conditions anal-fissures

RECND542

Anal Fissures

Condition:Anal Fissures
Other:Fistula of Anal & Rectal Regions
ICD-10 Codes:K60

Summary

Top 3 natural topical treatments for anal fissures

1. witch hazel (Hamamelis virginiana)
2. marigold (Calendula officinalis)
3. horsechestnut (Aesculus hippocastanum)

Naturopathic Treatments

Rule-out food sensitivieties
• elimination diet (especially dairy)

Topical Applications - to speed up healing
marigold (Calendula officinalis)
witch hazel (Hamamelis virginiana)
aloe (Aloe vera)
horsechestnut (Aesculus hippocastanum)
• honey

Increase fluidity of bowel movements and reduce their density
• drink 5- glasses of water/day
• gradually increase fiber
- marshmallow (Althea officinalis)
- slippery elam (Ulmus rubra)
- psyllium (Plantago ovata)
- oatmeal
- ground flax

Note: too much fiber and insufficient water intake may aggravate the issue

General advice
• use moist toilet paper or towelettes
• do not strain
• avoid standing or sitting for long periods of time

Conventional Treatments

• nitroglycerin medicated creams (anusol-HC)
• botox
calcium channel blockers
• surgery

Signs & Symptoms

• painful bowel movements
• bright red blood discovered with stool or on toilet paper
• visible tear in the skin surround the anus
• pruritis
• irritation or tenderness of anal skin
• minor lesion or skin tag near fissure

DDx

• pruritis ani
• inflammatory bowel disease (IBD)
herpes simplex
• proctitis
• syphilis
• pilonidal cyst and sinus
• gastrointestinal bleeding (pediatric)
• child sexual abuse
HIV, AIDS
• hiradenitis suppurativa
• foreign bodies
• anal abrasion
• rectal or anal carcinoma

Pathogenesis

• tear occurs in anoderm (anal canal) caused by:
- injury
- chronic diarrhea
- constipation
- inflammation (colitis)
- anal sex
- HIV
- cancer
- syphilis

Risk Factors
• infants and older adults
• childbirth
IBD
constipation
• insufficient water intake (leading to constipation)

Diagnostics

• physical exam
• subjective history

Diagnostic Tests
• physical exam
• CBC
• flexible sigmoidoscopy
• colonscopy
• anal manometry
• CT

References

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