Anal pain






Prescription



Main formula



Xian fang huo ming yin


Sublime Formula for Sustaining Life. This formula could be used to clear the Heat, remove the Toxin, subside the swelling and relieve the pain, indicated in the anal pain due to invasion of Toxic Heat. If there is not much hardening, remove Chuan Shan Jia Squama Manitis 3g and Zao Jiao Ci Spina Gleditsiae 3g. Pu Gong Ying Herba Taraxaci Mongolici cum Radice 10g, Ye Ju Hua Flos Chrysanthemi Indici 10g, Zi Hua Di Ding Herba Violae 10g and Lian Qiao Fructus Forsythiae 10g could be added into the prescription to clear the Heat, remove the Toxin and reduce the swelling.


Alternative formulas



Wu wei xiao du yin


Five-Ingredient Decoction to Eliminate Toxin. This formula is very good at eliminating the Toxin and subsiding the swelling, but its function to relieve the pain is not that strong. Chuan Xiong Radix Ligustici Wallichii 10g, Bai Zhi Radix Angelicae Dahuricae 10g and Lian Qiao Fructus Forsythiae 10g could be added to relieve the anal pain.


Huang lian jie du tang


This formula is good at clearing the Toxic and reducing the Fire, but its effect on the swelling and the pain is not as strong as the first one. Pu Gong Ying Herba Taraxaci Mongolici cum Radice 10g, Ye Ju Hua Flos Chrysanthemi Indici 10g, Zi Hua Di Ding Herba Violae 10g and Lian Qiao Fructus Forsythiae 10g could be added to the prescription to clear the Heat, remove the Toxin and reduce the swelling.


Modifications





1. If there is a fever, add Jing Jie Herba Schizonepetae 10g to clear the Heat and to reduce the fever


2. If there is constipation, add Da Huang Radix et Rhizoma Rhei 10g and Mang Xiao Natrii Sulfas 10g to clear the Heat and to promote defecation


3. If there is blood in the stools, add Bai Tou Weng Radix Pulsatillae 10g, Sheng Di Huang Radix Rehmanniae Recens 10g to cool the Blood and to stop the bleeding.


Patent remedy


Huang Lian Su Pian Coptis Extract Tablet.







Main points


GV-1 Changqiang, BL-25 Dachangshu, BL-30 Baihuanshu, SP-6 Sanyinjiao, LI-2 Erjian, LI-4 Hegu, LI-11 Quchi, and ST-25 Tianshu. Reducing method is used on these points.


Explanations





▪ GV-1, the Connecting point of the Governing Vessel, harmonises the collateral and relieves the anal pain


▪ ST-25, Front Collecting point of the Large Intestine, and BL-25, the Back Transporting point of the Large Intestine, clears the Toxic Heat in the Large Intestine and promotes the defecation


▪ BL-30 regulates the circulation of Qi in the Lower Burner and relieves the anal pain


▪ SP-6, the cross point of the three Yin channel of the foot, clears the Heat and relieves the anal pain


▪ LI-2, LI-4 and LI-11, the Spring point, the Source point and Sea point of the Large Intestine channel respectively, remove the Toxic Heat in the Large Intestine, promote the defecation and relieve the anal pain.


Alternative points


LI-7 Wenliu, LI-10 Shousanli, BL-35 Huiyang, BL-36 Chengfu, BL54 Zhibian, BL-56 Chengjin, BL-58 Feiyang, etc.


Modifications





1. If there is a fever, add GV-14, the meeting point for all the Yang channels, and LI-11, the Sea point of the Large Intestine channel, to clear Heat and reduce the fever


2. If there is anal soreness and swelling, add BL57 and LI-6 to relieve the soreness and reduce the swelling


3. If there is constipation, add ST-37, the Lower Sea point of the Large Intestine, to clear the Heat in the Large Intestine and promote the defecation


4. If there is blood in the stools, add BL-40 and BL-66 to clear the Heat in the Large Intestine and stop the bleeding.





A 45-year-old man had been suffering from anal pain for 5 days. He complained that he always had a painful anus after eating hot foods such as peppers. Sometimes there was fresh blood in his stools when he strained during defecation. A previous diagnosis of ‘fissure in ano’ had been made. Besides anal pain, he had a bitter taste in the mouth, constipation, irritability and yellow urine, a red tongue with a dry yellow coating and a rapid pulse.


Diagnosis


Accumulation of toxic Heat in the Large Intestine and hyperactivity of Liver-Fire.


Principle of treatment


Clear Toxic Heat and relieve the pain.


Herbal treatment




Xian fang huo ming yin (modified)





Subime Formula for Sustaining Life (modified)


Bai Zhi Radix Angelicae Dahuricae 3g


Fang Feng Radix Ledebouriellae 3g


Chi Shao Radix Paeoniae Rubra 3g


Tian Hua Fen Radix Trichosanthis 3g


Dang Gui Radix Angelicae Sinensis 3g


Jin Yin Hua Flos Lonicerae 9g


Gan Cao Radix Glycyrrhizae 6g


Zao Jiao Ci Spina Gleditsiae 3g


Ju Pi Pericarpium Citri Reticulatae 9g


Zhi Zi Fructus Gardeniae 10g


Explanations





▪ Jin Yin Hua, Zhi Zi and Gan Cao clear Heat in the Large Intestine, reduce Liver-Fire and remove Toxin


▪ Dang Gui and Chi Shao invigorate the circulation of Blood and resolve stagnation in order to reduce the swelling and stop the pain


▪ Zao Jiao Ci promotes the circulation of Blood


▪ Fang Feng and Bai Zhi remove Qi stagnation and relieve Intestinal Wind


▪ Tian Hua Fen clears Heat and reduces swelling


▪ Ju Pi regulates the circulation of Qi.

The patient took this herbal prescription daily. After 6 days his anal pain was under control. Upon follow-up 6 months later, he reported being free of the pain since the treatment.




Jun 19, 2016 | Posted by in PAIN MEDICINE | Comments Off on Anal pain

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