It is explained as when a tunnel like pipeline similar to a track develops at the end of bowel and the outer skin near to anus. At the site of inflammation there is a continuous pus discharge, irritation, itching along with discomfort, passing of stool will also be very painful at the affected area. In Ayurveda fistula in ano is called Bhagandara. The main factor in causing this disease is vitiation or imbalance in three doshas i.e. vata, pitta, kapha. Its classification is based on shape and size of track in fistula and according to which the treatment is given. In many cases of fistula-in-ano causes uncontrolled drainage of pus. In some few cases, where the channel opening outside closes, that result in recurrent anal abscesses.
Symptoms of anal fistulas
There are various symptoms which include:
- Pain, that occurs in various forms like constant, throbbing and worse in sitting down position
- Irritation of the skin near to the anus that also including swelling, redness and tenderness
- The affected site oozes out discharge of pus or blood
- Continuous Constipation or pain on passing stool along with bowel movements
- Fever is also present
- Sometimes rectal bleeding along with few symptoms of urinary tract, such as difficulty in starting a urinary stream, pain during urination may also be present
- Perianal cellulites may also be present
Causes of Fistula-in-ano
An anal fistula occurs after an anal abscess bursts suddenly due increase in amount of pus accumulation or may be due to not getting proper treatment of abscess in fistula. There are many reasons for formation of fistula-in-ano. The two main reasons of fistula-in-ano are:-
The most common cause of fistula is blockage in anal gland that leads to infection which further causes abscess formation.
- After the hemorrhoideal surgery
- Inflammatory bowel diseases
- Due to some infections like viral, fungal or TB
What are the affects of fistula-in-ano?
- It will affect the intestines which causes inflammatory bowel disease (IBD) or diverticulitis.
- It affects most of the people with an anal abscess
- It affects few people with HIV
- People suffering from Crohn’s disease are also affected
Classification of Fistula-in-ano
Fistula-in-ano has been classified according to its location in relation to the structures and surrounding to the anus and rectum:-
It is also also classified in two other ways:-
- Simple or complex – When there is single tract is involved or when more then there is interlinking connections.
- low or high – it depends on the closeness of sphincter muscles and the position of tract
Herbs in treatment of Fistula-in-ano
An herb plays a very important role in healing of fistula.
Triphala is used since ancient times as a bowel repair in the form of tonic, it is known to be very helpful in digestion, gives support to regular bowel movements, healthy respiratory, cardiovascular, urinary, reproductive, and nervous systems. It consists of combination of the three fruits Amalaki (Emblica officinalis), Bibhitaki (Terminalia belerica), Haritaki (Terminalia chebula) they have a synergistic effect to booster many other systems also.
Benefits of Triphala
- It helps in natural internal cleansing
- It helps in maintaining regularity
- It rejuvenates and nourishes the body tissues
- It supports healthy digestion and its absorption
- It acts as Natural antioxidant
Triphala has property of powerful antioxidant and also protecting cells from the damaging. The three fruits which includes Triphala are also known to show individual effects:
- Amalaki (Emblica officinalis) : due to its cooling property it is used in managing pitta doshas and thus supports liver functions and boost up the immunity.
- Bibhitaki (Terminalia belerica) : it works best in kapha dosha, thus helps in respiratory disorders.
- Haritaki (Terminalia chebula) : it works well in controlling all three doshas vata, pitta, and kapha. It has a “scraping” property which removes all toxins and maintains health.
Terminalia Chebula (Haritaki)
- Haritaki has various properties like laxative, rejuvenative, purgative, astringent and dry properties.
- The paste of its fruit is effective in reducing swelling, fasting the healing process and also cleaning up the wounds
- The paste gives relief to the eyelids, in case of conjunctivitis.
- Gargling with haritaki helps in stomatitis, oral ulcers and sore throat.
- The herb helps in improving memory, and conditions like dysuria and urinary stones
- When it is taken along with honey helps in hepatitis.
- Haritaki helps in improving appetite and along with digestion.
- it is anti-inflammatory and astringent, it is helpful in urethral discharges
- It serves as a good astringent for loose gums, bleeding and ulceration in gums.
- It responds well to gastrointestinal ailments, tumors, ascites, piles, enlargement of liver-spleen, worms and colitis.
Phyllanthus emblica (Amalaki)
- It is helpful in indigestion
- It helps in boost up the immune system
- It is useful in gastritis
- It act as an anti-inflammatory thus helps in reducing the inflammation near the anal region.
Terminalia belerica (Vibhitaki)
- Its fruit is used to dress wounds for arresting the bleeding.
- It has a property of rejuvenative and laxative
- Fruit paste is applied on swollen and painful parts.
- The seed oil works best in skin diseases and premature graying of hair.
- The ripened fruit shows action of an astringent and anti-diarrheal.
- The decoction prepared with this is useful in excessive thirst and vomiting.
Curcuma longa (Curcumin)
- Curcumin is a herb which is carminative anti-allergen and diuretic in nature. Due to which it has been used for managing pitta doshas.
- It reduces the irritation, swelling, discomfort and pus around the ano-rectal area
- It is also used or beneficial in other problems like Skin Disorders Gastrointestinal Disorder, Allergies, Gallbladder Problems, Edema, Auto-immune Disorders, Liver Disease, Burns, Chicken Pox, Tumors, Metabolic Disease, Cataracts and other Eye Disorders.
- Curcumin has been used for those who are suffering from pain and inflammation:
Commiphora Mukul (Guggul)
- This herb is traditionally used for the treatment of digestive problems, arthritis, skin diseases, pains in the nervous system, obesity, infections in the mouth, and menstrual problems.
- It helps in reducing pain in anal region
- It is also beneficial in reducing inflammation in the areas of anus
- It helps to eliminate and expel dead tissues, wastes, and toxins from the body.
- It stimulates the activity of white blood cells in the body and also contributed in building up of the immune system.
Azadirachta Indica (Neem)
- Neem has various medicinal properties like anthelmintic, antifungal, anti-diabetic, antibacterial, antiviral, anti-fertility and sedative.
- All parts of neem such as the tree, seeds, leaves, flowers and bark, are useful in preparing various kinds of medical preparations.
- Neem oil is also used in cosmetics, like soap, shampoo, balms, creams and also in skin problems like treatment of acne thus keeping the elasticity of skin.
- Patients suffering from chicken pox are advised to sleep on neem leaves.
- The paste of neem leaves is applied on skin to treat acne.
- Neem leaves extract is helpful in treating malaria and purifying blood.
- Neem is used in vitiated conditions of pitta doshas like hyperdipsia, leprosy, skin diseases, eczema, leucoderma, pruritus, intermittent fever, wounds, ulcers, burning sensation, tumors, tubercular glands, anorexia, vomiting, dyspepsia, intestinal worms, hepatopathy, cough, bronchitis, inflammation and fatigue.
So, herbs are very safe, can use for longer duration, natural, without any side effects easily available in market in various herbal combination forms of herbal Medicines