It is crack or vertical ulcer in lower anal canal,it may be with sentinel tag as shown in fig.
Anal fissure alone is treated coservatively ,in which Ayurvedic drugs as Panchsakar Churna or Satsakar Churna,Abhayarista etc. and as medicated oils Jatyadi Tail or Anu Tail in the form of self retaining enema before defeacation is used, for this purpose half cut plane rubber catheter of no.7 or 8 fitted in the nosal of disposable syringe of 5ml rather than needle, the device used as self retaining enema apparatus as shown in fig.
Patient is also advised to take hot sitz bath or hip bath in a simple plastic tub filled luke warm water after defecacation for about 4-5 minutes as shown in fig.
Patients are relieved from pain, swelling and bleeding within 3-4 weeks.
Anal fissure if does not cured or recurred then to take concent after the diagnosis and pathological investigations closed posterior sphinctrotomy is done through Kshar Sutra Therapy.
After local aneasthia about 2.0 cm.posteriorly away from the anal verge an artificial fistula is created underneath the anal fissure the Kshar Sutra is anchored with other end of the probe which has an eye.
Gently probe is passed through the anus and Kshar Sutra is ligated with three consecutive knots.
After cleaning the part cotton soaked with Jatyadi Tail or Anu Tail put on the part that is supported with "T" bandge or tight underwear.
After care management is same as conservative treatment in which Ayurvedic drugs as Panchsakar Churna or Satsakar Churna,Abhayarista etc. and as medicated oils Jatyadi Tail or Anu Tail in the form of self retaining enema before defeacation is used, for this purpose half cut plane rubber catheter of no.7 or 8 fitted in the nosal of disposable syringe of 5ml rather than needle, the device used as self retaining enema apparatus as shown in fig above.
Patient is also advised to take hot sitz bath or hip bath in a simple plastic tub filled luke warm water after defecacation for about 4-5 minutes as shown in fig above.
Patients are relieved from pain, swelling and bleeding within 3-4 weeks.
Patient is also advised for walkimg 4-5 km. per day and mild work person can.
Kshar Sutra is changed every week upto the cut through.
Remaining wound after cutting of last Kshar Sutra soon healed.
Antibiotics and analgesics are used as per need.
If anal fissure is along with sentinel tag or pile then it is ligateted simultaneosly with the help of proper instrumemts under preventive and hygenic condition.
