Anal fissure

The symptoms of anal fissure can often be relieved by wheatgrass which, although you may not know it, has quite remarkable pain-relieving and healing properties.

So, you may not need to change your diet, drink gallons of water, use stool softeners or load your bowel with fibre. You might also be relieved of the pain and bleeding that can be so distressing.

Surgery and other expensive, time-consuming procedures should only be considered as a last resort.

What is anal fissure?

location of anal fissure
Fig. 1. Where anal fissure is located

A fissure is a split or tear at the outer end of the anal canal wall, usually at the posterior or back side of the anus. In chronic fissures, a skin tag, known as a ‘sentinel pile’ often develops at the edge of the anal opening and can be mistaken for a painful hemorrhoid.

The power of wheatgrass healing

Anal fissure results from a breakdown in the anal wall which can persist for weeks, months or even years. Wheatgrass, because of its remarkable healing and anti-inflammatory properties can significantly assist many fissure sufferers by stopping bleeding, easing pain and assisting the healing process.

An example of how effectively wheatgrass can heal is shown in the pictures below. This is a skin graft that has been treated by standard medical means for six weeks. It is healing very slowly and looks unhealthy (Fig. 1) because of poor blood supply. Wheatgrass extract was applied at this stage, and in Fig. 2, after only 2 days, the graft is already recovering well and the blood supply has restored vitality to the wound. In Fig. 3. the graft has completely healed in just 3 weeks. One would therefore expect wheatgrass to heal other “wounds” such as anal fissure.

Skin graft before wheatgrass
Fig. 1. Skin graft before wheatgrass

Skin graft wheatgrass healing
Fig. 2. Two days later. Note healthy appearance

Fig. 3. Graft completely healed 3 weeks

How does wheatgrass work for anal fissure?

Having used wheatgrass on thousands of patients successfully for a variety of conditions it is clear that it
facilitates natural healing e.g. for wounds, burns, etc. One can sometimes observe the healing process in
burns and infected wounds for example. The open wound is re-covered with a thin film of new cells in 24-48 hours. Often the patient’s pain disappears as well – phenomena that are not often seen when the body is healing itself unaided.

It is well known that cell messengers produced by the body called Growth Factors are an essential and very important part of the healing process, including reduction of inflammation. It may be that wheatgrass facilitates  production of these growth factors that help ‘normalize’ damaged tissue and facilitate healing. Whatever the process, wheatgrass is clearly an effective natural healing agent.

What are the symptoms of anal fissure?

  • Pain, which can be severe, during and after bowel movements
  • Bright red blood in the stool (blood on the toilet paper)
  • Constipation – due to pain causing avoidance of passing stool
  • Anal itchiness, burning
  • Difficulty in passing urine

Why is there so much pain?

The area where anal fissure occurs is supplied by numerous nerve endings that are highly sensitive. Even a tiny split in the wall of the anal canal can be very painful, particularly during a bowel motion when the anal muscles are stretched.

Who gets anal fissure?

Anal fissure is very common. For example, an estimated 250,000 new cases occur each year in the US alone. It can occur in newborns and right across the age spectrum to old age, and affects both sexes equally. It is most common from young adulthood to middle age. Pregnancy and childbirth can aggravate or initiate the condition.

How long does it last?

Approximately 50-60% of anal fissures will heal spontaneously. However it can recur or become chronic (sometimes lasting for years) in the other 40-50%.

How is anal fissure diagnosed?

Symptoms of pain and rectal bleeding will alert your doctor to make a simple examination of the outer end of the anal canal. If an acute fissure is present, it will look like a small tear in the posterior (the back end, near the spine) of the anus as shown in Figure 1. Chronic fissures have thickened edges and often a “sentinel pile” can be seen.

If bleeding is present, further investigations such as colonoscopy to exclude other causes of blood loss may be necessary.

How is anal fissure treated?

There are a number of applications your doctor could prescribe but which might also cause unwanted side effects. Instead, my approach is to use wheatgrass extract by applying a small amount over the anal opening (it is not necessary to insert it) with a cotton bud/Q-tip once every two days – and persevere. Because the bioactives in wheatgrass penetrate the skin rapidly, this method often works well. Pain relief can occur within hours, or may take longer, but it often works when standard medicinals fail. Although there is no 100% guarantee of healing, the overall rate is high.

Because the fissure itself is not a life-threatening condition, it is not essential to heal the fissure providing pain is eliminated, although most of them do heal in time.

What causes anal fissure?

Doctors invoke all kinds of reasons why fissures develop including constipation, hard bowel motions, diarrhea, inflammation, reduced blood flow to the anal region, poor bowel habit and even ‘spikey’ foods such as peanuts. They seem to overlook the fact that many fissure patients do not have constipation, (some in fact have diarrhea). In fact, some fissures are present at birth. It is unlikely the cause is related to trauma unless there is some direct injury to the anal wall e.g. from colonoscopy or childbirth.

More likely, the fissure occurs first and the constipation follows. In other words, constipation is caused by anal fissurenot the other way round as is often taught. It may be that one of the most important factors leading to fissure, is stress – physical, emotional etc. Many patients have had fissure for so long, they have difficulty recalling how they felt when it first occurred. Others are under stress when they present with the condition.

So, aim to fix the fissure, not the constipation.

Dr. Chris Reynolds.