Pain management in Fissure-in-Ano by Invasive and Non-Invasive Methods: An Ayurvedic Review

Abstract

Fissure-in-ano (Guda-parikartika) is a tear, crack or ulcer in the anus which is one of the most troubling and painful surgical diseases that affect majority of the population. In Ayurveda it is mentioned as a sequel of some diseases or as a complication of some Panchakarma procedures or due to improper food habits and lifestyles leading to vitiation of Pitta dosha and develops indigestion in the patient which vitiates Apana vata and its functions which leads to fissure causing severe pain in the anal region along with severe spasm of Anal sphincter. Hence it becomes mandatory to pacify the Vata dosha for relieving pain which helps in relaxation of sphincter facilitating fissure healing. In this regard the various approaches are described in Ayurveda towards the Guda parikartika for controlling pain by correction of the Agni (Pachakagni) and Vatanulomana with multiple options by minimal invasive and non-invasive procedures. The invasive procedures are Kshara and Agnikarma, similarly non-invasive procedures are various medicated local applications and Basti therapies. However these therapeutic methods should be used judiciously as per the condition of the disease