Abstract

A SINGLE CASE STUDY ON THE EFFICACY OF APAMARG PRATISARNIYA KSHAR IN THE MANAGEMENT OF PARIKARTIKA (FISSURE-IN-ANO)

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

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Abstract

Parikartika, correlated with Fissure-in-Ano in modern medicine, is a prevalent and distressing anorectal disorder characterized by severe pain, burning sensation, and bleeding during defecation. Conventional treatments, including surgical sphincterotomy, often carry risks like incontinence and recurrence. Kshar Karma (alkaline cauterization) is a renowned para-surgical procedure in Ayurveda, and Apamarg Kshar (alkali derived from Achyranthes aspera) is specifically indicated for its Shodhana (cleansing), Ropana (healing) and Srava Shamaka (reducing discharge) properties. A 32-year-old male patient presented with complaints of excruciating cutting pain (Guda Pida), intense burning sensation (Guda Daha), and occasional bleeding during defecation for three months. Local examination revealed a linear tear at the 6 o'clock position in the anal canal with significant sphincteric spasm, confirming a diagnosis of acute Parikartika (Fissure-in-Ano). The patient was treated with local application of Mridu Pratisarniya Apamarg Kshar on the fissure bed. A single application was done, followed by post-operative care including Sitz bath, laxatives (Haritaki Churna) and dietary advice. Outcome - The patient reported a dramatic reduction in pain and burning sensation within 24 hours. Complete healing of the fissure was observed on the 7th-day follow-up. All subjective parameters (pain, burning, constipation, itching) and objective parameters (sphincter spasm, bleeding) showed a 100% improvement. No recurrence was noted at the 30-day follow-up, and no adverse effects were observed. Conclusion - This case study demonstrates that Apamarg Pratisarniya Kshar application is a highly effective, safe, and minimally invasive treatment for Parikartika. It promotes rapid healing, provides immediate symptomatic relief, and potentially reduces the risk of recurrence, making it a superior alternative to conventional surgical methods.

Keywords: Parikartika, Fissure-in-Ano, Apamarg Kshar, Kshar Karma, Achyranthes aspera.