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Anal fistula, also known as fistula-in-ano, is an abnormal channel that develops between the anal canal and the skin near the anus. It usually occurs due to an anal infection that causes accumulation of pus (abscess) in the anal area. This pus keeps on being released out through the channel.  

There are numerous glands present just inside the anus. An abscess may develop if one of these glands is blocked. About 50% of these abscesses result in the formation of fistulas. Rarely, a fistula may be caused by other processes like Crohn’s disease, tuberculosis, trauma, sexually transmitted diseases or cancer.

According to a pathological study, anal fistulas are commonly seen in the age group of 31 to 60 years, with a higher tendency in females. Anal fistula leads to unpleasant symptoms, such as discharge of pus, pain, discomfort and surrounding skin irritation. Generally, it does not heal on its own and requires surgical intervention.

Sometimes, the surgery may be performed more than once if a large amount of muscle needs to be cut. Extreme caution is needed while performing the surgery to avoid damaging the anal sphincter and affecting bowel emptying.

In recent years, the treatment for anal fistula has shifted from surgery to medical methods since surgery tends to permanently damage the internal anal sphincter and increases the risk of anal incontinence.

Homeopathy offers a non-surgical alternative to treating anal fistulas. Unlike conventional medicines, homeopathic medicines are given on the basis of the physical and mental traits of an individual and just their clinical symptoms.

When taken in the right dosage, as per the prescription of a qualified doctor, these remedies stimulate the person’s innate immunity and help heal anal fistulas in a non-invasive, safe and effective manner. Some of the commonly used remedies for anal fistula are berberis vulgaris, silicea, causticum and hydrastis canadensis. 

  1. Homeopathic medicines for anal fistula
  2. Dietary and lifestyle changes for anal fistula as per homeopathy
  3. How effective are homeopathic medicines and treatments for anal fistula
  4. Side effects and risks of homeopathic medicine and treatment for anal fistula
  5. Takeaway
  • Berberis Vulgaris
    Common Name: Barberry
    Symptoms: Berberis vulgaris works well in those who have a low threshold for pain. Patients who benefit from this remedy show sudden changes in symptoms, such as hunger with loss of appetite, radiating pain and alternating feelings of thirst with thirstlessness. They also experience the following symptoms:

    • Painful urination
    • Constant urge to pass stool
    • Pain and burning in anus and perineum (area between the anus and vulva in women and between the anus and scrotum in men)
    • Pain and burning feeling in testicles and scrotum in male (Read more: Testicular pain treatment)
    • Tearing of skin around anus

Symptoms aggravate on standing at one place for long and with continuous movements like active exercise.

  • Causticum
    Common Name: Hahnemann’s tinctura acris sine kali
    Symptoms: This remedy is mainly used to treat tearing pain in muscles and fibrous tissue. It is also effective against weakness that tends to progress to paralysis of muscles. Patients who benefit from this remedy experience some of the following symptoms:
    • Hard stool that is greasy or is covered with mucus
    • Partial paralysis of rectum 
    • Straining while expelling stool
    • Pain along with a burning sensation in rectum
    • Piles

Symptoms worsen in cold weather, on exposure to dry, cold winds and on moving about. Symptoms improve in rainy and humid weather and from the warmth of the bed 

  • Silicea Terra
    Common Name:
    Silica, pure flint (silicea)
    Symptoms: Silicea works well for the treatment of abscesses, spasms, epilepsy and distended abdomen. The following conditions also respond to this remedy:

    • All types of fistula like anal fistula, fistulous ulcer in breasts, boils and fistulous tracts under the skin 
    • All diseases related to pus formation
    • Straining and stinging pain in rectum
    • Haemorrhoids

Symptoms aggravate in cold weather, in the morning, on lying down, and washing the affected area. However, the complaints improve in summers and in humid or wet weather. 

  • Hydrastis Canadensis
    Common Name:
    Golden seal (hydrastis)
    Symptoms: Hydrastis works best in elderly patients who get tired easily. It acts on the mucous membranes (inner lining of the gut and other organs) and is used to treat peculiar discharge of mucus (thick, ropy secretion). Patients who benefit from this remedy also experience other symptoms like:

    • Muscle weakness
    • Burning in chest
    • Bronchitis, especially in old patients
    • Weak digestion
    • Constipation
    • Anal fissures
    • Smarting (sharp and stinging) pain in rectum while passing stools and for long after emptying bowels
    • Piles 
  • Calcarea Phosphorica
    Common Name:
    Phosphate of lime
    Symptoms: Phosphate of lime is prescribed to those who get chest symptoms alternating with anal fistula. Patients who benefit from this remedy also exhibit the following symptoms:

    • Forgetfulness
    • Weak digestion
    • Numbness along with crawling sensations
    • Hard stool resulting in bleeding
    • Hot, undigested stool with bad-smelling flatus

Symptoms worsen in cold and damp conditions and they improve in dry and warm weather and especially in summer. 

  • Nitricum Acidum
    Common Name:
    Nitric acid
    Symptoms: Nitric acid acts on all the areas in the body where the mucus membranes meet skin. It is most effective in patients who are dark-complexioned and have crossed the middle life. Common symptoms that can be treated with this remedy are:

    • Fissures
    • Constipation
    • Pain while passing stool
    • Irritability
    • Bleeding from bowel
    • Violent pain after passing stools, which lasts for hours
    • Foul-smelling sweat, urine, and stools

Symptoms worsen in the evening and at night but improve while riding in a carriage 

  • Staphysagria
    Common Name:
    Stavesacre
    Symptoms: Staphysagria is used for the management of genito-urinary conditions. It works well in sensitive individuals who are easily annoyed and exhibit violent outbursts of passion. They also experience symptoms like:

    • Sunken eyes and a tendency to get styes
    • Colicky pain on being angry
    • Bleeding gums and black crumbling teeth
    • Constipation
    • Stomach gas and abdominal swelling in children 
    • Haemorrhoids

Symptoms worsen on touching the affected area, on using tobacco and with increased sexual activity. Symptoms get better with rest at night and after breakfast. 

  • Thuja Occidentalis
    Common Name:
    Arbor vitae
    Symptoms: Patients who benefit from this remedy tend to have a fixed set of ideas and they feel as if there is something alive in their abdomen. Thuja occidentalis acts well on the skin, gastrointestinal tract, and genito-urinary organs. It helps treat the following symptoms:

    • Eye pain (ciliary neuralgia with dry, scaly eyelids
    • Severe headache, mainly on the left-side
    • Inflammation of sclera (the white part of the eye)
    • Chronic diarrhoea that worsens after breakfast
    • Loss of appetite
    • Abdominal distention along with flatulence
    • Anal fissures 
    • Constipation along with aggressive pain in the rectum
    • Piles
    • Stitching and burning pain in anus

Symptoms worsen at night, in damp air, from the heat of bed, on consuming coffee and after breakfast. All complaints get better when the patient lies down on their left side or draws their limbs upwards.

  • Carbo Vegetabilis
    Common Name:
    Vegetable charcoal
    Symptoms: Carbo vegetabilis is given to lazy and sluggish people who are overweight or fat, experience hyperventilation and faint very easily. These patients like to have all the windows open. Symptoms that indicate a need for this remedy are:

    • Hair fall with itchy scalp
    • Sudden memory loss
    • Heavy and constricted feeling in the head
    • Contracting pain in the stomach that extends up to the chest
    • Bleeding from nose and gums
    • Slow digestion resulting in rotting of food in stomach
    • Inability to wear tight clothing
    • Abdominal distention
    • Itching and burning in rectum and perineum
    • Burning in the anus area
    • Bluish, burning piles with pain after passing stools 

Symptoms worsen in damp and warm weather, in the evening and night, on consuming cold food, coffee, butter or wine. Symptoms improve in cold conditions and after burping. 

  • Kali Carbonicum
    Common Name:
    Carbonate of potassium (kali carbonicum)
    Symptoms: Kali carbonicum is used to treat depression, coldness and stitching pain in any part of the body. Individuals who benefit from this remedy are highly intolerant to cold, irritable, anxious and hypersensitive to touch. They also experience the following symptoms:

    • Constant feeling that one's stomach is filled with water
    • Gagging, flatulence, and nausea which improve on lying down 
    • Headache on being exposed to cold wind
    • Ulceration and itching around the anus
    • Piles
    • Dry hair with severe hair fall
    • Large stools that are difficult to pass
    • Burning in the rectum and anus

Symptoms get worse in cold weather, in the morning at about 3 am and while lying on the left side, whereas they get better in warm weather, during the daytime and while moving. 

  • Paeonia Officinalis
    Common Name:
    Peony (paeonia)
    Symptoms: Paeonia officinalis is used to treat rectal ulcers and conditions that affect the rectum and anus. Patients who benefit from this remedy are very nervous and experience vertigo while moving. They also exhibit other symptoms like:

  • Swelling and itching in anus 
  • Nightmares
  • Diarrhoea along with burning sensation in anus
  • Painful ulcers on the skin like bedsores
  • Varicose veins
  • Haemorrhoids; presence of crusts on anus along with purple discolouration of the anal area 

Homeopathic medicines are extremely diluted natural substances that are administered in minute doses based on the patient’s personality and severity of the disease. The action of these remedies can get easily affected by certain lifestyle and dietary habits. To prevent this, homeopathic physicians advise their patients to include the following modifications in their daily regime: 

Do’s: 

  • Maintain an active lifestyle and cultivate healthy food habits.
  • Live in a clean and hygienic environment. 
  • In acute cases, it is advised to gratify the patient’s desire for food and drink, without persuading any diet that may hinder the effect of medicines.

Don’ts: 

  • Beverages like coffee, herb teas and beer or liquor with medicinal substances are best avoided as they affect the efficacy of homeopathic medicines. 
  • Excessively heated rooms, as well as woollen and tight clothing, must be avoided in warm weather.
  • Overexertion of mind and extreme emotions must be avoided.

Homeopathy is a personalised system of medicine. Every individual gets a unique set of remedies that may or may not work well in other patients. Scientific studies show that homeopathic remedies can be used to treat anal fistula. 

A case study conducted in India reported the positive effect of homeopathy in anal fistula. The case involved an unmarried woman who was unsuccessfully operated on thrice for anal fistula without any positive outcome. The woman was given homeopathic remedies like silicea, and myristica sebifera to be taken weekly after bedtime. Within four months of treatment, the patient's fistula was found to be improved and she did not experience pain on passing stools. 

In another case study, a man with anal fistula was treated with strict homeopathic regimen (remedies along with lifestyle and dietary modifications) for about four months before he reported symptomatic improvement. The condition was observed to be completely resolved after the completion of the treatment.

The biggest advantage of homeopathic treatment is that the medicines have minimum or no side effects. These remedies are said to be safe for patients of all age groups either as a standalone therapy or as an adjuvant with conventional treatment. 

It is best to consult a qualified doctor before taking any remedy.

Anal fistula is a tube that connects the anal area with the skin near the anus. It usually develops due to an anal abscess and is conventionally treated with surgery.

Homeopathy provides a non-invasive option for the treatment of anal fistula. It aims to treat the patient as a whole instead of focusing on symptomatic improvements alone. Case studies show that individualised homeopathic remedies can safely and effectively treat anal fistulas, preventing the need for surgery and providing permanent relief from the pain and everyday discomfort. A qualified homeopathic practitioner should be consulted for the therapy to achieve optimal benefit and rapid recovery. 

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References

  1. Cleveland Clinic. [Internet]. Cleveland, Ohio. Anal Fistula
  2. Department of Surgery. Anal Fistula. University of California San Francisco; [internet]
  3. William Boericke. Homoeopathic Materia Medica. Kessinger Publishing: Médi-T 1999, Volume 1
  4. British Homeopathic Association. Is homeopathy safe?. London; [Internet]
  5. National Center for Complementary and Integrative Health [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Homeopathy
  6. Dutta Abhijit. A Case of Anal Fistula Treated by Individualized Homoeopathic Medicine. ijms. 2019; 7: 1-3.
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