratanhia Peruviana (Rat.)

Common name: Krameria, Mapato

Ratanhia is used to treat anal fissures with pain and burning sensation in the anus while passing stool that continues several hours after. Anal pain is as if from a knife or pieces of broken glass piercing the anus. Constipation that requires straining to pass stools calls for Ratanhia.

Nitricum acidum (Nit-ac.)

Common name: Nitric acid

Nitric. acid. treats anal fissures with bleeding and severe pain. The nature of Nitric. acid. pain is cutting, stitching, stinging, tearing, or sharp splinter-like. This remedy treats anal fissures caused by constipation that requires great straining to pass stools.

Paeonia officinalis (Paeon.)

Common name: Peony

Paeonia is prescribed for anal fissures with foul-smelling discharge from anal cracks. The patient complains of intense pain in the anus while passing stools. This pain often stretches for several hours after passing stools. This remedy is of great value for itching and burning at the anus due to anal fissures.

Bryonia alba (Bry.)

Common name: Wild hops

Bryonia is recommended for anal fissures due to constipation with dry, hard, and large stool. This remedy treats anal fissures by softening the stools. In addition, it regularizes bowel movements and helps prevent future fissure recurrences.

Graphites naturalis (Graph.)

Common name: Black lead

Graphites yield good results in managing anal fissures with severe, sharp, and cutting types of anal pain during stools. The anus is often sore to the touch. Even trying to wipe the anal area causes intense pain. Graphites is prescribed for bleeding anal fissures due to large stools that pass with difficulty.

Causes of anal fissure

There is a tear in the anal mucosa in the anal fissures that causes extreme pain. Your anal sphincter further increases the pressure on the mucosa. This pressure decreases the blood flow to the affected area, which further worsens your anal fissure. This becomes an endless cycle till you treat anal fissures. The following factors can cause a tear in the anal mucosa:  

Constipation

Different reasons like lack of fiber in the diet, dehydration, stress, medicines, pregnancy, or habit can cause constipation. Straining to evacuate the bowels during constipation can cause anal fissures.

Diarrhea

Passing bulky stool quickly, like in diarrhea, can lead to abrasion of the anal mucosa resulting in anal fissures. 

Multiple pregnancies

Increased pressure of the uterus and growing fetus during the later stages of pregnancy can cause anal fissures. Straining during labor can result in trauma leading to anal fissures.

Gastrointestinal diseases

Anal fissures can be due to underlying GI disorders like Crohn’s disease, ulcerative colitis, and irritable bowel syndrome (IBS).

Other diseases

Some other diseases like sexually transmitted diseases (HIV, syphilis, gonorrhea, chlamydia), tuberculosis, and cancer can lead to anal fissures.

Sexual activities

Anal sex or putting any object in the anus, like sex toys, can cause trauma to the anal mucosa causing anal fissures.

Symptoms of anal fissures

Pain

Pain in and around the anus is the most common symptom of anal fissures. The pain is often severe and felt during passing stools. Anal fissure pain can continue for several hours after passing stool. 

Bleeding

Another common symptom of anal fissures is streaks of blood while passing stools. It can be seen as blood on the outer surface of the stools, blood in the pot, or blood on the toilet paper after wiping.

Burning and itching

Burning and itching in anal fissures are due to the irritation and inflammation of the skin around the anus. The underlying tissues become more susceptible to irritation from stool, moisture, and friction. 

 Foul-smelling discharge 

A foul-smelling discharge from an anal fissure is due to infection. 

Skin tag around the anus

In long-standing cases of anal fissures, a skin tag, small lump, or swelling near the anal opening is common.

Tightness in the anal sphincter

Muscle spasms or tightness in the anal sphincter is due to the body’s protective response. This spasm is a natural defense to prevent further tearing of anal mucosa. 

Fecal incontinence in severe cases

The weakened muscles controlling bowel movements result in unintentional leakage of the stools.

Treatment for anal fissures

Ointment

Nitroglycerin ointments are applied externally on anal fissures. It acts by dilating your blood vessels, restoring blood flow, and helping your anal sphincter relax. 

Medications

Calcium channel blockers work on anal fissures by relaxing blood vessels and your anal muscles. 

Laxatives

If you have developed anal fissures due to constipation, laxatives can help. Bulk laxatives draw fluid into your gut and help soften your stools.

Injections

Botox injections act as muscle relaxants for anal fissures. The effects last for three months, giving your anal fissure time to heal.

Surgery

If your anal fissures are not healing with medications or they recur after healing, you can opt for a minor medical procedure called an internal sphincterotomy. 

Diet and lifestyle changes for anal fissures

Along with medication, diet and lifestyle changes help in recovering from the anal fissure. Such as:

  • Eat a fiber-rich diet to prevent constipation. Include more fruits, green vegetables, whole grains, and cereals. 
  • Drink at least eight glasses of water every day to prevent constipation. 
  • Sitz baths can help relieve pain and enhance healing in anal fissures.
  • Rush to the toilet whenever you feel the urge to pass stools. Avoiding this visit can result in constipation and cause injury to your anal mucosa.  
  • Keep the anal area clean and dry after passing the bowels. It helps in preventing anal infections.

Conclusion

The excruciating pain of anal fissures, burning, foul-smelling discharge, and bleeding cuts can be distressing. Fortunately, homeopathic remedies offer promising results. These remedies address the underlying causes and ensure a cure without surgery. Homeopathic treatments are affordable and diminish the chances of fissure recurrence. 

References

  • Newman M, Collie M. Anal fissure: diagnosis, management, and referral in primary care. Br J Gen Pract [Internet]. 2019 [cited 2024 Jan 5];69(685):409–10. Available from: http://dx.doi.org/10.3399/bjgp19x704957