Abstract

REVISITING PARIKARTIKA: AN EVIDENCE- BASED INTEGRATION OF AYURVEDIC AND MODERN APPROACHES TO FISSURE-IN-ANO

*Dr. Sonali Rana, Dr. Ram Naresh Singh

Abstract

Parikartika is a painful anorectal condition described in Ayurvedic literature, characterized predominantly by severe cutting, tearing, and burning pain in the anal region. Although classical Ayurvedic texts mention Parikartika both as an independent disease entity and as a complication of therapeutic procedures such as Vasti (medicated enema) and Virechana (therapeutic purgation), its clinical manifestations closely resemble those of Fissure-in-Ano in modern medicine. Fissurein- Ano is defined as a longitudinal tear in the anoderm of the anal canal, commonly associated with pain during defecation, bleeding per rectum, sphincter spasm, and constipation. The etiological factors described in both systems, including passage of hard stools, constipation, improper dietary habits, and local trauma, demonstrate significant overlap. Ayurveda explains the pathogenesis of Parikartika primarily through the vitiation of Vata and Pitta Doshas, leading to pain, inflammation, and injury to the anal tissues, whereas modern medicine attributes fissure formation to mechanical trauma, internal anal sphincter hypertonicity, and impaired local blood supply. This review critically examines the classical Ayurvedic descriptions of Parikartika and correlates them with the contemporary understanding of Fissure-in-Ano. Furthermore, it explores the role of integrative management approaches that combine Ayurvedic therapies with modern conservative and surgical interventions. Ayurvedic modalities such as Basti, Kshara Karma, Avagaha Sweda (sitz bath), Jatyadi Taila, Yashtimadhu preparations, and bowel-regulating formulations may complement conventional treatments by promoting wound healing, reducing pain, minimizing recurrence, and improving overall patient outcomes. An evidence-based integrative approach may offer a comprehensive and patient-centered strategy for the effective management of this common anorectal disorder.

Keywords: Parikartika, Fissure-in-Ano, Ayurveda, Anorectal Disorders, Integrative Medicine, Kshara Karma.