Ahiputana (~diaper rash) in a child with surgically corrected Hirschsprung’s disease – Ayurvedic approaches of management

Ahiputana (~diaper rash) is a painful erythematous rash in the perineal and perianal area caused by prolonged contact with urine, feces, sweat, and lack of hygiene. The condition is common in children, causing itching, irritation, blisters, ulcerations, severe discomfort, and distress. A 4½-year-old-male child with surgically corrected Hirschsprung’s disease (HSCR) suffering from postoperative chronic bowel problems such as frequent episodes of loose stools, fecal incontinence, and daily soiling coupled with absolute negligence of postvoid toileting by parents since 3½ years, sought treatment for the severe rash in the perianal area. This condition was diagnosed with Ahiputana based on etiopathogenesis and was managed with the application of Jatyadi malahara (~ointment made with leaves of Jasminum grandiflorum Linn). For other associated complaints Balachaturbhadra churna, and Ashwagola churna (~husk of Plantago ovata Forssk) were used orally, while Vakshuddhikara churna was used for Jihwa-pratisarana (~application on the tongue). Hyderabad mix supplement and dietetic changes were used to improve nutritional status. Jatyadi malahara exhibited excellent wound healing properties, evidenced by a considerable reduction in the scores on the diaper dermatitis scale. Furthermore, other associated bowel symptoms improved with a combination of changes in Ahara, Vihara, and Ayurvedic formulations.