EFFICACY OF MARHAM-E-HINDI VERSUS LATERAL INTERNAL SPHINCTEROTOMY IN TREATMENT OF SHIQAQ-UL- MAQAD(ANAL FISSURE)

An anal fissure is a tear in the mucous membrane of the anal canal.. Anal fissures are most common in young adults. It is more common in women than in men. Fissure in ano is caused by a combination of internal anal sphincter hypertonicity and ischemia in the posterior midline region of the anal canal as a consequence of constipation. Anal Fissure treatment includes discomfort spasm and ischemia suppression. Medical sphincterotomy involves the use of a topical ointment containing a calcium channel blocker such as diltiazem. A common recommendation is to treat anal fissures conservatively rather than surgically.. According to the 2014 American College of Gastroenterology clinical recommendation on the management of benign anorectal diseases, acute anal fissures should be managed nonoperatively in the initial phase.. Acute fissures could lead to severe recurrent pain after defecation, although chronic fissures often cause less pain. The typical history of discomfort, bleeding, discharge, and clinical findings assist in diagnosing it., In the Unani System of Medicine, Shiqaq-ulMiqad (fissure in Ano) is a very common and painful condition9. Atibba states that Shiqaqul-Maqad is a breach in the anal mucosa due to Ghalbae Yaboosat and Hararat. The fecal matter becomes dry and hard during defecation it disrupts the anal mucosa. It may also be due to haemorrhoids, tortuosity of rectal vessels, proctitis, Ishaal and Warme Miqad Haar, Saudavi or Reehi,. The patient complains of intense, sharp, biting, and burning pain in the perineum. There are two types of Anal fissures: acute and chronic. Acute fissures present with a tag of hypertrophied skin called a sentinel pile and a hypertrophied papilla with a canoe-shaped ulcer in between.. Acute fissures normally heal with conservative treatment which involves analgesics, stool softeners, local anesthetic agents, a high fiber diet, and plenty of oral fluids. . Surgical intervention such as lord’s dilatation of the anal canal and lateral sphincterotomy should be performed in chronic fissures and if conservative treatment fails in acute fissures.