Reply To: Piles and anal fissures

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Christine Bailey

Dear Coriander,

Many thanks for your question about your client who is suffering with a number of health conditions including piles and fissures.

An anal fissure, also called an anorectal fissure, is a linear split or tear in the lining (“anoderm”) of the lower anal canal. Most anal fissures happen when a large, hard stool overstretches the anal opening and tears the delicate anoderm. Less often, anal fissures develop because of prolonged diarrhoea, inflammatory bowel disease or sexually transmitted diseases involving the anorectal area. Acute (short-term) anal fissures are usually superficial and shallow, but chronic (long-term) anal fissures may extend deeper through the anoderm to expose the surface of underlying muscle.  It is worth noting there are other conditions that should be ruled out such as Anal fistula and abscess.

Prevention is important to avoid reccurence. You may be able to prevent anal fissures by preventing constipation. Keeping the stools soft is important. It is also recommended you

use gentle techniques to clean the anal area, keeping the anal area dry by changing underwear frequently and using low toxin powder to absorb moisture if needed.

To help treat the fissures use of a medicated ointment to the fissure, and to soak the anal area in warm water for 10 to 15 minutes several times a day (“sitz bath”) can be helpful. For chronic fissures, surgery can correct the problem in more than 90% of cases.

There have been studies focusing on nerve stimulation to help the condition

Yakovlev et al. Sacral nerve stimulation: a novel treatment of chronic anal fissure. Dis Colon Rectum. 2011 Mar;54(3):324-7. doi: 10.1007/DCR.0b013e318202f922.


Having several fissures or having one or more in an area of the anus where fissures usually don’t occur can be a sign of a more serious problem, such as inflammatory bowel disease or a weakened immune system.  Therefore, if she is still struggling I would consider a comprehensive stool test to check for underlying infections and inflammation.

If there is inflammation then looking at lowering inflammation and nourishing the tissue could be beneficial. Collagen powder and sufficient protein in the diet would be helpful and consider colostrum if tolerate which can support immune health and healing.

If your client is constipation then drinking sufficient fluid, eating plenty of vegetables and soluble fibre would be beneficial. Prunes, kiwifruit, olive and flaxseed oil have been found to improve bowel regularity.  Other helpful aids include the following:

Magnesium and Vitamin C: Magnesium and vitamin C have both been shown to promote bowel evacuation. Taking magnesium and vitamin C simultaneously may stimulate a bowel movement.

Ranade VV & Somberg JC. Bioavailability and pharmacokinetics of magnesium after administration of magnesium salts to humans. American journal of therapeutics. Sep-Oct 2001;8(5):345-357.


Fibre and Prebiotics: Soluble fibre supplements keep the stool soft and easy to move and function as a prebiotic, which helps establish and maintain beneficial bacteria in the gut.

Psyllium, rich in soluble fibre, has been shown to relieve constipation. Other fibre supplements include inulin, partially hydrolyzed guar gum, and glucomannan.

Probiotics: Probiotics containing Bifidobacterium lactis (B. lactis) may shorten intestinal transit time, and B. lactis and Lactobacillus casei may have positive effects in adults with chronic constipation.

A useful probiotic that also includes greens to support detox pathways such as Pro Greens may be something to consider as well.


The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.

Lowering inflammation

KappArest (BRC) – take 2 with each meal –

EFA-Sirt Supreme (BRC) – take 2 three times daily –

Probiotic and prebiotic support

BioDoph-7 Plus (BRC) – take 2 daily –

IAG powder (BRC) – take 1tsp twice daily –

ProGreens (ARG) – take 1 scoop twice daily with plenty of water –

For constipation

Lipid-X (BRC) (magnesium oxide) – take 2 in the evening

Securil (ARG) – take 2 capsules 20 mins after breakfast –

Immune support and healing

Arthred Collagen Powder (ARG) – take 1 tbsp added to water shortly before each meal –

Phospholipid Colostrum (ARG) – take 1tbsp three times a day –

I hope this helps with your client