*Dr. Sudheer Kumar Patle, Dr. Ramesh Vanaji Ahire, Dr. Aparna Abhay Raut, Dr. Ashish Shrikant Hastak, Dr. Shubhangi Shashikant Wankhedkar


Guda-parikartika (Fissure-in-ano) is a painful condition which affects the anal region. It is characterised by a tear or ulcer in the anus. According to Ayurveda classics such as Sushruta Samhita and Charak Samhita, Parikartika is a complication of Vamana-Virechana and Basti Karma. Due to the change in way of living, intake of Viruddha Ahara, the prevalence of Parikartika is increasing at a faster rate in young and middle aged adults. Aproximately thirty to fourty percent of the population suffer from problems of anal region and around ten to fifteen percent cases of anorectal disorders are found to be of Guda Parikartika (anal-fissure). The main clinical feature is Kartanavat and Chhedandvat shoola in Guda. The Viruddh Ahara and Vihara, aggravates the Pitta Dosha which leads to the constipation. This inturn vitiates Apan vata resulting in formation of fissure causing severe pain in the anal region and severe spasm of anal sphincter.Modern medical science provides management of anal fissure through analgesics, anti-inflammatory drugs, stool softeners, topical anesthetics, soothing agents, Lord’s dilations, Fissurectomy, Anal advancement flap surgery etc. Conventional treatment modalities are time consuming, expensive and have various side effects. As Ayurveda emphasizes on eliminating the main causative factor of a disease; many scholarshave mentioned various procedures of invasive and non invasive nature to pacify the vitiated Doshas. The painful condition of Parikartika can be treated by proper fiber rich diet, internal medications and local applications of formulations comprising of Madhura, Sheeta, Snigdha dravyas etc. Some procedures such as Anuvasana basti, Picchabasti, Madhura, Kashaya dravya Siddha basti, Lepa, etc. are also found to be effective in the management.

Keywords: Guda-parikartika, Kartanavat, Chhedandva, Shoola, Constipation, Madhura, Anal sphincter, Basti.

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