Acupuncture treat anal fissure

Anal fissures are caused by trauma to the anus and anal canal. The pain and inconvenience is very dramatic. The cause of the trauma usually is a bowel movement, and many people can remember the exact bowel movement during which their pain began. The fissure may be caused by a hard stool or repeated episodes of diarrhea which can be repeated happening during the onset of the disease. Occasionally, the insertion of a rectal thermometer, enema tip, endoscope, or ultrasound probe (for examining the prostate gland) can result in sufficient trauma to produce a fissure. During childbirth, trauma to the perineum (the skin between the posterior vagina and the anus) may cause a tear that extends into the anoderm. The fissure once starts, can be very difficult to heal as it is repeatedly under stress and attacked. Usually the anal muscle once exposed in the fissure area will be sensitive and contract due to any impact, such as stool, water, fart, or fall bladder, or intestine weight pressure while standing. Also cramping is caused by reactive contraction, and movement is counter active to alleviate the condition.

The most common location for an anal fissure in both men and women (90% of all fissures) is the midline posteriorly in the anal canal, the part of the anus nearest the spine. Fissures are more common posteriorly because of the configuration of the muscle that surrounds the anus. This muscle complex, referred to as the external and internal anal sphincters, underlies and supports the anal canal. The sphincters are oval-shaped.

Nature healing has been introduced at many places. I generalize in the following points
1) drink more water, eat high fiber food and avoid spicy food
2) avoid diarrhea.
3) rinse/clean anal area with hot/warm water before and after bowel movement
4) try to set bowel movement after dinner so that trauma area can have more time healing while body is relaxed during sleeping. Also lying position is more comfortable than standing.
5) avoid multiple bowel movements during the day. Only once after dinner. Reason not to have bowel movement in the morning is that the pain afterward might be aggravated in standing position and also the breakfast can triggered the bowel movement and make you feel the need for toilet once again.
6) relax the mind, so that the anal muscle can relax.
7) might have some OTC insert for lubrication, antibiotic or pain relief.

Surgery which cut some muscle fiber and close wound is found effective, but the con side are
1) longer time of recovering
2) possibility of incontinence.

Acupuncture has been a less invasive and conservative means to treat anal fissure.

There also some clinic test which give positive results. On page 36 of issue #5, 2005 of the Zhen Jiu Lin Chuang Za Zhi (Clinical Journal of Acupuncture & Moxibustion), He Zhou and Lu A-li published an article titled, “Clinical Observations on the Acupuncture Treatment of 60 Cases of Anal Fissure.” A summary of this article is presented below.

Treatment method:

Acupuncture was performed at Chang Qiang (GV 1), Da Chang Shu (Bl 25), and Qu Chi (LI 11). Twisting hand technique was used to obtain and move the qi, and strong needle sensation was used to promote retention of this qi and to prevent its dispersion. The needles were retained for 30 minutes, and treatment was carried out once every other day, with 10 treatments equaling one course. Results were analyzed after one course. During this course of treatment, patients were forbidden to eat acrid, peppery foods and were advised to increase their consumption of high fiber foods. They were also encouraged to keep their anal region clean and their defecations smoothly and freely flowing.

Study outcomes:

Cure was defined as complete disappearance of symptoms and healing of the fissures in the anal region. Improvement meant that the symptoms disappeared and that the lesions had basically closed. No effect meant that there was no obvious improvement in symptoms and that the opening of the lesions had not changed. Based on these criteria, 48 cases (80%) were judged cured, 10 cases (16.6%) improved, and two cases (3.3%) got no effect. Therefore, the total effectiveness rate was 96.7%.

The treatment modality can be extended to diarrhea, dysentery, hematochezia, constipation, hemorrhoid, proctoptosis or further conditions like epilepsy and mania, pain in the lower back.