AYURVEDIC MANAGEMENT OF ACUTE FISSURE-IN-ANO- A CASE SERIES

Abstract

Fissure-in-ano is a tear in the longitudinal axis of the lower anal canal. It is a common distressing ano-rectal disorder, which mostly affecting the age group of 18 to 40. Acute anal fissure is a deep tear in the anal canal with excruciating pain, severe sphincter spasm with surrounding oedema. Bright streak of blood with the passage of stool and pain after defecation are the characteristic features. Intake of hot and spicy food items, junk food, daily intake of non-vegetarian food in increased quantity, skipping of food, irregular bowel habits, less intake of water, constipation, sleep deprivation, mental stress etc are the predisposing factors of this disease. Surgical management in fissure in-ano shows complications like persistent mucous discharge and faecal incontinence.

In Ayurveda, fissure-in-ano is correlated with parikartika, which having vata-pitta predominant clinical features. Its treatment principle is vatanulomana, agnivardhana, vata-pitta samana anna-pana-kriyas, vrana shodhana and ropana. In this case series, 18 to 20 years old 4 acute fissure-in-ano patients with severe pain, constipation, bleeding per rectum were selected. They were with common nidanas like intake of hot and spicy food items, junk food, daily intake of non-vegetarian food in increased quantity, skipping of food etc. On examination, linear ulcer on anal verge with slight bleeding, tenderness and sphincter spasm and diagnosed as acute fissure-in-ano. The selected patients were managed with nidana parivarjana, internal administration of gandharvahasthadi kashayam, brihat triphala choornam as laxative, triphala kashayam for sitz bath, anal dilatation and 10 ml instillation of haridradi ghritha. These patients got wound healing and complete relief from tenderness, pain, bleeding from fissure, sphincter spasm within 10 days. So, it can be concluded that, Ayurvedic management in acute fissure-in-ano is an effective and safe alternative method.