Fissure and Fistula are two major anorectal problems of humans and they arise from improper eating habits and lifestyles. Fissure is actually an unnatural crack or opening in the skin of the anal canal, while fistula is described in medicine as an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect. In case of acute fissures, severe periodic pain may be felt after defecation. However, the intensity of fissures pain decreases with chronic fissures. Anal fissures usually extend from the anal opening and are usually located posteriorly in the midline. Its depth may be superficial or sometimes down to the underlying sphincter muscle.

On the other hand, the fistula is a form of bodily cavity that burrows under the skin or mucous membrane and has an opening at both ends. A fistula may lead from one cavity to the other cavity of the body, or else it may open out from one cavity to the surface of the body. It is like a cut in or around anal canal and mucus membrane and it mostly strains while passing stool during chronic dysentery and severe constipation. However, modification in food and work habits can help preventing both fissure and fistula.

Anal fissure is caused for various reasons. The main cause of anal fissure is the lack of a balanced diet and undisciplined lifestyle. Fissure can develop due to damage in the anal tissue and for putting higher than normal pressure in the anal sphincters. Many women can develop an anal fissure while giving birth. Various health conditions like Vitamin B-6 deficiency, abdominal pain, fever, weight loss, Crohn`s disease, inflammatory bowel disease (IBD) that causes bloody diarrhea, syphilis, a suppressed immune system, tuberculosis, HIV infection, anal cancer, etc. are also considered as causes of anal fissure. Fistula can be caused due to a few diseases, certain medical treatments or injury to the body. Diseases like Crohn`s disease and trauma to the body like prolonged, severe childbirth, etc. are also considered as causes of fistula.

The major symptoms of anal fissure include sharp, stinging or burning pain during and following a bowel movement; spots of bright red blood on toilet tissue; itching and malodorous discharge, etc. Constipation is another symptom of anal fissure. Symptoms like a "sentinel pile" may also occur due to anal fissure. Anal fissure can be diagnosed through a visual examination of the anus and surrounding tissue. The symptoms of fistulas include pain, fever, tenderness, itching, feeling sick, etc. Apart from these, draining pus or a foul-smelling discharge are also considered as symptoms of fistula. The fistula can be diagnosed by a fistula probe and through a diagnostic test named Anoscopy.

There are numerous types of fistula. The major types include umbilical fistula, vesico vaginal fistula, anal fistula, etc. The other types include the Intersphincteric fistula, Transphincteric fistula, Suprasphincteric fistula, Extrasphincteric fistula, etc. The umbilical fistula is an abnormal passage that communicates with the gut at the umbilicus. The anal fistula is the most common among all types of fistula and it forms near the anus. It may or may not communicate with the rectum and is caused by an abscess. It is characterised by constant oozing of pus and is accompanied by pain. In this case, generally the faeces enter the opening and make the healing difficult.

Fissure and fistula can be treated through various alternative medicinal methods. The traditional medications like Ayurveda, Homoeopathy and the other medications like Naturopathy or nature care; Yoga; Magnetic therapy; etc. are used frequently for treating fissure and fistula. Apart from these, different home remedies and water treatments are also used for treatment of fissure and fistula.

However though fissure and fistula can be diagnosed and treated through various treatment methods, there are some measures that help in preventing these anorectal problems. Leading a healthy lifestyle and following a well-balanced dietary habit help a lot in keeping these disorders away.