Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa B.A.M.S
The problem with anal fistula is, there are good chances of recurrence with mild changes in diet and lifestyle. So, having a good diet plan and healthy lifestyle habits ensures quicker healing of rectal fistula.
Diet and lifestyle tips for fistula in ano:
Avoid constipation – Constipation aggravates fistula complaints; avoid any food known to cause indigestion and constipation
Keep hydrated – Drink plenty of water, this helps in clearing the channels and also to flush the stools and toxins from the body. It helps you hydrated.
Read related: Anal Fistula Symptoms, Types, Differential Diagnosis, Treatment
Have fibre rich foods – Fibre works by increasing the amount of stools in the intestines and also helps in their expulsion. Fibre rich foods help a lot in anal fistula. Fibres are best obtained from the fruits and vegetables that you consume daily. Make sure you get at least 30-35 grams of fiber per day. One has to take lot of water while taking fibre foods. Both help in cleansing colon and avoid or cure constipation. Examples of fibre rich foods are as below listed –
- Brown rice
- Brown bread
- Wheat germ
- Wheat bran
- Oat bran
- Whole grain pastas
- Peas and beans
- Seeds and nuts
- Whole wheat pasta
- Green pepper
- Prunes and prune juice
- Fiber supplements etc
- Keep away spicy foods – Avoid very spicy and very hot food items, they may aggravate the symptoms including pain and bleeding during defecation
- Raw cabbage juice – Eat half a cup of raw cabbage juice every day. It helps in softening the stools and helps in their easy expulsion.
- Papaya – Eat papaya as it is, it helps in bowel clearance and helps avoid constipation
- Amla juice – Take at least 1 glass of juice of Indian gooseberry per day
- Orange juice – 1-2 glasses of orange juice per day is good for anal fistula
- Avoid large and heavy meals – Have light and small (less quantity yet nutritive) meal at a time and avoid large and heavy to digest foods. This gives a relaxation to the intestines and it will have time to digest a small quantity of light food at a time.
- Avoid excessive cleansing – Avoid excessive cleansing of anal region as it may lead to irritation and itching of the particular area
- Sitz bath – This must be practiced by all patients of anal fistula. The patient should sit by immersing his or her buttocks in warm water up to almost 30 minutes at a time. Small quantity of salt may be added to the water. Alternatively some analgesic oils can also be added to the warm water to pacify the symptoms.
- Cushions – Use ring shaped cushions that take weight off the anus. It reduces the pressure over the blood vessels of the anal region.
- Avoid alcohol and caffeine – Too much alcohol and caffeine will cause dehydration, avoid them.
- Attend your urge – Don’t avoid the natural urge to defecate, if your body gives you a signal for bowel movement; don’t put it off till later. Waiting too long or too often can weaken the signals that let you know it’s time to go. The longer you hold it in, the dryer and harder it can get, which makes it tougher to pass.
Read related: Vega Dharana: Suppression of urges, types, symptoms, and management
Practice healthy bowel habits – Healthy bowel habits when practiced help lessen constipation and strain on the anal canal. Follow the below mentioned habits:
When using the loo, take enough time to pass the faeces comfortably, but avoid sitting on the toilet for long time
- Don’t strain while passing stools
- Keep the anal region dry gently clean your anal region after each bowel movement
- Use soft, dye free and scent-free toilet paper or wipes to clean
- If you have diarrhoea or dysentery get them treated promptly
- Take proper treatment for Crohn’s disease and irritable bowel syndrome (if you have either of them)
Laxatives – Take safe and herbal laxatives (in consultation with your doctor) if fibre diet or fiber supplements are not enough to treat constipation. Bulk forming laxatives or fiber supplements increase your stools by allowing them to absorb and hold fluid. They also encourage contractions in the colon to move the stools along. Ask your doctor for the right type of laxative which fits with you and enquire how long you should take it.
Change diapers frequently – In babies, change diapers often and treat constipation
Avoid flour and sugar – Many people have habit of eating food which is prepared from flour with lots of sugar, spices and oil which is very harmful for health, avoid them
Vegetables, Fruits and Nuts – Take a lot of them, they are not only tasty and nutritious, they offer vitamins and minerals that support your immune system and speed wound healing. Beta-carotene, a plant based compound found in orange, yellow and red vegetables and fruits and in green leafy vegetables, converts to vitamin A when the food is digested. Vitamin A supports the integrity of the skin and tissues that line body cavities. Vitamin C found in citrus fruits, tomatoes and many other fruits and vegetables, boosts the immune system and helps your body resist infection. Almonds, cashew nuts and peanuts contain zinc, a mineral that contributes to new cell formation and wound healing. Raw produce retains a higher amount of water-soluble nutrients, such as Vitamins B and C, than do cooked fruits and vegetables. Unless you have a preference for raw food, eating baked, steamed or roasted foods that are high in fibres may be equally beneficial for healthy digestion and wound healing.
Steamed, baked or boiled vegetables and fruits – may be easier to digest if eating raw foods causes gas, indigestion, bloating and abdominal pain, as is seen to occur in few individuals.
Add fat – Add a little extra fat to your food to make for an ideal fistula diet. A glass of buttermilk, with salt, or a glass of milk with a spoon of clarified butter can usually help soften the stools and allow them to pass without much pain. During this period, also stay away from refined foods and eat lots of fresh vegetables.
– with honey is good in comparison to tea or coffee, lemon juice added to hot water and with some honey added is a good drink for fistula
Milk with butter – Drink a cup of hot milk, to which a spoon of clarified butter has been added. This will ensure that you don’t suffer from constipation.
Avoid late night eating – Finish food much earlier to bed, avoid eating main food or snacks at late night, and also avoid eating out. These things may meddle with your digestion process.
Sleep well – Disturbance of sleep or late night sleep can disturb the bowel health just as it disturbs general health. Therefore have a qualitative and quantitative sleep.
Avoid stress – Stress can cause constipation and indigestion which are related to anal fistula. Avoid stress. Get into Yoga and breathing exercises.
Click to Consult Dr Raghuram YS MD (Ayu)