Hello again!

The colourful festival of Holi is over.  This signifies that cold season is over and heat has started to rise.  Some heat-related ailments have started to show up.  Piles, fissure, and fistula are some of these.  Symptoms are painful stools, burning sensation, and/or bleeding.  There are two types in these, bleeding or non-bleeding.

Individuals with pitta predominance are prone to get these conditions, especially during hot season. Improper digestion most often is the underlying reason for all anal conditions.  Digestive fire is called as ‘Agni.’ This ‘agni’ must be protected in order to remain free of such diseases.

Pitta provoking diet such as chili, hot spices, alcohol may lead to sudden outburst of these underlying conditions, especially in hot season.

Total lack of ghee in the diet may lead to a kind of 'dryness'in the body.  This sort of dryness could indeed be one of the causes of anal fissure.

The treatment of these conditions includes internal medication such as Surana vatak, triphala guggulu, abhayarishta, etc.   Also local application of ghee, or ghee based ointments are really helpful.  For immediate pain relief, application of leech has always proved to be useful.   There may be some variations according to other doshas (e.g. triphala guggul is not suitable for patients with acidity, etc.).  Medications should be aimed to improve digestion. Few patients need basti treatment (mocharasa picchabasti and oil basti alternately).

Prolonged sitting or driving, may worsen this condition and hence these should be avoided.  If not possible, frequent change of position is advisable.