How to Manage Anal Fissures? Foods, Remedies and Lifestyle TipsLuke Coutinho
Let’s talk about anal fissures, shall we? It is affecting millions as you read this. Yet no one wants to speak openly about it. Most people think anal fissures and piles are the same. Many of them wait until it is too late due to the embarrassment of having to discuss it with their parents, partners, or friends. They think it is a skin tag even though it constantly burns or itches. Lack of action at the right time can culminate into a much bigger problem in the long run, where many of them need to be wheeled in for surgery. Some professionals may prescribe surgery immediately without asking you to make dietary and lifestyle changes. But if you are going to a good doctor, they will tell you that in most cases (except extreme ones), surgery can be avoided.
Piles vs anal fissures
When the veins in the anal region get inflamed and seem bulky, it could be a case of piles. In this, the most common symptom is a skin tag. What are anal fissures? These are little cuts along the anal region and can even be bloody. When left unaddressed, these can become deeper due to constant movement like physical exercise, walking, sitting, constipation, or loose motions. In severe cases, it can even expose some of the muscle tissue. It may look like a crack in the skin and may bleed.
Symptoms to look out for:
- Skin tag. A piece of skin that may hang out. You could feel it when you put your finger towards the inner part of your anus or the rim of your anus.
- A lump that appears bloody. It could burn or itch.
If you have these symptoms, get them checked immediately because prevention is always better than cure.
What causes anal fissures?
In most cases, it is constipation where the stool becomes hard and you try to push that out. The straining and the hard stool can affect the delicate tissues around your anus and causes abrasions and cracks. When the bacteria and germs from your stool get into these cracks, it can become septic or cause bleeding. It is why sometimes your doctor may put you on antibiotics to reduce the infection, especially if it becomes pussy, if you have undergone surgery, or the cuts are unable to heal on their own.
If you need a laxative to pass out a motion, what is your body trying to tell you to fix? Your gut health. It all starts from your digestive system to your small intestine to your large intestine and the rectum region. Address why it is happening. Is the lack of fluids? Is it less consumption or overdoing fiber? Is there a tumor forming that is preventing you from passing the motion? Is it a polyp? It is why doctors ask patients to get a scan done.
Constipation is signaling that one of the drains in your body is clogged. You need to fix it. What happens when you let a clogged drain in your bathroom fester? It becomes a breeding space of dirt and bacteria and fills up the whole space with an unbearable stench. Your body follows the same principle. You need to get that poop out of your body. Don’t hold onto that waste in your system for long. It will become gassy, ferment, and damage the inner walls of your large intestine. It can lead to the absorption of toxins and bacteria into your bloodstream instead of eliminating them and leading to an array of issues like autoimmune conditions and infections, among others. So, address and fix your constipation. Learn five natural ways to ease it here.
Avoid making these pooping mistakes.
- Don’t try to poop when you can’t. People may not be constipated but sometimes in a hurry to pass out a stool they sit on the pot and keep pushing it out. Don’t do this.
- Don’t poop at different times of the day. You need to correct your bowel movement patterns. You can skip and change the schedule based on your convenience. Sit on the pot at the same time every day. In the same way that you retrain your body to sleep and eat at fixed times, maintain the biorhythm of your colon. Your mind and boy are connected. Everything works with anchors. Get your poop time and rhythms right.
- Don’t sit on the pot for a long time to scroll mindlessly on your phone or read books or newspapers. There is a time, space, and intention for everything. All you need to do is sit and pass a motion. That’s it.
When you have diarrhea or IBS and pass 5 to 6 motions a day, it can create abrasion in your anal region. For those who already have anal fissures, imagine passing motions multiple times a day where there’s an existing cut. It only leads to more inflammation. It is why you must address and manage IBS, ulcerative colitis, Chron’s disease, and other gut-related issues. You need to reduce inflammation at a gut level in order to improve your fissures.
Tight anal muscles
You can get fissures if your anal muscles are constantly tight. It is why kegel or pelvic floor exercises and hip flow exercises are important. Learn how to do kegel exercises here. These work to open your hip flexors, thigh muscles, glutes, and groin area.
Some yoga asanas that can help you manage anal fissures are Dhanurasana, Trikonasana, and Viparita Karani. These open up the entire anal region, allow air to pass through, and use muscle movement to generate healing.
Although if you suffer from recurrent anal fissures be careful or avoid certain movements that can make them worse. These can create more friction between your skin against the cut in the anal region.
What to avoid?
- Heavy weightlifting
Sitting for too long
If you have fissures, avoid sitting for long durations. It will only make the pain worse. Move around and be active.
A lot of people don’t want to talk about it. If you have fissures and piles and engage in anal sex, please understand you are doing more destruction to your system. We have known people who have had to go in for immediate surgeries after that because of the amount of thrust, abrasion, and infection that it can create. So be mindful of that.
Lifestyle and dietary changes to manage anal fissures
If you are already severely constipated by the time you are asked to change your diet or make lifestyle changes and your doctor has given you a laxative or a stool softener – use it. I would prefer you pass a motion than struggle to pass it out and create more abrasions. Use laxatives with an intention.
Tell yourself this: “I am using the laxative or a stool softener as a crutch right now because I have a problem that I don’t wish would get worse.” While you are taking it, take the effort to improve your diet and lifestyle too.
Now there are two types: insoluble and soluble fiber. Follow a balanced diet. Sometimes, your doctor or nutritionist may prescribe fiber supplements and those can work beautifully for you too. But if you have a case of ulcerative colitis, Crohn’s, or IBS where fiber creates more irritation to your gut lining, you need to go slower or lower on fiber. So your doctor and nutritionist will work with a combination of soluble or insoluble fiber that works best for you. Adopt a diet that is rich in whole grains, protein sources, vegetables, fruits, nuts, and seeds. It will give you sufficient fiber for your bowels to work the right way. Do not overdo or underdo fiber.
Triphala is an ancient remedy. It works brilliantly for some people, but not for others. But you lose nothing by trying it. Having a teaspoon of Triphala in the morning with a little bit of pure honey or pure ghee works is excellent. Having Triphala with plain water at night is also good. Make an informed decision. Triphala not just works as a laxative but also helps you to repair the gut and populate its microbiome.
Chew your food
Many people after slowing down from fast eating to chewing their food mindfully have reported back to me saying, “Luke, my constipation is getting better, my motions are well-formed, consistent, and flowing out easily.” This is a reminder that digestion starts in the mouth. Chew every bite.
If you have low stomach acid, you are unable to break down most proteins in your food. You have partly digested food entering your system. Your small intestines need to take the brunt of it. This undigested food passes on to the large intestines and into your rectal region and creates issues. Digestion is everything. It starts from the way you eat right up to your rectal region. So, work on the whole system, not just laxatives and stool softeners.
Stop abusing laxatives
Many people are abusing laxatives because they don’t want to make an effort to correct their bowel movements or diet. It will do you more damage in the long run. Very few people medically will have to have laxatives every day, for instance, those who have gone through colorectal surgeries or cancers or had a part of their rectum removed. For everyone else, you’re just being lazy and not looking at the root cause or changing your lifestyle.
Excessively relying on laxatives also causes increased cases of gut dysbiosis today, where along with your stool, it is also pushing out the good stuff your body needs. As a result, you have issues with your gut microbiome, feel bloated and acidic, struggle with weight gain, or experience acne, pigmentation, dull and thinning hair, and so on. There are no shortcuts. You can’t use a laxative more than the prescribed time.
Are there natural foods that work as laxatives? YES. Have a glass of carrot juice with a little bit of olive oil. Have medicated ghee in the morning. Eat your salads. If raw vegetables irritate your gut, you can steam or partially cook them.
If you are dehydrated, you are constipated. It is as simple as that. Some of the easiest money I have made in my career is from people who have taken appointments with severe constipation. When I look at their water intake, it is as less as 2 glasses! Tell them to have 9 to 10 glasses of water. In a week, they get back, “My constipation has disappeared.” So, stay adequately hydrated.
Follow a simple diet
- When you have problems with your gut, the first line of action is to move to a simple diet.
- Stop your junk, sugar, dairy, and gluten. Have khichdi and semi-soft foods.
- Move back to your fruits and vegetables. Let the gut relax and allow the inflammation to reduce. Once your gut begins to heal and become stronger, start reintroducing other foods.
- When you have a fissure, avoid eating spicy foods. They make you more acidic and add to the burning sensation making fissures unbearable.
- Some superfoods for fissures are carrots, walnuts, and green tea, among other foods.
Eat on time
One of the most important pieces of advice is to eat on time. There is a biorhythm in your body. When you eat, there’s a signal in your body that induces you to poop, a couple of hours later. When you eat a meal, it goes to your intestine, you absorb all your nutrients, and the waste moves down. Once the digestion is complete, the next step is elimination. This is your biorhythm. I don’t care if you are a billionaire, millionaire, or the busiest person in the world, it works the same for everyone. If you respect this rhythm, you will have good health. If you abuse it, you have disharmony and disease. Your body may learn to adjust to your irregular cycles because it works on the principle of survival and adaptation. But
while you push it beyond that set point, it will break down.
Address your emotional constipation
There is always an emotion involved with every condition in the human body. People with recurrent fissures (no matter what they do), need to look at their deep-seated emotions. Whatever you are holding on to, you need to let it out. It can affect your gut health. Analyze the emotional part of your journey if you have constant anal fissures.
What can you apply?
You may be prescribed steroidal creams to soothe the cuts. One of the best and most effective ways is to use pure coconut oil. Take some on your fingers. Apply it to the cut in the anal region. Do this before you sleep at night and in the morning before you pass a motion. Apply it 3 to 4 times a day if you can. Once you have oiled your anus, it will feel a little bit funny while you walk but you will get used to the feeling.
If coconut oil doesn’t work for you, use pure ghee. It works two ways. It is highly anti-inflammatory and also works as a lubricant. When some people pass a motion, the first stool is hard. But the rest of it is well-formed and easy to flow out. Lubrication is sometimes required when the anal muscles get too tight. Even if you’re slightly constipated, try this remedy. It will help you poop easily and not upset the already existing fissure.
Hot water and Epsom salt sitz
You can try hot baths or sitz. These are also great. Take hot water in a bucket, but ensure it is not hot enough to burn you. Put some Epsom salt in it. Slowly lower yourself or squat into the water. The anal region opens up, and you have a little heat and warm water touching the fissure. It can help with relief.
My baby has anal fissures. What should I do?
Yes, even babies can get fissures when they are constipated. Follow the same protocol and ensure you change their nappies regularly. Nappy rashes make fissures worse. Don’t allow waste to stay in their diapers for a long time.
Anal fissures take about 3 to 6 weeks to heal completely. You can help your body do this best by giving it the right internal and external environment, foods, movement, sleep, and emotional wellness.
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