A Case Study on Parikartika W.S.R Fissure in Ano

Abstract

Parikartika is one of the well-known ano-rectal diseases. Reference to this can be found in the Bruhatrayees. Around the Rajasthan Pradesh, the term \"Parikartika\" refers to Parikartanavatvedana. Additionally, it exhibits symptoms like anus bleeding, burning sensation and sometimes swelling. Parikarthika (Fissure in Ano) is regarded one of the most painful anorectal diseases. As a result of improper changes in modern lifestyle and irregular eating patterns, this disease is become more common now. Due to this, it has recently occurred in all age groups and regardless of gender. This case study describes how an acute fissure in ano was effectively treated using Ayurvedic treatment modalities. A 35year-old male patient arrived with symptoms of pain and burning both during and after defecation, as well as having blood streaks appear in his stool. The patient was diagnosed with acute fissure, due to the presence of a longitudinal ulcer in the lower part of the anal canal. Both internal and external Ayurvedic treatment plan was used. He was treated with Ayurvedic medicines, which gives effective results within 3 days of Ayurvedic treatment.

Introduction

I. INTRODUCTION

Parikartika is described elsewhere in the Ayurvedic Samhita. A complication of Virechana Vhyapad (therapeutic purgation) is described in the Charak Samhita 1. It is referred to as Basti Vhyapad in the Susruta Samhita 2. It is referred to by Kashyapa as Garbhini Vhyapad (Disease Occurs during Pregnancy) 3. The most frequent and painful form of Ano-rectal disease is fissure-in-Ano. Pregnant women and young people are frequently affected. It is extremely painful due to damage to the somatic nerve supply in the anal region. Treatment options in contemporary science include analgesics, antibiotics, laxatives, ointments, and procedures like anal dilatation, sphincterotomy and fissurectomy. Fissure-in-Ano surgeries are pricy and necessitate a lengthy hospital stay. Each of these procedures has its own set of difficulties. The term “Parikarthika” in Ayurvedic medicine refers to a condition where a patient feels as though their anal canal is being cut open with scissors 4. Parikarthika’s management strategies should be chosen based on which drugs and procedures aid in both ulcer healing and the alleviation of cutting and burning pain.

II. CASE STUDY

The main complaint of a 35-year-old male patient was

1. Gudapradeshkartanvatvedana (Excruciating pain)
2. Gudapradeshshoth (anal region swelling)
3. Gudapradeshdaha (anal region burning sensation)
4. Malavashtmbha (Constipation)
5. Saraktamalapravrutti (Blood-stained stools)

Patient had above complaints since last 20 days.

H/o – fissure in ano: since last 2 years.

No H/o any major surgery.

A. Personal Illness History

The patient has a two-year history of fissure. For this he was given modern medicine. Twenty days prior, the patient was in a normal condition. The patient had been afflicted with Gudapradeshkartanvatvedana (Excruciating pain) for the previous 20 days, along with Gudapradeshshoth (swelling at the anal region), Gudapradeshdaha (burning sensation at the anal region), Malavashtmbha (Constipation), and Saraktamalapravrutti (Blood-stained stools). This time, despite the use of modern medications, all the symptoms were intolerable and the pain and burning sensation persisted. He visited our ayurvedic hospital to receive Ayurvedic treatment.

• Nadi (pulse)                               : 70/min.
• Mala (stool)                               : Malavashmbha, Saraktayukt
• Mutra (urine)                                            : Prakrut
• Jihwa (tounge)                                          : Coated
• Agni                                                            : Kshudhamandya
• Shabda (speech)                                       : Prakrut (Normal)
• Sparsha (skin)                                           : Prakrut
• Druka (eyes)                                             : Prakrut
• Akruti                                                         : Krusha
• Bala                                                            : Madhyama
• Raktachaapa (B.P)                    : 110/90 mm/Hg

III. MATERIAL AND METHOD

A. Method

Centre of study: Shri Bhanwar Lal Dugar Ayurved Vishwa Bharti, Sardarshahar, Rajasthan

B. Material

(Table 1- 2).

C. Samaprapti 5

Ruksha Guna of Vata Dosha is the primary cause of parikartika. Prolonged sitting, late-night sleeping, drinking, dry diet and low water intake result in Vataparkop (due to aggravation of the rukha guna of Vata dosha). Earlier in this case study if modern medicine does not relieve the patient’s symptoms, to drug resistance brought on by prolonged use of the same medicine.

IV. DISCUSSION

One of the painful Anorectal diseases, fissure in Ano, manifests as an acute superficial break in the anal canal's continuity. Parikarthika as Sadya Vrana because a painful longitudinal ulcer is present Fissure in Ano treatment protocols should be based on the drugs that promote healing based on the drugs that. The main advantage of this treatment is the complete reduction of complaints like pain, burning sensation, oozing of blood during and after defecation within 3 days after the treatment. Complete healing of ulcer in fissure in Ano within 3 days is one of another advantage noted.

Triphala Guggul which has Vrana Ropana properties. Helps to clean the fissure wound area, improve the blood flow of the regions, and thus helps to relax the anal sphincter. Triphala also heals the tissue along with increasing the digestion of the patient at the same time acting as a mild laxative. Jatyadi taila are Shodhak, Ropaka, Shothahara and Vedanasthapana. The ingredients like Lodhra, Neem, Haridra, Daruharidra, Abhaya, have antimicrobial activity. Manjistha, Sariva, Karanja ingredients are having vrunashodhana (wound cleansing) property. Abhaya have antioxidant and wound healing properties. Kutki improves re-epithelialization, neo-vascularization and migration of endothelial cells, dermal myofibroblasts and fibroblasts into the wound bed. Jati, Patola have vranaropana (Wound healing) action, Neel Kamal (Nymphaea stellate) has astringent and antiseptic properties. Kushta has anti-inflammatory action. Yashtimadhu has soothing and healing action on skin lesions topically. Tuttha (copper sulphate) induces vascular endothelial growth factor (VEGF) expression in the wound. Your blood is cleansed of toxins introduced by a poor diet or a polluted environment because of Kaishore Guggul. Gout is managed and your body's uric acid production is balanced because of it. It is created using herbal extracts that naturally reduce inflammation. It works well to treat wounds and ulcers. Abhyaristh is an Ayurvedic formula that has been clinically proven to improve digestion and help the body get rid of toxins. It is made from natural extracts that are laxative and stimulate peristaltic motions, making bowel evacuation. Raktsthmbhan vati, Nagakeshar, Shuddhalaksha, Mocharasa, Shuddha Gairika Key Benefits of this Ayurvedic tablet may prevent and reduce blood loss. It might be useful for nosebleeds and gum bleeding. It may improve the overall health.

A. Hetu Ahar

1. Rukshanasevan (daily consumption of biscuits and other bakery products) 
2. Ruksha-Amla-lawana Ahar (weekly consumption of fast food and junk food).
3. Madhaypaan (Alcoholism)
4. Guruanasevan (Heavy meals)
5. Low water intake

B. Hetu Vihar

1. Seating for long time
2. Ratri Jagarana
3. Manasika Nidan- Chinta

Conclusion

All agreed that Ayurveda produces slow results, but when used properly in a particular situation, it can give amazing results. One of the best instances of Ayurveda’s magic is this case.

References

[1] Kashinath shastri, Gorakhnath chaturvedi (1996) Charak Samhita 23rd edn., Uttarardha, siddhi-stan, Adhaya no. 6, shloka no. 61-62, Chukhambha vishbahrati publication,Varanasi, pp. 1027. [2] Kavi raja ambika dasshastri (1997) Sushrut Samhita 11th edn., Chikitsa stan, Adhaya no-34, Shloka no.16, Varanasi, Chukhambha sanskruta sanstahan publication, Varanasi, pp.151. [3] Sharma hemraj (1995) Kashyapa Samhita, 4th edn, Garbhinichikitsastan, Chukhmba publication, p. 65. [4] Kumar Praveen, Sijoria KK. Diagnosis and management of Anorectal diseases, first ed, Delhi: Chaukhamba Sanskrit Pratishthan. 2002;179 [5] Kulkarni parajakta, Parikartika : case study, int j res Ayurved pharma 6(4): 450.

Copyright

Copyright © 2023 Dr. Rahul Kumar, Dr. Vishnu Dutt Sharma. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.