Anal fissure

Anal fissures are an unnatural crack or tear in the anus, usually extending from the anal opening and located posteriorly in the midline. This location is probably because of the relatively unsupported nature of the anal wall in that location.

Symptoms-

The symptoms of anal fissure include:

• Pain during, and even hours after, defecation.
• Visible tear in the anus
• Blood on the stool or on toilet paper or toilet bowl
• Constipation
• Burning, possibly painful itching
• A tearing sensation during defecation, sometimes described as "like passing glass".

Remedies-

1. Graphites. [Graph]
In eczematous subjects where the anus is extremely sore and the stools are covered with mucus, with no tenesmus or constriction, Graphites is the remedy. There is no special irritability of the parts, but the fissures are usually caused by large faeces. The parts are sore and smart.

2. Nitric acid. [Nit-ac]
From its affinity to the outlets of the body this remedy becomes an important one in fissure where there is a sensation as if splinters or sticks were in the anus. There is much tenesmus and constriction, and a constant oozing of the foetid matter from the parts, with burning, rawness and smarting.

3. Ratanhia [Rat]

Ratanhia has much constriction about the anus, which aches and burns for hours after stool, there are cutting and lancinating pains in the rectum, and dryness of the anus with sudden stitches in it. The temper is irritable. It is also a useful remedy for thread worms.

4. Paeonia [Paeon]
Paeonia has fissures with much oozing. The anus if offensively moist and sore smarts all the time. Burning and biting, lasting several hours after stool may also be present; must walk the floor all night.

5. Silicea. [Sil]
Here the irritable sphincter comes to mind and the slipping back of the partially expelled stool. It also has great pain, coming on half an hour after stool and lasting several hours. Platina has fissure of the anus, with crawling and itching every evening. Severe pain after each stool with burning and tenesmus lasting a long time.

Hemorrhoids

Hemorrhoids are enlarged veins in the anus or lower rectum. They often go unnoticed and usually clear up after a few days, but can cause long-lasting discomfort, bleeding and be excruciatingly painful.

Types of hemorrhoids

External hemorrhoids are those that occur outside of the anal verge (the distal end of the anal canal).

1. Internal hemorrhoids are those that occur inside the rectum. As this area lacks pain receptors, internal hemorrhoids are usually not painful and most people are not aware that they have them. Internal hemorrhoids, however, may bleed when irritated.

2. Prolapsed hemorrhoids are internal hemorrhoids that are so distended that they are pushed outside the anus.

3. If the anal sphincter muscle goes into spasm and traps a prolapsed hemorrhoid outside the anal opening, the supply of blood is cut off, and the hemorrhoid becomes a strangulated hemorrhoid.

Symptoms-

The list of signs and symptoms mentioned in various sources for Hemorrhoids includes the 10 symptoms listed below:

•  Blood in stool
•  Rectal bleeding
•  Blood on toilet paper
•  Anal itching
•  Anal swelling
•  Anal lump
•  Anal mucus discharge - less common
•  Feeling of rectal fullness
•  Feeling of unfinished defecation
•  Severe rectal pain - if a vein becomes strangulated

Complications-

The list of complications that have been mentioned in various sources for Hemorrhoids includes:

•  Ruptured hemorrhoid
•  Gastrointestinal bleeding
•  Anemia - if bleeding is severe
•  Thrombosis - clotting in the veins
•  Strangulation - blockage of the vein.

Remedies-

1. Aesculus. [Aesc]
This remedy is especially suitable to the form of haemorrhoids arising from portal congestion, abdominal plethora. They may or may not bleed, but there is a feeling in the rectum as of splinters or sticks. This remedy has many liver symptoms and haemorrhoids Other indicating symptoms are aching in the lumbar region, protruding purple piles with severe pains in the sacrum and small of the back and fullness in the region of the liver. Dryness, burning and itching are good indications. Pulsatilla is one of the best remedies in haemorrhoids after Aesculus. Passive congestion and dyspeptic troubles are the keynotes; blind haemorrhoids. Haemorrhoids that bleed easily

2. Collinsonia. [Coll]
Collinsonia is indicated in obstinate cases of haemorrhoids which bleed almost incessantly. It is of special use in females with inertia of the rectum and a congestive tendency to the pelvic organs. It suits pregnant women who suffer from piles, and pruritus may be a marked symptom. The indicating symptoms are chiefly a sensation of sticks in the rectum, with constipation from inertia of the lower bowel. It is especially applicable to heart pains resulting from a suppression of a habitual haemorrhoidal flow. It is somewhat similar to Nux, but is a far more useful remedy.

3. Hamamelis. [Ham]
Hughes esteems this remedy as one of the best in haemorrhoids, and clinical testimony is decidedly with him. It has bleeding haemorrhoids, and the flow of blood is quite copious, and the great characterizing indication is excessive soreness. Sulphur has constipation and itching about the anus, worse at night, which may be considered as keynotes for its use.

4. Aloes. [Aloe]
This is also a most useful haemorrhoidal remedy. It is indicated where the piles protrude like a bunch of grapes, bleeding often and profusely, and are greatly relieved by the application of cold water. There is a very marked burning in the anus the bowels feel as if scraped. There is a tendency to diarrhoea, with the well-known uncertain feeling in the lower bowel. This tendency to diarrhoea will distinguish from Collinsonia, which has the tendency to constipation. Ratanhia has burning in the anus and protrusion of varices after a hard stool. The characteristics of this remedy are burning and fissure of the anus, great painfulness and sensitiveness of rectum Capsicum.

5. Nux vomica. [Nux-v]
If the haemorrhoids be large and blind, with a burning, stinging and constricted feeling in the rectum and a bruised pain in the small of the back and especially if excited by sedentary habits or abuse of stimulants, then Nux may be prescribed with confidence. Itching haemorrhoids keeping the sufferer awake at night, relieved by cold water, or bleeding piles with constant urging to stool, and a feeling as if the bowel would not empty itself are further indications. Arsenicum. Indicated in bluish piles with burning pain, prostration and debility. Muriatic acid. Great sensitiveness of the anus cannot make use of the softest toilet paper; the piles are so sore and sensitive that the slightest touch is unbreakable. Haemorrhoids in the aged. Graphites. Haemorrhoids which burn and sting, anus sore, worse sitting. The rectum seems to have lost its contractile power, and the varices protrude.

6. Lycopodium. [Lyc]
A very useful remedy for piles which do not mature, but remain as hard bluish lumps, and also for bleeding piles containing large quantities of blood.

7. Sepia. [Sep]

Sepia has haemorrhoids from retarded portal circulation; bleeding haemorrhoids with fullness in the rectum; oozing of moisture with great soreness.

8. Sulphur. [Sulph]
This remedy corresponds to ailments producing haemorrhoids and to the troubles resulting from piles which have stopped bleeding, and as a result fullness in the head and uneasiness in the liver; constipation is present; a desire for stool and itching of the anus. Inflamed and very painful piles, scanty evacuation of faeces in small, hard bits, like sheep's dung, with pressing; frequent or copious urination.

9. Lachesis [Lach]

Constipated, offensive stool. Anus feels tight, as if nothing could go through it. Pain darting up the rectum every time be sneezes or coughs. Hæmorrhage from bowels like charred straw, black particles. Hæmorrhoids protrude, become constricted, purplish. Stitches in them on sneezing or coughing. Constant urging in rectum, not for stool.

Anal fistula

An anal fistula is an abnormal connection between the epithelialised surface of the anal canal and (usually) the perianal skin

Anal fistulae originate from the anal glands, which are located between the two layers of the anal sphincters and which drain into the anal canal. If the outlet of these glands becomes blocked, an abscess can form which can eventually point to the skin surface. The tract formed by this process is the fistula.

Symptoms-

Anal fistulae can present with many different symptoms:

• Pain
• Discharge - either bloody or purulent.
• Pruritus ani - itching
• Systemic symptoms if abscess becomes infected

Complications-

Abscesses can recur if the fistula seals over, allowing the accumulation of pus. It then points to the surface again, and the process repeats.

Remedies-

1. Paeonia Officinalis [Paeonia]

The rectal and anal symptoms are most important. Biting and itching in anus; orifice is swollen. Burning in anus after stool; then internal chilliness. Fistula in anus diarrhea with anal burning and internal chilliness. Painful ulcer, oozing offensive moisture on perineum.

2. Sedum Acre [Sedum A]

Severe anal constricting pains of fistula remaining for few hours even after passing stools. One of the specific for fistula and fissure pains.

3. Silicea [Silic]

Rectum feels paralyzed. Fistula in ano Fissures and hæmorrhoids, painful, with spasm of sphincter. Stool comes down with difficulty; when partly expelled, recedes again. Great straining; rectum stings; closes upon stool. Feces remain a long time in rectum. Constipation always before and during menses; with irritable sphincter ani.

4. Berberis Vulgaris [Berb Vulg]

Constant urging to stool. burning, and smarting in anus and perineum. Tearing around anus. Fistula in ano.

Also other remedies like Calc sulph, Puls etc? are good remedies for fistula.