Fissure and Fistula comprise the main anorectal problems. They arise from faulty eating habits and incorrect lifestyles. All these disorders can be prevented through modification of food and work habits. Fistula is a form of sinus, which burrows under the skin or mucous membrane and has an opening at either end. It is a cut in or around anal canal and mucus membrane mostly on account of straining while passing stool during chronic dysentery and severe constipation. In Fistula, the rectum or anal canal gets infected forming a tunnel through which pus dribbles. 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.

There are numerous types of fistula:
Umbilical Fistula:This is an abnormal passage communicating with the gut at the umbilicus.

Vesico Vaginal Fistula: It is an opening from bladder to the vagina.

Anal Fistula: This is the form near the anus, which may or may not communicate with the rectum.

However, anal fistula is the most common, which is caused by an abscess and is characterised by constant oozing of pus and is accompanied by pain. Most frequently, the faeces enter the opening, making the healing difficult. Fissure also may lead to Fistula. It is very painful and generally treated with surgery. Even after surgery, fistula is notorious for recurrence. Such recurrence could be prevented if the dietary discipline suggested for piles is strictly followed. Persons suffering from anal fistula should take adequate rest and should avoid highly seasoned or spiced foods.

Treatment of Anal Fissure by Nature Cure:
Diet:
The treatment for anal fissure should aim at softening the stools, keep them regular and avoid constipation, to begin with, the patient should fast on raw juices for about five days. Juices of orange, mosambi, pineapple and carrot may be taken during this Period. The patient should drink a glass of juice every two hours from 8 a.m. to 8 p.m. mixed with water on 50:50 basis. A warm-water enema should be administered daily to cleanse the bowels.

The most important factor in curing anal fissure is a natural and simple diet. Thus, after the juice fast, the patient may adopt an exclusive diet of fresh fruits for further five days. In this regimen, he should take fresh juicy fruits such as orange, apple, pineapple, pear, peach, Papaya and grapes at five-hourly intervals. Thereafter, he may gradually embark upon a well-balanced diet.

The diet should also consist of unrefined foods such as whole grain cereals, honey, molasses and lentils, green leafy vegetables, especially spinach, trench beans, tomatoes, lettuce, onion, cabbage, turnip, pumpkin, beets and carrot; fresh fruits, especially pears, grapes, figs, papaya, mangoes, grapefruit, gooseberries, guava and oranges; dry fruits such as figs, raisins, apricots ad dates, milk products in the form of butter, ghee and cream.

Sugar and sugary foods should be strictly avoided because sugar steals the B Vitamins from the body, without which the intestines cannot function normally. Foods which result in constipation and anal fissure, are products made of white flour, rice, cakes, pastries, biscuits, cheese, fleshy foods, preserves and white sugar. Drinking adequate quantities of water is beneficial not only for constipation but also for cleansing the system, diluting the blood and washing out poisons. Water, should, however, not be taken with meals as it dilutes the gastric juices essential for proper digestion. It should be taken either half an hour before or an hour after meals.

Generally, all fruits, except banana and jackfruit, are beneficial in the treatment of constipation and anal fissure. Certain fruits like pears and grapes are, however, more effective and should be taken liberally by the patient. Drinking hot water with sour limejuice and a little salt is also an effective remedy for treating this condition.

Home Remedies:
Gentle instillation of about 60 grams of olive oil into the rectum will be beneficial in the treatment of anal fissure. It will soften the hardened stool. This should be repeated daily as needed.

Water Treatments:
For Fissure, curing constipation and applying hot and cold pack to the anal area are of great help. Hipbath in warm water every day for 30 minutes is beneficial for all types of Anorectal disorders.

The daily dry friction should form a regular feature of the treatment for anal fissure. The affected part should be bathed several times daily with hot and cold fermentations. A piece of linen material should be wrung out in hot water and applied for two or three minutes. The hot application should be repeated three times for the same length of time. This should be followed by a cold application. This order should always be adopted, namely three hot applications followed by one cold application.

Treatment of Anal Fissure by Yogic Asanas:
Fresh air and regular physical exercises are also essential. Yogic asanas beneficial in the treatment of these diseases are uttan padasana , pavanmuktasana, vajrasana, yogamudra, bhujangasana, shalabhasana and shavasana.

Treatment of Anal Fissure by Magnetic Therapy:
The magnets should preferably be applied locally by keeping the two magnets side by side and making the patient sit over them. In case the sitting is painful owing to the hardness of the magnets; a cotton padding, may be provided over the magnets. It is beneficial to apply north-pole oil before, the local application. If the patient is unable to sit over the magnets, the general application of the magnets to the soles of feet may be resorted to for 20 minutes daily in the morning. The healing can-be hastened by regular intake of mixed magnetized water four times daily.