Anal Fissure and Homeopathy- A Clinical Study

Dr Geena Aslam BHMS,MD(Hom)
Medical Officer,Department of Homeopathy. Govt.of Kerala

The anal canal is the last 4 cm of the alimentary tract and is developed from the anorectal canal and proctoderm .Like the rest of the gut it is a tube of muscle but the fibers are all muscular , consisting of the internal and external anal sphincters , which are composed of visceral and skeletal muscle respectively . These sphincters , assisted by the configuration of the mucous membrane , hold it continually closed except for the temporary passage of flatus and faeces3.

The very common problem of anal fissure was first described in 1829 by Recamier 2, who recommended stretching the anal sphincter to treat the condition .Anal fissure is a common disorder for which many people do not seek medical advice The typical anal fissure in the midline posteriorly from the pectinate line to the anal verge. Pain on defecation is the outstanding symptom of anal fissure. Although the tear is usually small , it can be very painful as the anus is very sensitive . Treatment of chronic anal fissure has shifted in recent years from surgical to medical methods . Traditional surgery which permanently weakens the internal sphincter is associated with the risk of incontinence.

Even though there are effective homoeopathic medicines for this disease , no body has undertaken a scientific study on this matter based on statistical data . This is an attempt to do a scientific study based on statistical data .

Aim of study
To assess the efficacy of Homoeopathic medicines in the treatment of anal fissure 

Materials: The materials for the study were collected from patients who attended the various out patient department of Govt. Homoeopathic Medical College Hospital , Kozhikode .
The study was extended from April 2003 to March 2004 .
The patients belonging to the age group of 15 to 55 years were selected for this study

Research Tools and Techniques: Anal fissure assessment tool was developed after literature review and in consultation with experts . A proctologist and a research methodologist were consulted for developing the tool .A total of 5 major areas were identified as important parameters and each item was rated on a scale 0 – 2 0 = Absence of symptoms and 2 = severe symptoms . So a maximum score comes to 6 .

Methods: All cases were diagnosed clinically based on clinical features , inspection of anal region and in cases where some rectal pathology was suspected , proctoscopic examinations were done to rule out major diseases . Detailed history was taken in each case with special reference to previous history , family history , occupational history , physical generals and mental generals
Systemic examination was done in all cases to exclude the possibility of other diseases .

The efficacy of Homoeopathic medicine in the treatment of anal fissure is evident by the reduction in the score after 6 months of treatment . Therefore the treatment is effective

Summary and conclusion
The following salient conclusions have been drawn based on the present study and after summarizing its findings.
1. Homoeopathic medicines are effective in the treatment of anal fissure
2. There are no specific medicines for anal fissure , but there is a specific medicine for each patient suffering from anal fissure . Prescriptions are made only on the basis of individual peculiarity of each patient and such constitutional prescriptions are more effective and their action long standing.
3. Anal fissure is common in the age group 35 – 44 years and is more common among females.
4. Anal fissure is a manifestation of syphilitic miasm on a psoric background 

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