International Journal of Trend in Scientific Research and Development (IJTSRD)

Volume 7 Issue 2, March-April 2023 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470

Management of Parikartika (Acute Fissure in Ano)

with Matra Basti- A Case Report
Dr. Laxman Marutirao Wandekar
MS (Ayu) Associate Professor, Department of Shalya Tantra,
Shree Satya Ayurvedic Medical College & Hospital, Moradabad, Uttar Pradesh, India

ABSTRACT How to cite this paper: Dr. Laxman

Ayurveda describes fissure as Parikartika. This phrase refers to Marutirao Wandekar "Management of
kartanvat vedena (a cutting type of pain) and burning nature. Parikartika (Acute Fissure in Ano) with
Additionally bleeding is some other essential signal of the disease. Matra Basti- A Case
Parikartika is considered one of the most painful diseases. Now a Report" Published
in International
days the incidence rate of this disease became more due to the
Journal of Trend in
irregular food habits and bowel habits as well as unproper modern Scientific Research
life style changes. Due to this its recent occurrence in all types of age and Development
groups irrespective of gender. (ijtsrd), ISSN: 2456- IJTSRD55126

Fissure in ano is very common yet troublesome condition. Due to life 6470, Volume-7 |
Issue-2, April 2023, pp.801-804, URL:
style, intake of low fibre diet, junk food, bakery food causes
www.ijtsrd.com/papers/ijtsrd55126.pdf
constipation and Recurrence nature of this disease makes the
treatment challenging. Copyright © 2023 by author (s) and
The symptoms can be correlated to Parikarthika according to International Journal of Trend in
Ayurveda, Many treatment modalities have been mentioned and Scientific Research and Development
Journal. This is an
practiced in management of Parikartika such as Deepana, Pachana,
Open Access article
Vaatanulomana, Avagaaha, Basti Karma and local application of distributed under the
Madhura, Sheetha, Snigdha Dravyas, Taila Poorana, Lepa and Pichu- terms of the Creative Commons
Dharana. In that Taila poorana (basti) works on the basis of cellular Attribution License (CC BY 4.0)
absorption and is easier method for adoption in parikartika disease. (http://creativecommons.org/licenses/by/4.0)
In this study described the effective management of acute fissure in
ano which was managed matra basti. through mahanarayan taila and
yastimadhu taila in equal quantity.
KEYWORDS: Parikartika, fissure in ano, Mahanarayan taila and
Yasthimadhu taila, oral medication

1. INTRODUCTION
In Ayurvedicsamhita this Parikartika is described in so many preparations and best surgery procedure also.
different place. In charak Samhita it describe as The condition fissure-in-ano, commonly encountered
complication of Virechana Vyapad (therapeutic in ano-rectal practice has similar location, pathology
purgation), In Susruta Samhita it describe as and clinical features of parikartika like anal pain,
Bastivhyapad, Kashyapa samhita mention it’s as burning sensation at anal region, constipation, stools
Garbhini Vyapad (Disease occurs in Pregnancy) streaked with blood etc.
Fissure-in-ano has become most common and painful
Management approach selection in Parikarthika
condition in ano-rectal disease. It is commonly seen
should to be selected on the basis of medicines and
in young age peoples and pregnant women. It is a
treatments which one helps for the healing of ulcer as
very painful because of injury to somatic nerve
well as to reduce the cutting and burning type of pain.
supply to the anal region.
The management protocols for fissure-in-ano in
In modern science treatments includes Analgesics,
Ayurvedic science are Snehavasthi (Oil enema
Antibiotics, Laxatives and ointment and anal
therapy), Avagaha Swedana (medicated lukewarm
dilatation, sphincterotomy, fissurectomy. Surgeries of
water sitz bath) and Lepanam (medicated ointments).
Fissurein-ano are expensive and require long stay in
Parikartika can be considered as Sadya Vrana due to
hospital. All these procedures having its own
the presence of painful longitudinal ulcer. Hence drug
limitation and complications. In Ayurveda there are

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 International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
preparations that have Vranaropana properties are B. Mala (stool) = Malavashmbha, Sarakta.
more effective in the management of Parikartika. C. Mutra (urine) = Prakrut.
Mahanarayan taila and yastimadhu taila is the one D. Jihwa (tounge) = Saam.
which is has properties like Saruja Shamana (Pain
E. Agni = Kshudhamandya.
relieving), Vranasodhana (Wound cleansing) and
Vranaropana (Wound healing) properties. Due to this F. Shabda (speech) = prakrut (Normal).
properties is the good medical option in the G. Sparsha (skin) = prakrut.
management of Parikarthika. H. Druka (eyes) = prakrut
2. CASE REPORT 5. MATERIALS AND METHOS
In this case study A 30 year old female patient having Material used
normal labour before 10 days back,and she came to A. Basti taila (Mahanarayan Taila, Yastimadhu taila
our hospital with chief compliant of – in equal quqntity 60ML)
A. cutting type of pain at anal fissure B. Sterile cotton pad
B. swelling at anal region. C. Red rubber cather no.8
C. burning sensation at anal region, D. Basti Syringe
D. Malavashtmbha (Constipation) E. Lignocaine jelly.
E. Saraktamalapravrutti (Stools streaked with blood) 6. Chikitsa (Method of Treatment procedure)
F. constipation. A single case study was conducted in the Shree Satya
Patient had above complaints since last 10 days. H/o Ayurvedic medical college and Hospital- lodhipur
–normal labour No H/o any major surgery. rajput Moradabad uttar Pradesh.
3. PERSONAL HISTORY Adivced to patient lie on left lateral position, all
Her Rajovruttanta was regular, menarche attained at aseptic precaution done perianal part cleaned with
15 years of age and her married life of 3 years and she betadine liquid, insert the red rubber catheter no.8 to
is known case of Hypothyrodiam and diabetes anal canal and push the quqntity of matra 60ml of
mellitus. matra basti of Mahanarayan taila and
Yastimadhutaila, after that locally applied jaytayadi
Investigation done ghrita on external part of anus and dresseing done
Hb -11 gm% with sterile cotton pad ,patient adviced to take rest for
Blood group -A positive ▪ 15 mins, the duration of treatment is 8 days.
BT -2 minutes 35 seconds ▪ Selected patient were noted before, during and after
CT -4 minutes 30 seconds ▪ the proposed treatment.
RBS -92 mg/dl ▪
Total duration of treatment was 8 days.
HIV -Negative ▪
HBsAG -Negative ▪ 7. Drug review of actions of mahanarayan taila
and yastimadhu taila actions
VDRL -Non reactive ▪Urine routine and microscopic
1. Mahanarayan taila uses and benefits
examination report-normal
Mahanarayana oil is a potent analgesic that spells a
4. HISTORY OF PRESENT ILLNESS word of magic for pain. blessed with the
Before 10days back the patient was normal but characteristics of, anti-inflammatory, Increases blood
gradually developing symptoms like cutting type of Circulation Cures Pain excellent anti-inflammatory
pain and burning type of pain during the defecation properties.
and after the defecation, associated with bleeding per
2. Yashtimadhu taila(mulethi) benefits &
rectum and history of chronic constipation .patient
medicinal uses
came to our hospital for further management. Mulethi contains a Glabridin compound, which
On Per rectal examination was done to analyze the reduces colonic inflammation. It can speed up healing
proper diagnosis. On inspection, a cut longitudinal process in inflamed mucosa and prevent ulceration of
ulcer with indurated margin was identified at 12 clock mucosa of the intestines.
position in the anterir upper part of anal verge.
Mulethi contains Glycyrrhizin, which is sweet in taste
Hypertonicity of anal sphincter was analyzed with and reduces inflammation of gastrointestinal tract.
digital rectal examination using a little finger. there is The main beneficial effects of Mulethi (Yashtimadhu)
no any external pile mass, nothing fistula opening. are on digestive system and It helps in relieving
A. Nadi (pulse) = 90/min. gastric symptoms such as heartburn, burning

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sensation in the abdomen, peptic and duodenal ulcer, Other oral medication given
abdominal colic, GERD and chronic gastritis. Triphala guggulu 2 tds
Ulcerative colitis Arogya vardhini vati 2 tds
Trivrut avaleha 1 tsf at bed time
Table 4: Showing Regression of symptoms during treatment
Sr.no. symptoms 1st day 2nd day 3rd day 4th day 5th day 6th day 7th day 8th day
1 Cutting pain/burning pain ++++ ++++ +++ + 0 0 0 0
2 Sphincter spasm ++++ ++++ +++ + 0 0 0 0
3 constipation ++++ ++++ +++ + 0 0 0 0
4 Stool streaks with blood ++++ ++++ +++ + 0 0 0 0

8. DISCUSSION with triphaladi churna helps to clean the fissure

Fissure in ano is one of the painful anorectal diseases wound area, improve the blood flow of the regions,
which presents as an acute superficial break in the and thus helps to relax the anal sphincter.
continuity of the anal canal. Parikarthika can be
9. CONCLUSION:
considered as Sadya Vrana due to the presence of
A case having features of Parikartika (fissure in ano)
painful longitudinal ulcer
was selected from OPD, Hospital shree Satya
Treatment protocols for fissure in ano should be Ayurvedic Medical college and hospital lodhipur
based on the medicines which aid the healing of rajput Moradabad Uttarpradesh for case study and
ulcers as well as to reduce the cutting and burning Mahanarayan taila and Yastimadhu taila both were
type of pain. Each medicine used in the patient has equal quqntity mixed and give matra basti 60ml to
different properties as mentioned previously. The patient and patient adviced to take basti for 8 days
main advantage of this treatment is the complete adviced.
reduction of complaints like pain, burning sensation, Assessment was done based on features like pain,
oozing of blood during and after defaecation within 5 burning sensation and sphincter tone. Significant
days after the treatment. Complete healing of ulcer in improvement was observed after treatment. , the
fissure in ano within 8 days is one of the another
treatment principle of acute fissure in ano should be
advantage noted. based on the aim to healing of ulcer, reduction of pain
Mahanarayan taila and yastimadhu taila is the one and burning sensation and also to correct the
which is having properties like Saruja Shamana (Pain constipation. Both internal and external treatments
relieving), Vranasodhana (Wound cleansing), and formulated in this case are to satisfy the above
Vranaropana (Wound healing) properties . mentioned treatment principles. hence we concluded
that.
Yastimadhu taila helps to keep Vrana moist and thus
promotes the healing process through its above- Pathya
mentioned properties. Jatyadi Ghritha helps to DIET RECOMMENDATIONS (AAHAR).
increase granulation tissue formation thus promoting Increased liquid intake. Fibres food in diet.
ulcer healing. Recommended food plan consists of cow milk, butter,
Due to these properties of Mahanarayan taila and buttermilk, wheat, ghee, rice, inexperienced
yastimadhu taila matra basti 60ml makes it a good vegetable, and normal food plan. Avoid chilies, fried
treatment option in the management of Parikarthika. meals and meals that can reason constipation.
Pachana,vrana shodhana, vrana ropana, and Rakta LIFESTYLE CHANGES (VIHAR) Sitz baths
Shodhana property of improves the vascular (immersing decrease frame in heat water) are
circulation in the anorectal region and reduces spasms beneficial, Avoid consistent sitting and immoderate
and congestion. Due to these properties, helps in the straining for the duration of defecating.
healing of anal fissures.
10. REFERENCES
Triphala guggulu also heals and pain killer as well as [1] Charak samita- Ayurved Dipika commentary
laxative work, the tissue along with increasing the (Chakrapani datta)- Vaidya Jadavaji Trikamji
digestion of the patient at the same time acting as a Acharya Published by Munshiram Manoharlal
mild laxative. Constipation is one of the reasons for Publishers Pvt.Ltd., 4th Edition-1981 2.
the occurrence of fissure in ano. Trivrut avaleha
(sukha virechaka)helps in easy bowel movements and [2] Sushrut samhita- Nibandh sangrahaa vyakhya-
thus relieves constipation.. Lukewarm water Sitz bath Vaidya Jadavaji Trikamji Acharya-Published

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 International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
by Chaukhamba Orientalia, Varanasi, 6 th publishers and distributors Pvt. Limited. New
Edition-1997 Delhi, India, 3rd Edition 2010.
[3] Kashyap samhita-Vruddhajeevakiya tantram [6] A Concise Text Book of Surgery- Somen Das,
va-Nepalrajguru Pandit Hemraj Published by Published by Dr.Das, 5 th Edition 2008.
Chaukhamba Sanskrit sansthan, 9 th
[7] bhaisajyaratnavalli, vatavyadhirogaadhikar and
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[4] A Manual on Clinical Surgery- Somen Das, vatavyadhi.
Published by Dr.Das, 9th Edition 2011. [8] Bhaisajya Ratnavali1. Sneha kalpa mentioned
[5] Manipal Manual of Surgery- K Rajgopal in the context of Kshudrarogadhikara in
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