FISSURE IN ANO: A CLINICAL APPROACH

Anorectal disorders such as fissure in ano, hemorrhoid, sinus, fistula in ano are direct link with our life style and bowel h abit. Sedentary li festyle, spicy and junk food, prolong sitting, smoking, alcohol are predisposing factor s of altered bowel habit which is major cause of these notorious diseases. Fissure in ano is a split at muco - cutaneous junction in anal canal. It causes intense pain dur ing defecation with passage of small amount of blood. Primary fissure can be acute or chronic while secondary are due to underlying diseases. Acute fissure usually respond to conservative treatment, if not then convert into chronic fissure associated with tag which is treated with surgical intervention . Fissure in ano is described as parikartika in Ayurvedic literature s by complication of virechan (purgation therapy). It is due to alleviation of vata and pitta dosha which causes severe pain with burning sen sation. Avagaha sweda (sitz bath), high fiber diet isabgol, local application of jatyadi oil, guggul u preparation are such measures prove highly efficacious in management of fissures. B ilwa di churna, kutaj, takra are effective in colitis or IBS which cause s secondary fissure. These Ayurvedic medicaments can prevent acute fissure to convert in chronic one hence probability of surgery can be reduced to a great extent.