Abstract: Anal Fistula (fistula -in -ano) develops after Anal Abscess. The incidence of a fistula-in-ano developing from an anal abscess ranges from 26% to 38%. One study showed that the prevalence of fistula-in-ano is 8.6 cases per 100,000 population. Allopathically, such cases are advised to drain the abscess and close the Anal Fistula surgically. Recurrences are common after surgery. In the present case of Anal Fistula, the patient had undergone multiple surgical processes . But never got the desired result. The present case shows that the Homoeopathic medicine, chosen on the basis of individualization, helps in the treatment of Anal fistula.
Introduction: An ANAL FISTULA (also called Fistula -in-ano) is an infected tunnel/passage between the skin and the anus.
Pathology: Anal Fistula usually caused by an infection near the anus, which results in a collection of pus (abscess) in the nearby tissue. When the pus drains away, it can leave a small channel /passage / fistula behind. The fistula left behind is called Anal Fistula.
Clinical feature: Anal Fistula develops after bursting of Anal Abscess. So, patient almost always know the presence of abscess as it is painful. After bursting of abscess , the non healing of the drainage tunnel results in fistula formation. it results in following symptoms
- An opening on the skin around the anus
- A red, inflamed area around the tunnel opening
- Oozing of pus, blood or stool from the tunnel opening
- Pain in the rectum and anus, especially when sitting or passing stool
- Fever
Presentation of the case: A 28-year-old previously healthy man, presented with Fistula -in – ano since 3 years. First appeared as a painful abscess and after bursting of abscess, there was an opening around the anus. He went through multiple surgical procedures but of no use.
Character of discharge: yellow and corrosive
Past history: non
Family history: no history of similar illness.
Thermal reaction: chilly
Thirst: normal
Desire: salty food and sweet food
Aversion: Nil
Perspiration: normal
Stool: sometimes constipated usually soft
Urine: normal
Mental general: He is anxious about his fistula as it is recurring inspite of repeated surgical procedures. Complaints strated after argument at home and he left the home afterwards.
Diagnosis: Fistula -in -ano
Rubrics taken for Repertorisation and reportorial chart table 1
Treatment: On the basis of repertorisation, patient was given Nitric acid 200/1 dose and later Nitric acid 10m/1 dose
Plan: to give medicine on the basis of repertorial totality.
Follow up: Patient continued to report decrease in discharge and the second image below was again taken 3 months after starting treatment. Feeling of wetness around the anus.
Discussion: There are very few published case reports and studies in the homeopathic treatment of Anal Fistula. Most patients opt for surgery to get rid of anal fistula amd after recurrence many turn up for homeopathic treatment.
Indication of Nitric acid from materia medica- The discharges are thin, bloody, offensive and excoriating; sometimes a dirty yellowish green. Suppuration where there is no tendency to repair. This is often the case when the patient is syphilitic. For suppuration and ulceration in cancerous affections with bloody, watery, offensive discharges and sticking pains. Constant acrid moisture about the anus
Conclusion: Medical treatment of Anal Fistula is difficult, and patient suffers from it years together. Recurrences are very common even after allopathic medicines and surgery. Nitric acid has marked action around anal area
Dr Renu Pande, MD
Founding Member – HomeopathyPoint
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