Fitula fissure in ano Homeopathic treatment

A very painful channel created between the rectal canal and the skin around the surface of the anus. At times, there is pus formation and slight bleeding.

Fistula-in-Ano is a track, lined by granulation tissue which opens deeply in the anal canal or rectum and superficially on the skin around the anus. It arises from anorectal abscess due to blocked infection in anal glands lying between the two layers of anal sphincters. It can extend to the lower back, subscrotal region, vagina etc. It is characterized by swelling, pain, inflammation and discharge of pus leading to discomfort and uneasiness. It can be managed by various ways according to the pathology associated to it and sometimes treatment and surgery helps with healing process.

According to the medical Dictionaries A fistula is an abnormal tunnel connecting two body cavities (such as the rectum and the vagina) or a body cavity to the skin (like the rectum to the outside of the body). One way a fistula may form is from an abscess - a pocket of pus in the body. The abscess may be constantly filling with body fluids such as stool or urine, which prevents healing. Eventually the fistula breaks through to the skin, another body cavity, or an organ. Fistulas are more common in Cohn's disease than in ulcerative colitis. Approximately one quarter of people with Cohn's disease develop fistulas.Fistulas often occur in the area around the genitals and anus (known as the perineum).

Causes of Fistula(fissure in ano)

  • Physical strain
  • Defecation problems
  •  Low fiber diet
  •  Weak anal sphincter muscles
  •  Skin dry, especially mucus membranes
  •  Small tight anus
  •  Prolong standing disease like tuberculosis, ulcerative colitis, crohn’s disease, Ca-rectum or Ano rectal or gynecological surgery

four types of Fistula or fissure in ano

Enterocutaneous: This type of fistula is from the intestine to the skin. An enterocutaneous fistula may be a complication of surgery. It can be described as a passageway that progresses from the intestine to the surgery site and then to the skin.
Enteroenteric or Enterocolic: This is a fistula that involves the large or small intestine.
Enterovaginal: This is a fistula that goes to the vagina.
 Enterovesicular: This type of fistula goes to the bladder. These fistulas may result in frequent urinary tract infections, or the passage of gas from the urethra during urination.


High Anal: Fistula track which is heaving an internal opening in between the pectinate line to just below the ano rectal ring. It has 3 varieties:

 a) Intersphicteric

 b) Transphincteric

c) Supralevator

Low Anal: In these fistulae generally it opens at a level of anal crypts at a level of pectinate line. It has 5 varieties: a) Subcutaneous

b) Sub mucus

c) Low anal

d) High anal

e) Pelvi rectal

Symptoms of Fistula(fissure in ano)

Symptoms of fistulas can include pain, fever, tenderness, itching, and generally feeling poorly. The fistula may also drain pus or a foul-smelling discharge. These symptoms vary based on the severity and location of the

1. Pain while passing stools : The lower anal canal is exquisitely sensitive area of skin and can produce fairly significant signals of pain if damaged. Sharp agonizing knife-like pain starts when the individual passes stool. The pain is severe and persists for an hour or so. It ceases suddenly. The sufferer is comfortable until the next action of bowel. The individual tends to be constipated rather than go through painful ordeal. If a fissure becomes chronic (long-standing) and deep, another kind of pain can develop. It is a dull ache in the anus and pelvis that starts a few minutes after the bowel movement and can persist for hours after passing stools. This chronic fissure pain is due to spasm of the internal sphincter muscle (one of the small muscles in the anus) and can be quite debilitating.

2. Severe spasm of the anal sphincter (as a protective reflex)

3.Blood streaked stool (typically on the side of the hard stool) : It is important to note that the bleeding associated with a fissure-in-ano is bright red and associated with some pain or tenderness in the anus. Dark bleeding of greater amount without any anal tenderness or pain should never be ignored and should be brought to the notice of doctor.

4. Discharge, swelling, and itching occur especially with chronic fissures

Interestingly, homeopathy has many medicines to relieve the discomfort. Rightly chosen homeopathic medicine covers various aspects of fissure.  


Types of Fissure-in-ano

Fissure-in-ano may present as acute fissure of recent origin (less than 6 weeks of duration). At this stage fissures are superficial. Some of them may deepen to reach underlying layers and present as chronic fissure of a long duration (more than 6 weeks of duration) or recurring fissures. 

Fissure-in-ano is largely considered as a medico surgical disorder. However, looking at it in the light of homeopathic medicine, it is medically correctible conditions. Fortunately, in most cases, surgery can be avoided with homeopathy treatment


If acute fissures are not properly managed, they become chronic. Chronic and non-healing fissure-in-ano may present as a complicated condition, especially when it is associated with resistant constipation, 

1) Hemorrhoids (piles): Hemorrhoids are swollen, dilated veins of the rectum or anus. Hemorrhoids may be located at the beginning of the anal canal (internal hemorrhoids), or at the anal opening (external hemorrhoids).

2) Anorectal fistula: Anorectal fistula is a hollow tract (opening) leading from the anal canal or rectum to the skin through which watery pus drains.

3) Crohns disease: Crohn s disease is a chronic inflammatory process primarily involving the intestinal tract. It most commonly affects the last part of the small intestine (ileum) and/or the large intestine (colon and rectum). Also called as regional enteritis and ileitis.

4) Anorectal cancer: Cancer affecting rectum and anus.

5) Perianal abscess: Perianal abscess is a collection of pus outside the anus.

Chronic and recurring fissures may lead to permanent scarring or injury that prevents normal bowel movements.

Timely administered homeopathic medicines take care of acute and chronic fissures gently, effectively, and without producing any side effects.


Fistulas, depending on their location, can be diagnosed by some of the diagnostic tests often used in IBD. Barium enema, colonoscopy, sigmoidoscopy, or an upper endoscopy may be used.
Another test, a fistulogram, may also be used. In this test, dye is injected into the fistula, and X-rays are taken. The dye helps the fistula to show up better on the X-rays. The dye is inserted into the rectum, similar to an enema, for fistulas that are in the rectum. The dye must be 'held' inside during the procedure. With a fistula that is to the outside of the body, the dye is put into the opening with a small tube. X-rays will be taken from several different angles, so a patient may have to change positions on the X-ray table. As with any other kind of X-ray, remaining still is important .For a suspected enterovesicular (bladder) fistula, an intravenous pyelogram (IVP), another type of X-ray, is performed. Prepping for this test may include a clear liquid diet or fasting, because stool in the colon can obstruct the view of the bladder. The dye (contrast material) is injected into the arm, and several X-rays are taken.

Self care measure

 Take plenty of fluids
 Add fiber to diet 
Exercise regularly 
 Follow regular bowel habits 
 Take hygienic measure to keep anus clean and dry 
 Treat constipation or diarrhea immediately 
 Avoid friction or injury 
 Use dry cleaning by toilet paper 
 Avoid scratching 
 Avoid spicy, oily, non-veg food 
 Quit smoking and limit alcohol 
 Limit coffee intake 
 Before passing stool sit in a shallow bath tub of warm salt water for 10-15 minutes 
 Never suppress an urge for passing stool

Homeopathic Treatment

Homoeopathy is very proficient in managing all the symptoms of Fistula (fissure in ano)and furthermore plays a vital role in preventing relapse of the condition. Homoeopathic medicines are prescribed on the basis of physical, emotional, and genetic make up that individualizes a person. This constitutional approach framing mind and body works at the root-level. Homeopathic medicines will help decrease pus formation ,Promoting and restoring the digestive system, and Start healing of skin lining the Fistula by promoting granulation tissue. Homeopathic treatment will make you feel like a new person by making you free of Pain & discomfort. Homeopathic treatment is natural, safe, gentle and without side-effects. Another impressive thing about Homeopathy is that people on multiple medications can safely take Homeopathic medicines. Homeopathic drugs are non-habit forming and have no addictive characteristics,no side effects. Homeopathy has an exceptional proven safety record with the FDA with 200 years of clinical effectiveness. Since Homeopathy treats in totality, it leads to a permanent long-lasting cure, rather than a temporary suppression of symptoms, and you will be able to enjoy all kinds of food to the fullest. So, food lovers, you won't have to think anymore before eating.

Fissure-in-ano (anal fissures) finds an excellent treatment with homeopathy. Most cases heal and surgery can be avoided.As homeopathy promote healing of granulation tissue in Fissure.

The duration of treatment for Fissure-in-ano:

Most patients show significant improvement in about three to four weeks. The full length of treatment is usually for about  months. Some patients may need longer course of medication.

 It is possible to avoid surgery in most cases, if timely homeopathic treatment is used.

Fissure-in-ano treatment using homeopathyFissure-in-ano (anal fissure) is treatable without surgery.The treatment for Fisure-in-ano can best be achieved by medicines, which are capable of treating:

  • The underlying cause of the fissure
  • The tendency of having fissure
  • ConstipationLong term management of constipation and fissure-in-ano cannot be achieved by the use of laxatives. You need much more than that.Homeopathy can do it.


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About Dr. GS Makkar

Dr. GURPREET SINGH MAKKAR is a dynamic homeopath from India(pb). He is an ardent student of classical Homeopathy. He is a registered doctor degree holder (B.H.M.S.) from Sri Guru Nanak Dev Homoeopathic medical college(S.G.N.D Barewal Ludhiana,PUNJAB, India.
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