Anal Fissure – Ayurvedic Perspective & Treatment
Definition of Anal Fissure
An anal fissure is a small tear or cut in the lining of the anal canal,
which can cause pain, bleeding, and discomfort during or after bowel movements.
It is a common anorectal condition, seen in both men and women, and across all age
groups.
Causes of Anal Fissure
– Constipation and hard stools (most common)
– Straining during defecation
– Chronic diarrhea
– Childbirth trauma
– Anal intercourse
– Low-fiber diet
– Sedentary lifestyle
– Inflammatory bowel diseases (e.g., Crohn’s disease)
– Poor anal hygiene or excessive wiping
– Infections or STDs (rare)
Symptoms of Fistula
Acute Fissure:
– Fresh tear
– Less than 6 weeks old
– May heal on its own with conservative treatment
Chronic Fissure:
– Lasts more than 6 weeks
– Edges become fibrotic, and sentinel piles may form
– May require surgical or parasurgical intervention like Ksharasutra
Symptoms of Anal Fissure
– Sharp, stabbing pain during and after defecation
– Bright red bleeding in stool or on toilet paper
– Visible tear or crack near the anus
– Itching or burning sensation
– Swelling or skin tag (sentinel pile)
– Spasms in the anal sphincter
– Feeling of incomplete evacuation
Ayurvedic Perspective & Treatmen
In Ayurveda, Anal Fissure is often compared to:
“Parikartika” – a condition described in classical Ayurvedic texts involving cutting-type pain
around the anal region
Ayurvedic Treatment for Anal Fissure
1. Internal Medicines (Herbal)
– Triphala Churna – for regular bowel movements
– Avipattikar Churna – mild laxative and pitta pacifier
– Gandhaka Rasayana – healing and antibacterial
– Abhayarishta – useful in constipation
– Arshoghni Vati – relieves pain and inflammation
2. Topical Application
– Jatyadi Taila or Nirgundi Oil – healing of wound and pain relief
– Hingvashtaka Churna – relieves flatulence and supports digestion
3. Panchakarma Therapy
– Basti Karma (medicated enema) – to pacify Vata dosha
– Sitz bath (Warm water with Triphala decoction) – 2–3 times a day
4. Diet & Lifestyle (Pathya-Apathya)
– High-fiber diet (fruits, green vegetables, whole grains)
– Hydration – 2–3 liters of water/day
– Avoid spicy, deep-fried food
– Avoid straining at stools
– Regular physical activity
Ksharasutra Treatment for Chronic Anal Fissure
Ksharasutra is a medicated thread prepared using herbal alkaline drugs (like Apamarga
Kshara, Snuhi latex, and Haridra).
Procedure (for Fissure with Sentinel Tag or Polyp):
– Pre-operative care – bowel cleaning, antiseptic preparation
– Excision of fibrotic tissue or sentinel pile
– Application of Ksharasutra if needed for non-healing wound/fistula tract
– Daily dressing and Ksharasutra change every 7 days
– Promotes gradual cutting, healing, and scar formation
Advantages of Ksharasutra:
– Minimally invasive
– Less recurrence rate
– Preserves anal sphincter (less risk of incontinence)
– Can be done under local anesthesia
– Effective in chronic, non-healing fissures
Ksharasutra Treatment for Chronic Anal Fissure
– Avoid constipation – take fiber and mild laxatives
– Sit in warm sitz baths daily (Triphala decoction or plain water)
– Keep the anal area clean and dry
– Avoid long sitting hours
– No heavy lifting or straining
– Follow-up visits for thread change if Ksharasutra applied
– Avoid spicy and fried foods
– No sexual intercourse (anal or vaginal) until complete healing
| Aspect | Details |
| Condition | Anal Fissure (Parikartika) |
| Causes | Constipation, straining, trauma, poor diet |
| Types | Acute & Chronic |
| Symptoms | Pain, bleeding, itching, visible tear |
| Ayurvedic View | Vata-Pitta imbalance, Parikartika |
| Herbal Remedies | Triphala, Avipattikar, Gandhaka Rasayana |
| Procedures | Basti, Sitz bath, Ksharasutra (for chronic cases) |
| Precautions | High fiber diet, hygiene, avoid straining, follow-ups |
