Management of Parikarthika (Fissure-in-Ano) Through Ayurvedic Treatment: A Case Report

Background: Parikarthika, which is clinically comparable to fissure-in-ano, is a frequently encountered anorectal disorder characterized by severe pain and discomfort during defecation. In the current era, its prevalence has increased due to faulty dietary patterns, reduced physical activity, and irregular bowel habits. Ayurvedic texts describe Parikarthika as a condition presenting with intense cutting and burning pain in the anal region, commonly associated with constipation and bleeding. The present case report aims to evaluate the efficacy of Ayurvedic management in acute fissure-in-ano. A 21-year-old female patient presented with complaints of severe pain and burning sensation during and after bowel evacuation, along with fresh bleeding per rectum. Local examination revealed a longitudinal ulcer located at the posterior midline of the anal canal, confirming acute fissure-in-ano. The patient was managed through a comprehensive Ayurvedic treatment protocol that included Nidana Parivarjana, internal medications, and local therapy with Jatyadi Taila Pichu, along with Avagaha Swedana. Complete healing of the fissure was achieved within 12 days, with marked relief in pain, burning sensation, and bleeding. Pain was reduced from 8/10 to 1/10 within 12 days. No recurrence was observed during a follow-up period of two months.