How to heal anal fissure permanently? - #8853
Hello, Doctor. I have been dealing with recurrent anal fissures since September 2023. It first occurred due to hard stool, and it has reappeared multiple times since then—in December 2023, February 2024, June 2024, August 2024, November 2024, and now in January 2025. The pattern seems consistent: whenever I pass a large, hard stool, the fissure reopens. The initial part of my bowel movement is hard and big, but the rest is soft. I don’t strain during bowel movements. I notice a small cut in the anal region every time it reoccurs. I have made lifestyle changes, including drinking 1 liter of water daily and eating more vegetables while avoiding excessive meat. Recently, I’ve been applying Lookman-E-Hayat oil (3ml) for relief. However, I am concerned about the recurrence. Can I use more of this oil, or would you recommend a different treatment? Are there any effective Ayurvedic stool softeners I can take daily? I read that people with low blood pressure, like me, should avoid Triphala—could you clarify if that’s true? I am looking for a way to heal this and prevent it from coming back. Thank you for your guidance.
Doctors’ responses
I’m sorry to hear about your recurrent anal fissures, as they can be both painful and frustrating. Given your history, it’s clear that the condition is triggered by hard stools, which put stress on the anal region and reopen the fissure. Here are some Ayurvedic and lifestyle suggestions to support healing and prevent recurrence:
Stool Softeners:
Psyllium husk is an excellent natural stool softener. It helps increase fiber intake, ensuring softer, bulkier stools and reducing the risk of further fissures. Take 1-2 teaspoons of psyllium husk in warm water before bed. Triphala can be helpful for improving digestion and regularity; however, since you mentioned low blood pressure, Triphala might be less ideal for you as it can sometimes reduce blood pressure further. Instead, you could try a gentler herbal alternative like Isabgol (psyllium husk), which is safe for most people. Ghee: Consuming 1 teaspoon of warm ghee daily can also help lubricate the intestines and soften stools, reducing the strain during bowel movements. Dietary Changes:
Increase your intake of high-fiber foods like vegetables, fruits, whole grains, and legumes to help soften stools. Water intake: While 1 liter is a good start, aim for about 2-2.5 liters per day, especially if you are trying to prevent constipation and keep stools soft. Topical Treatments:
The Lookman-E-Hayat oil you’ve been using may provide temporary relief, but it’s essential to ensure that the fissure is healing completely between flare-ups. You can continue using the oil for soothing and healing, but it’s important not to rely solely on topical treatments. Ghee or Coconut Oil: Applying a small amount of ghee or coconut oil can also help soothe and moisturize the area, promoting healing of the fissure. Aloe Vera gel: Applying fresh aloe vera gel can also offer a cooling and healing effect for the fissure. Hygiene and Healing:
Ensure you are using a gentle, non-irritating soap for cleansing the area. After a bowel movement, rinse with lukewarm water rather than wiping harshly to avoid further irritation. After a bowel movement, consider soaking in a sit bath (a shallow bath with warm water) for about 10-15 minutes to relax the anal muscles and promote healing. Avoid straining: Even though you mentioned you don’t strain, it’s important to ensure you’re not holding your breath or rushing during bowel movements. Lifestyle Adjustments:
Stress can also contribute to digestive issues, so incorporating stress-reduction practices like yoga, meditation, and pranayama (breathing exercises) can help promote overall digestive health and prevent constipation. To address your concern about Triphala and low blood pressure, Triphala is generally safe but can lower blood pressure in some people. Given your low blood pressure, it might be safer to avoid Triphala and stick with other fiber-rich herbs like Isabgol or Psyllium husk that don’t impact blood pressure as much.
By incorporating these Ayurvedic practices, dietary changes, and topical treatments, you should be able to manage your anal fissures more effectively and reduce their recurrence. If the issue persists or worsens, it’s advisable to consult an Ayurvedic practitioner or a healthcare professional who can provide a more personalized treatment plan.
Ayurvedic Management for Recurrent Anal Fissures 1. Internal Medications:
Gandharva Haritaki Churna: 1 tsp with lukewarm water at bedtime. This acts as a gentle stool softener. Panchasakar Churna: 1 tsp mixed with warm water early in the morning to ensure smooth bowel movements. Kasisadi Taila Capsules (if available): Supportive for healing internal injuries.
2. External Application: Continue using Lookman-E-Hayat oil for relief, but also consider Jatyadi Taila for external application to promote faster healing of the fissure. Apply after cleaning the area with warm water.
3. Dietary Recommendations: Increase fiber intake: Include psyllium husk (Isabgol) mixed with water or milk daily. Hydration: Increase water intake to 2–2.5 liters/day. Foods to Avoid: Spicy, oily, and fried foods. Limit red meat. Include: Steamed vegetables, fruits like papaya and figs, and whole grains.
4. Lifestyle Adjustments: Avoid sitting for prolonged periods—use a cushion if necessary. Do light yoga poses like Pawanmuktasana and Malasana to improve digestion and reduce strain. Ensure a fixed bowel routine to avoid sudden hard stools.
5. Clarification on Triphala: Triphala Churna: It is generally safe even for those with low blood pressure but should be used cautiously in moderation (e.g., 1/2 tsp at bedtime with warm water).
6. Preventive Measures: Use ghee (1 tsp) daily with warm milk to lubricate the digestive tract. Consume castor oil (1 tsp) mixed with warm water before bedtime if bowel movements are consistently hard. Avoid stress during bowel movements and ensure complete evacuation.
7. Panchakarma Option (if feasible): Consider Matra Basti (enema with medicated oil) under an Ayurvedic practitioner’s guidance. It can help in lubrication and healing.
8. Monitoring: Regular follow-ups are essential to assess progress. If symptoms persist, consult an experienced Ayurvedic doctor to rule out chronic fissures or related conditions. With consistent care, these measures can aid in healing and prevent recurrence effectively.
Hi Doctor, how to relax anal sphincter muscle? Because my starting stool is little hard then rest is smooth which is causing fissure to occur again. Also does the anal hole become small after fissure bcz when i pass little bulky stool also fissure occur again
Doctor, thank you so much i will follow accordingly. Also I have been applying 3ml of Lookman-E-Hayat oil inside my anus for relief from recurrent fissures. Is it safe to use this oil internally, or could it cause any side effects? Would you recommend switching to Jatyadi oil for internal application instead?
Yes you can try using Jatyadi oil for a week on a cotton swab.
Recurrent anal fissures can indeed be frustrating, and while you’ve made some beneficial lifestyle changes, let’s dive deeper into Ayurveda for a sustainable way to manage this. The Issue here is primarily related to vata imbalanced with apana vata (responsible for downward movement and elimination) being disturbed. It’s also a sign weak agni or digestive fire which needs strengthening.
First off, hydration is critical but 1 liter a day might not be enough. Aim for 2-3 liters daily to keep the stools soft. Also, explore more fiber-rich foods - whole grains like barley and oats plus fruits like papaya (helps soften stools) and bananas can be helpful. Ghee too can aid in lubrication: mix a teaspoon of it into warm milk before bedtime.
Now for that Lookman-E-Hayat oil: it can be useful, but a gentle herbal remedy like Jatyadi Taila is often recommended in classical Ayurveda for healing anal fissures. It’s soothing for the tissues and might enhance healing. You can apply it after your bowel movement — but do seek a consultation to make sure it’s suitable for you.
Regarding stool softeners, there’s Avipattikar churna which can be helpful. Unlike Triphala, it has heating properties that won’t aggravate low blood pressure. Start with half teaspoon mixed with warm water before meals, once a day, and monitor how you respond.
Enhanced digestion is key for prevention. You might want to sip warm jeera or ginger water during the day to stoke that digestive fire. A good probiotic, like homemade buttermilk (takra), is supportive for gut health, take it with a pinch of roasted cumin powder regularly.
Let’s not forget lifestyle - mind your mental stress, and engage in relaxed activities like yoga asana, focusing on ones that support digestion, like Pavanmuktasana (wind relieving pose) and Vajrasana (thunderbolt pose) after meals. Regular pranayama practice, particularly Anulom Vilom, can harmonize vata.
For the Triphala and low BP dilemma: moderate use is fine. But if you’re cautious, definitely opt for alternatives mentioned prior. Lastly, swing by an Ayurvedic practitioner if the fissures are stubborn - they might propose therapies like Ksharasutra or specific enemas (Basti) that can offer additional benefits.
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