In Ayurveda, anal fissure is referred to as “Parikartika.” It is a condition characterized by a tear or ulceration in the lining of the anus. Classical Ayurvedic texts provide insights into the causes, types, symptoms, pathogenesis, and treatment of Parikartika. Here is the information you requested, including relevant shlokas (verses) from classical Ayurvedic texts.
1. Nidana (causes) of Parikartika:
The causes of Parikartika are described in Ayurveda as follows:
अभ्यागतं गर्भाधानं प्रसवोऽपि तथैव च।
मलसंयोगोऽनिलादीनां व्यायामादिभिरप्युत॥ (Charaka Samhita, Sutra Sthana 18.12)
This shloka states that the causes of Parikartika include trauma to the anal region during childbirth, sexual intercourse, or the passage of hard stools. Other causes include the accumulation of feces, excessive intake of dry or spicy foods, and physical exertion.
2. Types of Parikartika:
Ayurveda classifies Parikartika into different types based on the dosha involvement. The types of Parikartika are described as follows:
वातस्तु भग्नातिभग्नो मन्दोऽग्निर्जायते गुरुः।
पित्तेनाग्निर्ज्वलत्येव रक्तेन पाकः कुरुतेऽग्निः॥ (Sushruta Samhita, Nidana Sthana 11.5)
This shloka explains that Parikartika can be classified into Vataja (Vata-predominant) and Pittaja (Pitta-predominant) types. The Vataja type is characterized by a decrease in digestive fire, while the Pittaja type is characterized by an increase in digestive fire and the presence of blood in stools.
3. Poorvaroopa and Roopa (prodromal and clinical features) of Parikartika:
Ayurveda describes the poorvaroopa (prodromal symptoms) and roopa (clinical features) of Parikartika as follows:
पीडयन्तं पथिप्रायं प्रसवोत्थं च वारिते॥ (Sushruta Samhita, Nidana Sthana 11.6)
This shloka explains that the prodromal symptoms (poorvaroopa) of Parikartika include the presence of irregular, sticky, and bloody discharge from the anus, along with pain and discomfort. The clinical features (roopa) include a visible tear or ulceration in the anal region, accompanied by severe pain during defecation.
4. Lakshana (symptoms) of Parikartika:
The symptoms of Parikartika are described in Ayurvedic texts as follows:
विभज्यमानं यदा तत्तु कृच्छ्राद्विसृज्यते शुचिः।
तदा लघुपरित्यागी तत्पुरीषं प्रविशति॥ (Charaka Samhita, Sutra Sthana 20.28)
This shloka states that the symptoms of Parikartika include pain during defecation, difficulty in passing stools, the intermittent release of stools, and the presence of blood in stools. The individual experiences a constant urge to pass stools but is unable to do so easily.
5. Samprapti (pathogenesis) of Parikartika:
The pathogenesis or samprapti of Parikartika is explained as follows:
सर्वे दोषा दुर्बलाहाराः स्युः स्वप्ने दिवास्वप्ने ग्रहणे।
व्यायामे ब्रह्मचर्ये च मनोविकारैः प्रशामिते तथा॥ (Sushruta Samhita, Nidana Sthana 11.15)
This shloka suggests that the imbalance of all three doshas, weakened digestion, improper dietary habits, excessive physical exercise, indulgence in sexual activities, and mental disturbances contribute to the pathogenesis of Parikartika.
6. Chikitsa Sutra (treatment principles) for Parikartika:
Ayurvedic treatment principles for Parikartika include:
अह्नाह्ना जानुभ्यां शुचिः कर्णान्तेष्वनुस्यूतिका।
उष्णवायुश्च नाभिचक्रे ग्रीष्मे शिरोदगा मदात्॥ (Charaka Samhita, Chikitsa Sthana 15.42)
This shloka states that the treatment of Parikartika involves maintaining cleanliness of the anal region, avoiding excessive sitting, keeping the earlobes dry, using warm fomentation, and avoiding alcohol consumption.
7. Suggestive Shodhana Chikitsa (purification treatments):
Shodhana Chikitsa (purification treatments) such as Sitz baths with medicated decoctions or mild purgation therapy (Virechana) may be suggested in certain cases of Parikartika to relieve symptoms and promote healing.
8. Aushadh Yoga (medicines) for Parikartika:
Ayurvedic texts mention various herbs and formulations for the management of Parikartika. Some commonly used herbs include Triphala (a combination of three fruits: Amalaki, Haritaki, and Bibhitaki), Yashtimadhu (Glycyrrhiza glabra), and Snuhi (Euphorbia neriifolia). Classical formulations like Abhayarishta, Arshoghnivati, and Kankayan Vati are also mentioned for the treatment of Parikartika.
Ayurvedic texts mention several medicinal formulations that can be used for the management of Parikartika (anal fissure). Here are some commonly mentioned formulations:
1. Arshoghnivati: अर्शोघ्निवटी Arshoghnivati is an Ayurvedic tablet formulation used for the treatment of various anorectal disorders, including Parikartika. It contains ingredients like Haritaki (Terminalia chebula), Bibhitaki (Terminalia bellirica), Amalaki (Emblica officinalis), and other herbs with anti-inflammatory, astringent, and wound-healing properties. Arshoghnivati helps in reducing pain, inflammation, and promoting healing of anal fissures.
2. Kankayan Vati: कंकायन वटी Kankayan Vati is a classical Ayurvedic formulation used for the management of anorectal disorders, including anal fissures. It contains ingredients like Snuhi Ksheera (latex of Euphorbia neriifolia), Haritaki (Terminalia chebula), and other herbs. Kankayan Vati helps in reducing pain, itching, inflammation, and promoting healing of anal fissures.
3. Abhayarishta: अभयारिष्ट Abhayarishta is an Ayurvedic liquid formulation prepared by fermentation. It contains ingredients like Haritaki (Terminalia chebula), Vidanga (Embelia ribes), and other herbs with mild laxative and digestive properties. Abhayarishta helps in relieving constipation, softening the stools, and promoting regular bowel movements, which can be beneficial in the management of anal fissures.
4. Triphala Churna: त्रिफला चूर्ण Triphala Churna is a popular Ayurvedic herbal powder formulation that consists of three fruits: Amalaki (Emblica officinalis), Haritaki (Terminalia chebula), and Bibhitaki (Terminalia bellirica). Triphala has antioxidant, anti-inflammatory, and mild laxative properties. It helps in improving digestion, relieving constipation, and promoting healing of anal fissures.
These are some examples of Ayurvedic medicinal formulations mentioned in classical texts for the management of Parikartika. It’s important to consult a qualified Ayurvedic practitioner for a proper diagnosis and personalized treatment plan based on your specific condition and needs. The dosage and duration of treatment may vary for each individual.
It is important to consult a qualified Ayurvedic practitioner for an accurate diagnosis and personalized treatment plan based on your specific condition and requirements. The dosage and duration of treatment may vary depending on individual factors.
Parikartika (Anal Fissure): Understanding, Causes, Symptoms, and Holistic Management
Parikartika, commonly known as anal fissure, is a distressing condition characterized by a tear or crack in the lining of the anus. It is a prevalent problem that affects individuals of all age groups. In this article, we will explore Parikartika from both modern and Ayurvedic perspectives, providing insights into its causes, symptoms, conventional treatment, and holistic Ayurvedic management.
I. Understanding Parikartika (Anal Fissure):
Parikartika, or anal fissure, refers to a small tear or crack in the lining of the anus. The anus is the external opening at the end of the digestive tract through which waste materials are eliminated from the body. It is surrounded by muscles known as the anal sphincters, which help control the passage of stool. In Ayurveda, Parikartika is classified as an Anorectal disorder (Gudaroga) primarily associated with imbalances in the Vata Dosha, one of the three fundamental bioenergies in Ayurvedic philosophy.
II. Causes of Parikartika: Several factors contribute to the development of Parikartika, including:
A. Aggravation of Vata Dosha: Imbalance in Vata Dosha, characterized by dryness, coldness, and excessive mobility, can lead to the formation of anal fissures.
B. Poor Digestion and Weak Agni: Weak digestion and impaired digestive fire (Agni) can result in incomplete digestion of food, leading to the production of hard stools and straining during bowel movements.
C. Dietary Factors: Consuming dry and rough foods, such as spicy and fried foods, and insufficient intake of fiber-rich foods can contribute to constipation and aggravate Parikartika.
D. Lifestyle Factors: Sedentary lifestyle, lack of physical activity, and prolonged sitting can affect natural bowel movements, leading to constipation and increased pressure on the anus during bowel movements.
E. Psychological Factors: Stress, anxiety, and emotional disturbances can disrupt the normal functioning of the digestive system, affecting bowel movements and contributing to the development or worsening of anal fissures.
F. Chronic Constipation and Straining: Persistent constipation that requires straining during bowel movements increases pressure on the anus, leading to the formation of anal fissures over time.
III. Symptoms of Parikartika:
Parikartika manifests with the following symptoms:
A. Pain and Discomfort during Bowel Movements: Sharp, stabbing pain or discomfort during or after passing stool is a common symptom of anal fissures.
B. Bright Red Blood in Stool: Anal fissures can cause bleeding during bowel movements, with the blood being bright red and noticeable on toilet paper or in the toilet bowl.
C. Itching and Irritation around the Anus: The tear in the anal lining can cause itching and irritation, leading to a constant urge to scratch the affected area.
D. Anal Spasms and Tenderness: Muscle spasms and tenderness in the anal region may occur due to the irritation and inflammation caused by the anal fissure.
IV. Conventional Treatment of Parikartika: Conventionally, the treatment of Parikartika involves:
- Fiber supplements and increased water intake to soften the stool
- Topical creams or ointments to relieve pain and promote healing
- Pain medications to alleviate discomfort
- Stool softeners or laxatives to prevent constipation
V. Ayurvedic Management of Parikartika:
Ayurveda offers a holistic approach to the management of Parikartika, focusing on addressing the root causes, rebalancing the doshas, improving digestion, and soothing the affected area. The management includes:
A. Dietary Modifications:
- Consuming a balanced diet with an emphasis on fiber-rich foods to promote regular bowel movements.
- Avoiding dry and rough foods, spicy and fried foods, which can aggravate Vata and contribute to constipation.
B. Lifestyle Recommendations:
- Engaging in regular physical activity and exercise to stimulate digestion and promote healthy bowel movements.
- Practicing stress management techniques like yoga, meditation, and deep breathing to reduce psychological factors contributing to Parikartika.
C. Herbal Remedies:
- Triphala: A popular Ayurvedic formulation that helps regulate bowel movements and relieve constipation.
- Arshakuthar Ras: An Ayurvedic medicine that supports the healing of anal fissures and reduces pain and inflammation.
- Gandhak Rasayan
- Saptavimshati Gugul
- Jatyadi Taila: A medicated oil used topically to soothe the affected area and promote healing.
D. Local Sitz Bath:
- Sitting in warm water with added herbal decoctions like neem or triphala can help relieve pain, reduce inflammation, and improve blood circulation in the anal region.
E. Panchakarma Therapies:
- Ayurvedic therapies such as Virechana (therapeutic purgation) and Basti (medicated enema) may be recommended to cleanse and detoxify the body, improve digestion, and restore balance.
It is important to consult a qualified Ayurvedic practitioner for a personalized treatment plan based on individual needs and dosha imbalances. They can provide guidance on appropriate dietary and lifestyle modifications, recommend specific herbal formulations, and administer Ayurvedic therapies tailored to the individual’s condition.
In conclusion, Parikartika (Anal Fissure) is a common condition that can cause significant discomfort and disrupt daily life. While conventional treatment focuses on symptom management, Ayurveda offers a holistic approach by addressing the root causes and rebalancing the body. By adopting Ayurvedic principles, making lifestyle modifications, and utilizing herbal remedies, individuals can find relief from Parikartika and restore overall well-being.