Chronic Fissure in Ano: Case Study on Conservative vs. Surgical Care
Journal name: Ayushdhara
Original article title: Management of Chronic Fissure in Ano: A Case Study on Conservative vs. Surgical Treatment Approaches
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Govind Meghvansi
MS Scholar, Department of Shalya Tantra, Post Graduate Institute of Ayurved, Dr S. R. Rajasthan Ayurved University, Jodhpur, Rajasthan, India.
Ram Karan Saini
MS Scholar, Department of Shalya Tantra, Post Graduate Institute of Ayurved, Dr S. R. Rajasthan Ayurved University, Jodhpur, Rajasthan, India.
Vishnu Dutt Sharma
Associate Professor, Department of Shalya Tantra, Post Graduate Institute of Ayurved, Dr S. R. Rajasthan Ayurved University, Jodhpur, Rajasthan, India.
Rajesh Kumar Gupta
Professor & HOD, Department of Shalya Tantra, Post Graduate Institute of Ayurved, Dr S. R. Rajasthan Ayurved University, Jodhpur, Rajasthan, India.
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: Management of Chronic Fissure in Ano: A Case Study on Conservative vs. Surgical Treatment Approaches
Year: 2024 | Doi: 10.47070/ayushdhara.v11i2.1527
Copyright (license): CC BY-NC-SA 4.0
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Summary of article contents:
Introduction
Chronic fissure in ano, commonly known as anal fissure, is a painful condition that can significantly disrupt a patient's quality of life. Although acute fissures often heal spontaneously, chronic cases necessitate timely intervention due to persistent symptoms. The challenge lies in selecting the optimal treatment approach, balancing effective clinical outcomes with patient comfort. This case study examines the management of chronic fissure in a 45-year-old male patient, contrasting conservative treatment methods with surgical options to determine the most effective strategy for relief and healing.
Conservative vs. Surgical Treatment
The case study presents two treatment arms: conservative and surgical. The conservative management approach incorporates dietary changes, stool softeners, topical analgesics, and sitz baths, focusing on symptom relief and healing promotion. In contrast, the surgical arm typically employs techniques like lateral internal sphincterotomy (LIS), which addresses underlying issues like sphincter hypertonicity. A pivotal aspect of this study is the examination of both methods based on pain scores, healing rates, and recurrence statistics. Notably, the surgical intervention demonstrated significant improvement in symptoms and quality of life for the patient, emphasizing the value of selecting an effective treatment modality based on individual patient circumstances.
Shared Decision-Making in Treatment Selection
The importance of shared decision-making between healthcare providers and patients is another critical element highlighted in the case study. The persistence of the patient's symptoms and their failure to respond to conservative measures led to a joint evaluation of options. The patient's active involvement in the decision-making process was crucial, ultimately leading them to opt for surgical intervention. This collaborative approach ensured the treatment plan aligned with the patient鈥檚 preferences and values, improving both satisfaction and treatment outcomes. Such patient-centered care is pivotal in optimally addressing chronic conditions and enhancing the therapeutic relationship.
Conclusion
In conclusion, the management of chronic fissure in ano requires a nuanced understanding of various treatment modalities and the need for individualized care. This case study underscores the complexities of chronic fissure management and highlights the potential effectiveness of surgical interventions, particularly when conservative methods fail. By utilizing a multidisciplinary approach and fostering shared decision-making, healthcare providers can deliver tailored solutions that yield favorable outcomes and substantially improve patient quality of life. Future research with larger patient cohorts will be beneficial in validating these findings and refining treatment strategies for similar clinical situations.
FAQ section (important questions/answers):
What are the common treatments for chronic fissure in ano?
Common treatments include conservative methods like dietary changes and topical analgesics, as well as surgical options like lateral internal sphincterotomy, which aims to relieve symptoms and promote healing. The choice depends on the severity of symptoms and patient preference.
How is a chronic fissure in ano diagnosed?
Diagnosis typically involves a thorough medical history and an anoscopy, which allows healthcare providers to visualize the anal canal directly, confirming the presence of a fissure while ruling out other conditions such as hemorrhoids or abscesses.
What are the expected outcomes after surgical treatment for fissures?
After surgery, patients often experience significant pain relief and healing of the fissure. Complications are uncommon, and many patients report a notable improvement in their overall quality of life, with a low risk of recurrence.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for 鈥淐hronic Fissure in Ano: Case Study on Conservative vs. Surgical Care鈥�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Pain:
Pain is a significant symptom of anal fissures, which are painful ulcers in the lining of the anus. Chronic pain during defecation is often a primary reason patients seek treatment, either through conservative measures or surgical intervention.
2) Swelling:
Swelling in the anal region, or Gudapradeshialpashoth, is a common symptom of chronic fissures in ano. It contributes to the discomfort experienced by patients and is targeted in treatments aimed at promoting healing and reducing inflammation.
3) Parikartika:
Parikartika is the Ayurvedic term for chronic fissure in ano, understood as a condition influenced by aggravated Vata and Pitta doshas. The management of Parikartika involves pacifying these doshas to relieve symptoms and promote healing.
4) Blood:
Blood in stools, or Saraktamalapravrutti, is a symptom of chronic fissure in ano. Patients may experience stools streaked with blood due to the ulceration and inflammation of the anal lining.
5) Discussion:
The Discussion section of the paper elaborates on the clinical presentation, diagnostic challenges, and treatment decision-making for chronic fissure in ano. It highlights the importance of shared decision-making between healthcare providers and patients.
6) Dosha (Dosa):
Dosha refers to the fundamental bio-elements in Ayurvedic medicine, such as Vata and Pitta. The management of chronic fissure in ano includes strategies to balance these doshas, thereby promoting healing and reducing symptoms.
7) Food:
Dietary recommendations are a part of the conservative management for chronic fissure in ano. Patients were advised to avoid spicy and non-veg food, and consume fibers, buttermilk, and cow ghee with warm milk to ease symptoms and facilitate healing.
8) Drug:
Various drugs were used in the conservative treatment of chronic fissure in ano, such as Shatdhout Ghrut for wound healing and Kaishor Guggul to reduce pain and swelling. These medications play a crucial role in symptom management.
9) Burning sensation:
Burning sensation, or Gudapradeshidaha, in the anal region is a symptom of chronic fissure in ano. It is addressed in treatment plans to alleviate patient discomfort and promote healing of the fissure.
10) Cow milk (Cow's milk):
Cow milk, especially taken with cow ghee, is recommended as part of the diet for patients with chronic fissure in ano to aid digestion and reduce constipation, contributing to overall symptom relief.
11) Pharmacological:
Pharmacological interventions for chronic fissure in ano include the use of stool softeners and topical analgesics. These are part of the conservative treatment approach aimed at relieving symptoms and promoting healing.
12) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
Shalya Tantra is a department in Ayurvedic medicine focusing on surgical techniques. The study includes authors specializing in Shalya Tantra, highlighting its relevance in the surgical management of chronic fissure in ano.
13) Pittadosha (Pittadosa, Pitta-dosha):
Pitta dosha is one of the bio-elements in Ayurvedic medicine. Aggravation of Pitta dosha is believed to contribute to the symptoms of chronic fissure in ano, thus treatments aim to pacify this dosha.
14) Butter milk (Buttermilk):
Buttermilk, often mixed with Jeera and Saindhav, is recommended in the diet for patients with chronic fissure in ano. It helps improve digestion and supports overall treatment objectives in conservative management.
15) Rajasthan:
Dr. S. R. Rajasthan Ayurved University in Jodhpur is the institution where the authors of the study are affiliated. It signifies the regional context and the academic backing for the research on chronic fissure in ano.
16) Knowledge:
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17) Samhita:
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18) Jatyadi:
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19) Tantra (Tamtra, Tantrism):
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20) Vishnu (Visnu):
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21) Shalya (Salya):
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22) Repair:
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23) Sharman (Sarma, Sharma, Sarman):
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24) Nature:
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25) Debate:
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26) Pitta:
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27) Gupta:
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28) Kumar:
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29) Ayus (Ayush):
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30) Ulcer:
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31) Picu:
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32) Vata:
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33) Diet:
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34) Ghi (Ghee):
[see source text or glossary: Ghee]
35) Milk:
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36) Gold (Golden):
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Other Science Concepts:
Discover the significance of concepts within the article: 鈥�Chronic Fissure in Ano: Case Study on Conservative vs. Surgical Care鈥�. Further sources in the context of Science might help you critically compare this page with similair documents:
Holistic approach, Dietary modification, Anal fissure, Recurrence Rate, Multidisciplinary approach, Chronic fissure-in-ano, Pain score, Patient satisfaction, Lateral internal sphincterotomy, Diagnostic Findings, Postoperative course, Shared decision-making.