Management of Parikartika w.s.r. to Acute Fissure-in-Ano with Dhanwantaram Taila Pichu

Abstract

Fissure-in-ano, commonly known as an anal fissure, is a frequently encountered anorectal disorder characterized by significant pain and discomfort. In Ayurvedic literature, the condition Parikartika closely correlates with fissure-in-ano and is described by symptoms such as cutting and burning sensation in the Guda (anal region). The management of this condition primarily aims at alleviating pain and enhancing wound healing. Ayurveda outlines various therapeutic approaches for Parikartika, including Deepana, Pachana, Vatanulomana, Avagaha Sweda, Basti Karma, and the application of Madhura, Sheeta, and Snigdha Dravyas in forms such as Taila Poorana, Lepa, and Pichu Dharana. Among these, Pichu Dharana is considered a simple and effective procedure that works through local absorption at the tissue level. The present case study evaluates the efficacy of Dhanwantaram Taila Pichu in the management of acute fissure-in-ano. A 35-year-old female patient presented to the outpatient department with complaints of severe cutting pain in the anal region (Gudapradeshi Kartanavat Vedana), mild swelling (Alpa Shotha), burning sensation (Daha), constipation (Malavashtambha), and passage of blood-streaked stools (Saraktamala Pravritti) for five days. Administration of Dhanwantaram Taila Pichu, along with appropriate dietary and lifestyle modifications (Pathya), resulted in significant clinical improvement in this case.