Ayurvedic Treatment for ANORECTAL STRICTURE

Ayurvedic Treatment for Anorectal Stricture is planned to address the root cause of the disease and internal herbal medicines and external Ayurvedic procedures are adapted to treat the disease. An anal stricture means it is the narrowing of the anal canal. It’s also known as anal stenosis. It’s caused by scar tissue in the anal canal.

  • Signs and symptoms of anorectal stricture
  • Causes of anorectal stricture
  • Pathophysiology of anorectal stricture
  • Diagnosis of anorectal stricture
  • Treatments of anorectal stricture
  • Complications of anorectal stricture
  • Sannirudha guda in Ayurveda
  • Samprapthi (Maturation) and Lakshana of Sannirudha guda
  • Chikitsa (Treatment) of Sannirudha guda
  • Diet desirable to prevent Charmakeela
  • Yoga
  • Research articles link

Signs and Symptoms

The symptoms of an anal stricture include,

  • Strenuous, painful and infrequent bowel movements
  • Bleeding per rectum
  • Incontinence of stools
  • Anal discomfort
  • Rectal or anal tearing

Causes

The cause for the development of Anorectal stricture is the development of scar tissue following anorectal surgery. This includes surgery for haemorrhoids, anal fistula, etc. the surgery can cause a stiff scar that causes narrowing of the anal canal. Also, this occurs in diseases like inflammatory bowel disease, tuberculosis, radiation therapy, etc.

Pathophysiology

Ninety per cent of anal stenosis is caused by overzealous haemorrhoidectomy. The removal of large areas of anoderm and hemorrhoidal rectal mucosa, without sparing of adequate mucocutaneous bridges, leads to scarring and a progressive chronic stricture.

Diagnosis

Physical examination is used to confirm the diagnosis along with history taking of signs and symptoms. The visual examination of the anal canal, perianal skin along with digital rectal examination is done for the diagnosis of Anorectal stricture.  

Treatments

The treatment is selected considering its severity. In the case of mild stenosis, it is conservatively managed using stool softeners. A mild type of stricture is managed by sphincterotomy. A formal anoplasty is done to reconstruct the lost anal canal tissue to manage severe cases of anorectal stricture. Conservative management is adopted in every case.

Anoplasty in anal stricture includes,

  • Partial lateral internal sphincterotomy
  • Mucosal advancement flap
  • Y-V advancement flap
  • V-Y advancement flap

In postoperative care, it is advised to take a fibre-rich diet, bulk laxatives, etc. Sitz bath is done for comfort and hygiene.

Prognosis

The condition can be managed conservatively or by surgery in severe cases.

Complications

Anorectal stricture itself is a complication of surgery in the anal canal like haemorrhoidectomy. The surgical management of anal stricture can cause damage or weakening of sphincter muscles. Faecal incontinence can also occur. 

Disease and Ayurveda

In Ayurveda, Anorectal stricture can be correlated as Sannirudha guda.

Nidana- Causes

The causes include suppression of natural urges especially pureesha vega (urge of defecation) and adhovata leads to the aggravation of vata leading to the formation of stricture in the anus. Along with this, it can be developed as a complication of surgical procedures done for arsas and parikarthika Sannirudha.

Samprapthi and Lakshana Signs and Symptoms

Vata gets vitiated due to suppression of apana vata and the natural urges obstruct the mahasrota(alimentary canal) and narrow down the guda marga (anal canal) causing difficulty in defecation.

Prognosis

The condition can be maintained using the proper treatment and so is yaapya. Since this is an anatomical deformity the disease is not completely cured using medicines.

Chikitsa- Treatment

In Sannirudha guda the gradual dilatation is done as the treatment by Susruta acharya. Smearing with ghee and dilatation is done.

Home Remedies and Diet

Stool softeners and high fibre content food are advised. Sitz bath in lukewarm water helps to ease the area.

Yoga

The yoga postures beneficial in anorectal diseases include,

  • Pavanamukthasana
  • Baddhakonasana
  • Ardhamatsyendrasana
  • Halasana
  • Balasana
  • Adhomukha svanasana

Research articles link.

http://www.iamj.in/prposts/2017/images/upload/701_708.pdf

http://aiirjournal.com/uploads/Articles/2018/08/3381_18.Dr.%20Ankita%20Ashokrao%20Sulkekar%20&%20Dr.%20Sanjay%20C.%20Babar.pdf

Click to access Patil%20Preeti%20P.pdf

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