Abstract

A COMPREHENSIVE REVIEW ON THE MANAGEMENT OF PARIKARTIKA W.S.R. TO FISSURE-IN-ANO

Dr. Ashutosh Upadhyay*, Prof. Dr. Elizabeth P John, Dr. Ishan Parashar, Dr. Avinash Kumar Singh

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Abstract

Parikartika, a disease vividly described in ancient Ayurvedic texts, is characterized by symptoms like chedan (cutting pain), dahan (burning sensation) and vedana (pain) in the guda (anal region). Its clinical presentation bears a striking resemblance to the modern condition known as fissure-in-ano, which is a common and painful proctological disorder affecting a significant portion of the population worldwide. While modern medicine offers both conservative and surgical management, these approaches often come with drawbacks like recurrence and the risk of incontinence. Ayurveda, with its holistic and individualized approach, provides a wide range of effective therapeutic modalities. Objective - This review aims to systematically compile and analyze the Ayurvedic understanding of Parikartika. It further seeks to elaborate on the comprehensive management strategies available in Ayurveda, including dietary modifications (Ahara), lifestyle changes (Vihar), Shodhana (bio-purification) therapies, and a variety of Shamana (palliative) treatments. Methods - A thorough literary review was conducted from classical Ayurvedic texts such as Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya etc. with Modern medical texts and databases like PubMed, Google Scholar etc. were also searched to establish a correlation and understand contemporary research on Ayurvedic interventions for fissure-in-ano. Results and Conclusion - The review establishes a clear correlation between Parikartika and fissure-in-ano based on symptomatology. Ayurvedic management, focusing on pacifying the aggravated Vata and Pitta doshas, healing the ulcer (vrana), and promoting regular bowel habits, proves to be highly effective. Numerous studies on interventions like Jatyadi Taila, Kshara Basti and Panchavalkala Kwath have shown significant results in reducing pain, promoting healing, and preventing recurrence without the side effects associated with surgery.

Keywords: Parikartika, Fissure-in-Ano, Ayurveda, Basti, Jatyadi Taila, Kshara, Vrana Ropana.