A REVIEW ON PARIKARTIKA (FISSURE-IN-ANO): AN AYURVEDIC PERSPECTIVE

Proctological diseases include a diverse group of pathological disorders that generate significant discomfort to the patient. Parikartika is a common painful condition among anorectal diseases which resembles with fissure-in-ano. In the present era due to changing life style such as sedentary work pattern, increased stress, improper dietary and sleep habit and various life style disorders are increasing continuously. Anal fissure (fissure-in-ano) is a very common anorectal condition. The exact aetiology of this condition is disputed, however there is a clear association with elevated internal anal sphincter pressure. Hard bowel movements are implicated in fissure aetiology. The exact cause of an anal fissure is not entirely clear, but it is thought to result from trauma to the anal canal. This includes trauma to the anoderm during the passage of hard or large bowel movements, local irritation from diarrhoea, anorectal surgery, and anoreceptive intercourse. Half of all patients with fissures heal with non operative management such as high fibre diet, sitz baths, and pharmacological agents (topical/oral). When non operative management fails, surgical and parasurgical treatment will be the choice. In which lateral internal sphincterotomy has a high success rate but some complications like incontinence. In this article, we will review the symptoms, pathophysiology, and management of anal fissures.In Ayurveda, the sequential administration of Basti and certain Shaman Yogas are quite beneficial. Ayurvedic medicines are practical, effectively accessible and safe for long term use.