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Diagnosed With Anal Fissure. Having Problem While Sitting And Standing. Suggest Alternate Medicine

Posted on Sat, 5 Jan 2013

Question: Sir,
I have been diagonesd with anal fissure as i was experiencing pain while bowel movement and after that . I was also having problem while sitting & standing. the doctor did a physical exemination and said it was a anal fissure. he prescribed orni o, diltiact cream & pegmove .Its been 1.5 months but i have no relief.kindly suggest an alternate meds .Also i want to know if applying wheat grass cream or ayurvedic cream heals anal fissure (as i have read testimonials on net that it helps to heal)???
kindly advise

Answered by Dr. Dr.P.Ratnakar Kini (9 hours later)

Hi XXXXXXX,
Thanks for posting your query.
I am Dr.Ratnakar Kini, Gastroenterologist and I am pleased to answer your query.

Anal fissure occurs when a person is constipated. A tear occurs at the anal opening which makes bowel movements painful. The anal sphincter goes in for spasm making it more painful and this forms a vicious cycle.
The aims of treatment are -
1. Ease the bowel movement
2. Relieve the anal sphincter spasm

For easing bowel movements you need to take high fiber diet, fiber supplements and drink plenty of water. You have been taking pegmove. If you find this not effective, you can ask your doctor to prescribe preparations containing lactitol, ispaghula and peg.

For relieving the spasm of the anal sphincter, you continue applying diltiact. There are preparations available which contain anesthetic medication ( lignocaine) which will reduce the pain. You can discuss with your doctor about this.
In addition to this you can use sitz bath. Have lukewarm water in a wide mouth tub and sit in it with your anal part in the water for a few minutes. Do this 2-3 times a day. This will relieve both spasm and the pain.

Regarding wheat grass and ayurvedic cream, there are no clear scientific evidence that they are effective in the treatment of anal fissures.

I hope that answers your question.
If you have no more questions, kindly accept this answer and rate this service.
Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (8 hours later)

Sir,

thank you for your revert .

1) as im not in the same town where the doc had diagonesd me , I would request you to kindly prescribe a alternate of pegmove containing lactitol, ispaghula and peg.with the dosage (hope it wont cause loose motion).

2) Also i was having itching in my anal area and so he prescribed lox 2% jelly which I have been using now as diltiact causes itching in anal areas.
Can you pls prescribe an ointment containing anesthetic medication ( lignocaine) or is lox % ok?
3)Can I apply sodium fucidate ointment on the affected are?? a friend applied the same for 3 days and got immediate relief.
4) can you also tell me a name of wheat grass cream which i can try ??
Looking forward to your revert as i dont want o undergo surgery.

Answered by Dr. Dr.P.Ratnakar Kini (1 hour later)

Hi,

1. Take Laispeg - 1 scoop twice a day in 250 ml of water.

2. Lox is lignocaine. So continue using that.

3. There is no need to apply sodium fusidate.

4. As I mentioned in my earlier post, there are no clear scientific evidence for the efficacy of wheat grass cream in the treatment of anal fissure.

I hope that answers your question.

If you have no more questions, kindly accept this answer and rate this service.
Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (2 hours later)

Thank you .

1) Wanted to know if HEMOCARE or PROCTOSEDYL Ointment help ?

2) I have heard that any ointment containing zinc oxide helps? Is this true? does lox contain zinc oxide?
3) Is there any alternate medicine which could cure anal fissure ( homeopathy or herbal or ayurvedic??)

Pls ,I want to be cured as soon as possible

Answered by Dr. Dr.P.Ratnakar Kini (34 hours later)

Hi,
1. Yes , proctosedyl can help.It helps to relieve pain. Hemocare is an ayurvedic preparation and being an allopath I cant comment on that.

2. Zinc oxide is supposed to hasten the healing process. Lox does not contain zinc oxide.

3. Being an allopath, I cant comment on alternative medicine.

I hope that answers your question.
If you have no more questions, kindly accept this answer and rate this service.
Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (16 hours later)

Sir,

If zinc oxide hasten or accelerate the healing process , can you please prescribe any ointment which relieves pain and contains zinc oxide so that the fissure heals quickly?
or will i have to apply proctosedyl and any ointment which contains zinc oxide separately ?

Answered by Dr. Dr.P.Ratnakar Kini (7 hours later)

Hi
Zinc oxide is available separately.
I would like to say that the basic cause should be treated properly.
A good bowel movement helps in the healing process. So take Laispeg which I have mentioned in my earlier post.
The next thing is sitz bath.
All other measures should be only additional and not primary treatment.

I hope that answers your question.
If you have no more questions kindly accept this answer and rate this service.
Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (15 hours later)

Sir,

Thank you for your answer.

I understand that primary treatment is important .I am also suffering from Grade 1 bilateral varicocele. can i take slitz bath as it would increase the temperature of the testicle and increase the pain of varicocele.

Can i use a hot water bag and sit on it ?? will this work and not harm the varicocele??

Since slitz bath is not possible for me , I request you to prescribe a zinc oxide ointment for healing and how it should be applied with Lox %.

Look forward to your positive revert .

Answered by Dr. Dr.P.Ratnakar Kini (10 hours later)

Hi,
Sitz bath is not a contraindication for bilateral varicocele. You can discuss about this with your urologist.
Zinc oxide can be applied separately.
I would again reiterate that the main treatment is Laispeg, sitz bath, lox jelly and diltiact.
I hope that answers your question.
If you have no more questions kindly accept this answer and rate this service.
Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (12 hours later)

Sir,

can you name any OTC zinc oxide ointment which i can buy ? i apply lox in the morning before and after BM and in night before sleeping ...so when can i apply zinc oxide ointment ?

If not sitz bath ,can i sit on a hot water bag ??

Answered by Dr. Dr.P.Ratnakar Kini (7 hours later)

Hi,
Zinc oxide is available as Rashfree. You can apply in the afternoon. But as I told you it is not the primary treatment. You need to other medications I have mentioned in my earlier post.

Yes, you can use a hot water bag.

I hope that answers your question.
If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (18 hours later)

Sir,

Thank you for your revert.

1) FOR HOW MANY DAYS MAXIMUM SHOULD I APPLY RASHFREE AND ONLY 1 A DAY?
2) FOR HOW LONG SHOULD I SIT ON THE HOT WATER BAG? SHOULD MY ANUS BE IN DIRECT CONTACT WITH THE HOT WATER BAG?

ANY OTHER PRECAUTION SHOULD BE TAKEN SO THAT THE FISSURE HEALS QUICKLY AND DOES NOT AGGRAVATE ?

Answered by Dr. Dr.P.Ratnakar Kini (36 hours later)

Hi,
You can apply once or even twice a day till it heals.
The basic idea of sitz bath and hot water bag is to improve the blood circulation in that area. So make sure that the anal part is exposed to warmth.

Make sure you have good bowel movements.
I hope that answers your question.
If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (7 hours later)

Thank you for your answers . few last queries

1) For how long should I apply rash free cream ? ( 1 week, 2 week ??)
2) Should the rash free cream be applied only on the surface of the anus or inside ALSO ???

3) I searched for Liaspeg in almost 6 medical shops in Bangalore but could'nt find, can you please suggest a substitute ?

Answered by Dr. Dr.P.Ratnakar Kini (8 minutes later)

Hi,
As I told you in my earlier post, you need to apply it as long as you have the symptoms.
You need not apply inside. Apply it over anal verge.
It is Laispeg - a product of Fourrts India. Mention this company name and tell the medical shop guy to get it for you.
Alternative is Cremadiet Duo.

I hope that answers your question.
If you have no more questions, kindly accept this answer and rate this service.

Regards,
Dr.Ratnakar Kini

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar