What is this?
One may have ‘burning or pain during defecation’, which last for 1-2 hours after defecation. Along with this, bleeding may or may not present. An extra growth of skin in the mid line in front or back of the anus hangs out, which is felt while washing the area. Women after delivery commonly suffer from this.

Why and what happens here?
Main cause of this disease is passage of hard stool, which is tearing the delicate anal canal. This forms a wound or cut in front or back part of the anus, results in severe pain. Once damage occurs here, due to hard stool, it fails to heal. This is because daily it contaminates with stool. Further injury and bacterial contamination, un-cleanliness makes wound further worsen and fails to heal. Then it is called chronic fissure. Patient will have pain or burning sensation for months together. Though it heals with great difficulty, again passage of hard stool may again cut or injures the area and again there its formation of ulcer. This is why patient with fissure have repeated attack of symptoms. These types of attacks may last for years in some women.

What you have to do?
First thing is don’t become panic. This is not a grave disease. Keep the part clean. Sit in wide mouthed tub with warm water (water used for bathing purpose) without adding anything to it. This helps in cleaning and healing of the wound. Take soaked dry grapes about 8-10 and glass of hot milk at bed time. In majority of the patients this will subside pain. Then one has to consult doctor for further management.

What an Ayurveda surgeon does?
Taking only oral medications may helps in some patients if fissure is of recent orogin. Final and permanent remedy for this is again kshara karma. Under local anesthesia application of kshara to fissure bed. This burns the part mildly without damaging much tissue. So that fresh wound is created which heals faster. Agni karma follows this, senile pile excised and sphincterotomy is adopted to prevent recurrence. Intermittent anal dilatation to be done after the procedure in further follows up.

How this is advantageous?
This is advantageous than conventional surgery because – instead of excision of tissue (is done during fissurectomy) kshara is applied. Post operative pain is less. Recovery is fast. Less chance of recurrence, less cost.