Dietary Modifications in Fissure-in-ano: A Qualitative Study Based on Persian Medicine

Author(s): Sedigheh Tavakoli-Dastjerdi, Mandana Tavakkoli-Kakhki, Ali R. Derakhshan, Azam Teimouri, Malihe Motavasselian*

Journal Name: Current Nutrition & Food Science

Volume 16 , Issue 6 , 2020


Become EABM
Become Reviewer
Call for Editor

Graphical Abstract:


Abstract:

Background: Anal fissure (AF) is a common disease associated with severe pain and reduced quality of life. Factors related to lifestyle, including diet and bowel habits, play a pivotal role in its pathogenesis. Most of the chronic fissures are not responsive to drugs and more likely to recur. Given the significance of diet in Persian medicine (PM), investigation on physiopathology and appropriate foods can be useful for decreases in AF symptoms and consequences.

Objective: This study was intended to evaluate the role of diet in the formation and progression of AF from the perspective of PM.

Methods: In this study, the most important resources of PM dating back to thousands of years were reviewed. All these textbooks contained a section on AF, its causes, and treatment. Further analysis was performed on these resources in comparison with databank and resources of modern medicine to develop a food-based strategy for AF management.

Results: From the view of PM, the warmth and dryness of anus temperament accounted for AF. Both Persian and modern medicine identified constipation as another cause for AF. Therefore, avoidance from some foods and commercial baked goods was recommended. Both Persian and modern medicine forbad the following foods: potato, cabbage, cauliflower, pasta, beef, fish, and so forth. High fiber and oligo-antigen diets with some limitations have garnered more attention.

Conclusion: An integrative approach is recommended employing both Persian and modern medicine for AF. There have been some evidence in this regard, however standardized clinical trials are required for future research.

Keywords: Constipation, diet, fissure-in-ano, Persian medicine, temperament, food, traditional medicine.

[1]
Mapel DW, Schum M, Von Worley A. The epidemiology and treatment of anal fissures in a population-based cohort. BMC Gastroenterol 2014; 14(1): 129.
[http://dx.doi.org/10.1186/1471-230X-14-129] [PMID: 25027411]
[2]
Altomare DF, Binda GA, Canuti S, Landolfi V, Trompetto M, Villani RD. The management of patients with primary chronic anal fissure: a position paper. Tech Coloproctol 2011; 15(2): 135-41.
[http://dx.doi.org/10.1007/s10151-011-0683-7] [PMID: 21538013]
[3]
Poh A, Tan K-Y, Seow-Choen F. Innovations in chronic anal fissure treatment: a systematic review. World J Gastrointest Surg 2010; 2(7): 231-41.
[http://dx.doi.org/10.4240/wjgs.v2.i7.231] [PMID: 21160880]
[4]
Gupta PJ. Family practice in ano-rectal diseases. Pak J Med Sci 2006; 22(1): 85-90.
[5]
Krogh K, Chiarioni G, Whitehead W. Management of chronic constipation in adults. United European Gastroenterol J 2017; 5(4): 465-72.
[http://dx.doi.org/10.1177/2050640616663439] [PMID: 28588875]
[6]
Madalinski MH. Identifying the best therapy for chronic anal fissure. World J Gastrointest Pharmacol Ther 2011; 2(2): 9-16.
[http://dx.doi.org/10.4292/wjgpt.v2.i2.9] [PMID: 21577312]
[7]
Zaghiyan KN, Fleshner P. Anal fissure Clinics in colon and rectal surgery 2011;; 24(01): 022-30..
[http://dx.doi.org/10.1055/s-0031-1272820]
[8]
Hosseini SV, Sabet B, Nouri Amirkolaee M, Bolandparvaz S. A randomized clinical trial on the effect of oral metronidazole on wound healing and pain after anal sphincterotomy and fissurectomy. Arch Iran Med 2008; 11(5): 550-2.
[PMID: 18759524]
[9]
Tauro LF, Shindhe VV, Aithala PS, Martis JJ, Shenoy HD. Comparative study of glyceryl trinitrate ointment versus surgical management of chronic anal fissure. Indian J Surg 2011; 73(4): 268-77.
[http://dx.doi.org/10.1007/s12262-011-0239-0] [PMID: 22851840]
[10]
Son CG, Bian ZX, Wang JH, Raghavendran HB. Complementary and alternative medicine for diseases and disorders in digestive tract: basic to clinics. Evid Based Complement Alternat Med 2013; 2013565279
[http://dx.doi.org/10.1155/2013/565279]
[11]
Emtiazy M, Keshavarz M, Khodadoost M, et al. Relation between body humors and hypercholesterolemia: an Iranian traditional medicine perspective based on the teaching of Avicenna. Iran Red Crescent Med J 2012; 14(3): 133-8.
[PMID: 22737569]
[12]
Ali SM, Alam M. A scientific correlation between blood groups and temperaments in Unani medicine. Indian J Tradit Knowl 2007; 6(2): 319-23.
[13]
Derakhshan AR. Natural treatments for fissure in ano used by traditional Persian Scholars, Razi (Rhazes) and Ibn Sina (Avicenna). J Evid Based Complementary Altern Med 2017; 22(2): 324-33.
[http://dx.doi.org/10.1177/2156587216650302] [PMID: 27279645]
[14]
Najar FA, Faisal M, Ahmad K, Tahzeeb A. Prevalence and risk factors of anal fissure among the patients visiting surgery (Jarahat) OPD in NIUM. JoAYUSH 2017; 6(1): 35-7.
[15]
Avicenna [The Canon of medicine] Tehran: Soroush Press 2008.
[16]
Higuero T. Update on the management of anal fissure. J Visc Surg 2015; 152(2)(Suppl.): S37-43.
[http://dx.doi.org/10.1016/j.jviscsurg.2014.07.007] [PMID: 25305752]
[17]
Cheshti M. Exire Azam (Azam’s Elixir). Tehran: Iran University of Medical Science, Institute for Islamic and Complementary Medicine 2007.
[18]
Fattahi MR, Alorizi SME, Nimrouzi M, Zarshenas MM, Parvizi MM. A randomized clinical trial on treatment of chronic constipation by traditional persian medicine recommendations compared to allopathic medicine: a pilot study. Int J Prev Med 2017; 8: 50.
[http://dx.doi.org/10.4103/ijpvm.IJPVM_302_16] [PMID: 28757927]
[19]
Elsagh M, Behbahani FA, Fartookzadeh MR, Adibi P, Kamalinejad M, Anushiravani M. Categorization of functional constipation in traditional Persian medicine: a descriptive study. J Evid Based Complementary Altern Med 2016; 21(1): 48-52.
[http://dx.doi.org/10.1177/2156587215594745] [PMID: 26170133]
[20]
Nejatbakhsh F. The rules of nutrition in disease based on Iranian traditional medicine. Tehran: Choogan 2013.
[21]
Gibson PR, Shepherd SJ. Food choice as a key management strategy for functional gastrointestinal symptoms. Am J Gastroenterol 2012; 107(5): 657-66.
[http://dx.doi.org/10.1038/ajg.2012.49] [PMID: 22488077]
[22]
Carroccio A, Di Prima L, Iacono G, et al. Multiple food hypersensitivity as a cause of refractory chronic constipation in adults. Scand J Gastroenterol 2006; 41(4): 498-504.
[http://dx.doi.org/10.1080/00365520500367400] [PMID: 16635922]
[23]
Zareian MA, Nejatbakhsh F, Tabarrai Arani M. [Importance and methods of treating pregnancy constipation in conventional medicine and comparison with traditional medicine]. IJOGI 2017; 19(40): 19-32.
[24]
Jensen SL. Diet and other risk factors for fissure-in-ano. Prospective case control study. Dis Colon Rectum 1988; 31(10): 770-3.
[http://dx.doi.org/10.1007/BF02560104] [PMID: 3168663]
[25]
Brimah P, Adigun R. Jedi-jedi: towards a formal medical classification of a sugar problem in Africans. RGUILD 2014; 2(1): 10001.
[26]
Gupta PJ. Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. Ann Ital Chir 2008; 79(5): 347-51.
[PMID: 19149363]
[27]
Gupta PJ. Effect of red chili consumption on postoperative symptoms during the post-hemorrhoidectomy period: randomized, double-blind, controlled study. World J Surg 2007; 31(9): 1822-6.
[http://dx.doi.org/10.1007/s00268-007-9148-6] [PMID: 17647055]
[28]
Bao W, Ma A, Mao L, et al. Diet and lifestyle interventions in postpartum women in China: study design and rationale of a multicenter randomized controlled trial. BMC Public Health 2010; 10(1): 103.
[http://dx.doi.org/10.1186/1471-2458-10-103] [PMID: 20187965]
[29]
Elsagh M, Fartookzadeh MR, Kamalinejad M, et al. Efficacy of the Malva sylvestris L. flowers aqueous extract for functional constipation: A placebo-controlled trial. Complement Ther Clin Pract 2015; 21(2): 105-11.
[http://dx.doi.org/10.1016/j.ctcp.2015.02.003] [PMID: 25801702]
[30]
Carroccio A, Mansueto P, Morfino G, et al. Oligo-antigenic diet in the treatment of chronic anal fissures. Evidence for a relationship between food hypersensitivity and anal fissures. Am J Gastroenterol 2013; 108(5): 825-32.
[http://dx.doi.org/10.1038/ajg.2013.58] [PMID: 23588240]
[31]
Atarzadeh F, Daneshfard B, Dastgheib L, Jaladat AM, Amin G. early description of diet-induced blistering skin diseases in Medieval Persia: Avicenna’s point of view. Skinmed 2016; 14(5): 367-70.
[PMID: 27871350]
[32]
Caterina MJ, Schumacher MA, Tominaga M, Rosen TA, Levine JD, Julius D. The capsaicin receptor: a heat-activated ion channel in the pain pathway. Nature 1997; 389(6653): 816-24.
[http://dx.doi.org/10.1038/39807] [PMID: 9349813]
[33]
Esmaillzadeh A, Keshteli AH, Hajishafiee M, Feizi A, Feinle-Bisset C, Adibi P. Consumption of spicy foods and the prevalence of irritable bowel syndrome. World J Gastroenterol 2013; 19(38): 6465-71.
[http://dx.doi.org/10.3748/wjg.v19.i38.6465] [PMID: 24151366]
[34]
Gonlachanvit S. Are rice and spicy diet good for functional gastrointestinal disorders? J Neurogastroenterol Motil 2010; 16(2): 131-8.
[http://dx.doi.org/10.5056/jnm.2010.16.2.131] [PMID: 20535343]
[35]
Vergnolle N. TRPV4: new therapeutic target for inflammatory bowel diseases. Biochem Pharmacol 2014; 89(2): 157-61.
[http://dx.doi.org/10.1016/j.bcp.2014.01.005] [PMID: 24440740]
[36]
Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology 2014;; 146(1): : 67- 75. e5.
[http://dx.doi.org/10.1053/j.gastro.2013.09.046]
[37]
Böhn L, Störsrud S, Liljebo T, et al. Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice: a randomized controlled trial. Gastroenterology 2015;; 149( 6): : 1399- -407. e2..
[http://dx.doi.org/10.1053/j.gastro.2015.07.054]
[38]
Staudacher HM, Lomer MCE, Farquharson FM, et al. A diet low in FODMAPs reduces symptoms in patients with irritable bowel syndrome and a probiotic restores Bifidobacterium species: a randomized controlled trial. Gastroenterology 2017; 153(4): 936-47.
[http://dx.doi.org/10.1053/j.gastro.2017.06.010] [PMID: 28625832]
[39]
Attaluri A, Donahoe R, Valestin J, Brown K, Rao SS. Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. Aliment Pharmacol Ther 2011; 33(7): 822-8.
[http://dx.doi.org/10.1111/j.1365-2036.2011.04594.x] [PMID: 21323688]
[40]
Fernández-Bañares F. Nutritional care of the patient with constipation. Best Pract Res Clin Gastroenterol 2006; 20(3): 575-87.
[http://dx.doi.org/10.1016/j.bpg.2005.11.002] [PMID: 16782530]
[41]
Arya V, Singh S, Agarwal S, Ohri A. Resolution of constipation, anal stricture, and iron deficiency anemia after iron infusion: an analogy with Plummer Vinson syndrome. Springerplus 2016; 5(1): 1976.
[http://dx.doi.org/10.1186/s40064-016-3629-8] [PMID: 27917348]
[42]
Okubo H, Sasaki S, Murakami K, et al. Freshmen in Dietetic Courses Study II Group. Dietary patterns associated with functional constipation among Japanese women aged 18 to 20 years: a cross-sectional study. J Nutr Sci Vitaminol (Tokyo) 2007; 53(3): 232-8.
[http://dx.doi.org/10.3177/jnsv.53.232] [PMID: 17874828]
[43]
Savino F, Maccario S, Guidi C, et al. Methemoglobinemia caused by the ingestion of courgette soup given in order to resolve constipation in two formula-fed infants. Ann Nutr Metab 2006; 50(4): 368-71.
[http://dx.doi.org/10.1159/000094301] [PMID: 16809905]
[44]
Hashem Dabaghian F, Taghavi Shirazi M, Amini Behbahani F, Shojaee A. Interventions of Iranian traditional medicine for constipation during pregnancy. J Med Plant 2015; 1(53): 58-68.
[45]
Salari M, Salari R, Dadgarmoghadam M, Khadem-Rezaiyan M, Hosseini M. Efficacy of egg yolk and nitroglycerin ointment as treatments for acute anal fissures: a randomized clinical trial study. Electron Physician 2016; 8(10): 3035-41.
[http://dx.doi.org/10.19082/3035] [PMID: 27957300]
[46]
Borrelli O, Barbara G, Di Nardo G, et al. Neuroimmune interaction and anorectal motility in children with food allergy-related chronic constipation. Am J Gastroenterol 2009; 104(2): 454-63.
[http://dx.doi.org/10.1038/ajg.2008.109] [PMID: 19174791]
[47]
Bhooshan Pandey K, Ibrahim Rizvi S. Recent advances in health promoting effect of dietary polyphenols. Curr Nutr Food Sci 2012; 8(4): 254-64.
[http://dx.doi.org/10.2174/157340112803832228]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 16
ISSUE: 6
Year: 2020
Published on: 24 September, 2018
Page: [860 - 865]
Pages: 6
DOI: 10.2174/1573401314666180924123007
Price: $65

Article Metrics

PDF: 13
HTML: 2
EPUB: 1
PRC: 1