A Comprehensive Approach to Treating Acute Fissure-in-ano (Parikartika) with the AYUHEAL Suppository

Mayur Pawaskar; Zishan Ahmad Ansari

doi:10.52756/ijerr.2023.v35spl.015

Mayur Pawaskar Department of Shalyatantra, D. Y. Patil School of Ayurveda, Nerul Navi Mumbai, India https://orcid.org/0000-0002-9662-1543
Zishan Ahmad Ansari Department of Shalyatantra, D. Y. Patil School of Ayurveda, Nerul Navi Mumbai, India https://orcid.org/0009-0001-9043-1810

DOI: https://doi.org/10.52756/ijerr.2023.v35spl.015

Keywords: AYUHEAL Suppository, Fissure in ano, Guda Varti, Parikartika, rectum bleeding

Abstract

Parikartika refers to a medical condition characterized by sharp pain in the anal region. Parikartika, in the context of Western medicine, can be understood as being similar to Fissure-in-ano. This condition is characterized by a combination of increased tension in the internal anal sphincter and reduced blood supply in the posterior midline area of the anal canal. This clinical study examines the effectiveness of the AYUHEAL suppository. This poly-herbal compound is designed to have both local and systemic effects in treating patients with Parikartika, explicitly focusing on acute Fissure-in-ano. A total of fifty patients were subjected to clinical examination and diagnosed with acute Fissure-in-ano based on symptoms including anal pain, per rectum bleeding, burning sensation during and after defecation and constipation. The AYUHEAL suppository was administered thrice daily for seven days. The therapeutic effects of the suppository were evaluated by assessing various parameters on days 1, 3, 5 and 7. The findings demonstrated a notable amelioration in the symptoms, encompassing anal pain, rectal bleeding, post-defecation burning sensation, and constipation throughout the treatment period. Subsequent evaluations on the 21^st day showed no reappearance of Fissure-in-ano, indicating a consistently favorable result. This study shows that using AYUHEAL suppository as the cutting-edge treatment for seven days effectively reduced the symptoms of Parikartika, specifically acute Fissure-in-ano. The suppository's poly-herbal composition allows it to have an effect both at the local site and throughout the entire body, indicating its potential as a comprehensive approach to managing this condition. Additional research and extensive clinical trials are necessary to confirm these findings and investigate the long-term effectiveness of AYUHEAL suppositories in treating Parikartika.

References

Baviskara, P., Bedsea, A., Sadiqueb, S., Kundea, V., & Jaiswala, S. (2013). Drug Delivery on Rectal Absorption: Suppositories. Int. J. Pharm. Sci. Rev., 21(1), 70-76.

Chaudhary, R., & Dausage, C. S. (2019). Prevalence of Anal Fissure in Patients with Anorectal Disorders- A Single Centre Experience. Journal of Clinical and Diagnostic Research, 13(2), PC05-PC07. https://doi.org/10.7860/JCDR/2019/38478.12563

Chaurasia, B. D. (2020). Human Anatomy, vol. II, CBC Publishers & Distributors Pvt. Ltd., pp. 481-482, 484.

Das, S. (2018). A Concise Textbook of Surgery, Old Mayor’s Court, Kolkata, pp. 1064, 1085.

Dhayagonde, S. M., & Desai, S. (2022). Ayurvedic Management of Parikartika WSR Fissure in Ano: A Case Study. International Journal of Research - Granthaalayah, 10(4), 200-204. https://doi.org/10.29121/granthaalayah.v10.i4.2022.4581

Keck, J. O., Staniunas, R. J., Coller, J. A., Barrett, R. C., & Oster, M. E. (1995). Computer-generated profiles of the anal canal in patients with anal Fissure. Dis Colon Rectum., 38(1), 72–79. https://doi.org/10.1007/BF02053863

Krishna, A. P. S. & Haneefunnisa, M. (2018). Rectal Drug Delivery System, Indo American Journal of pharmaceutical Research, 8(09), 391-398.

Leon, L., & Lieberman, A. (2009). The theory and practice of industrial pharmacy, New Delhi. CBS publication, pp. 564.

Nelson, R. L., Thomas, K., Morgan, J., Jones, A. (2012). Nonsurgical therapy for anal Fissure. Cochrane Database Syst. Rev., 2, CD003431. https://doi.org/10.1002/14651858.CD003431.pub3

Nishihata, T., Kate, J., Kobayaahi, M., & Kamnda, A. (1984) Formulation and hydrolysis of enamine in aqueous solution. Chem. Pharm. Bull., 32, 4545-4550. https://doi.org/10.1248/cpb.32.4545.

Nyam, D. C., & Pemberton, J. H. (1999). Long-term results of lateral internal sphincter-otomy for chronic anal Fissure with particular reference to incidence of fecal incontinence. Dis Colon Rectum., 42(10), 1306–1310. https://doi.org/10.1007/BF02234220

Pandey, G. (2005). Dravyaguna Vijnana, Vol. I, Chowkhabmba Krishnadas Academy, Post Box-1118, K-37/118, Gopal Mandir Lane, Near Golghar, Varanasi, pp. 339, 414, 416, 460-461, 662, 753-754, 843.

Pandey, S. K. (2018). Parikartika and Its Management in Ayurveda, Int. J. Ayurveda & Med. Sc., 3(3), 21-23.

Pawaskar, M., Khan, A., & Dwivedi, A. (2019). A prospective clinical study to evaluate the role of “AYUGESIC” guda varti for pain management in post operative cases of open Haemorrhoidectomy. Journal of Ayurveda and Integrated Medical Sciences, 4(5), 86-91.

Ravindra, A. (2011). A text book of Bhaishya Kalpana vigyana, Varanasi Chaukhamba publication, pp. 217-218.

Rinait, A., Lamture, Y. R., Prateek, P., & Gode, D. (2020). Acute Fissure in ano: comparative study between medical & Lateral Internal Sphincterotomy, journal of critical reviews. http://dx.doi.org/10.31838/jcr.07.08.234

Saini, J. (2021). Parikartika: A Literary review based on various ancient classical ayurvedic lexicons, Int. J. Unani. Integ. Med., 5(2), 79-81. https://doi.org/10.33545/2616454X.2021.v5.i2b.173

Schouten, W. R., Briel, J. W., & Auwerda, J. J. (1994). Relationship between anal pressure and anodermal blood flow. The vascular pathogenesis of anal Fissures. Dis. Colon Rectum., 37(7), 664–669. https://doi.org/10.1007/BF02054409

Schouten, W. R., Briel, J. W., Auwerda, J. J., & De Graaf, E. J. (1996). Ischaemic nature of anal Fissure. Br. J. Surg., 83(1), 63–65. https://doi.org/10.1002/bjs.1800830120

Shastri, A. D. (2002). Sushruta Samhita Chikitsa Sthana 34/16, vol. I, Chaukhambha Sanskrit ansthana,Varanasi, pp. 187.

Shastri, A. D. (2007). Maharshi Sushruta, Sushruta Samhita of Acharya Sushruta, vol. I Varanasi Chaukhambha Sanskrit Sansthan, pp.147.

Shastri, A. D. (2010). Sushruta Samhita, vol. I, Chaukhambha Publication, pp.188.

Shenoy, K. R., & Shenoy, A. (2020). Manipal Manual of Surgery, Satish Kumar Jain CBS Publishers & Distributors 4819/XI Prahlad Street, 24 Ansari Road,Daryaganj, New Delhi, pp. 878, 879, 891.

Shukla, A. V. (2017). Charaka Samhita, vol. II, Chaukhambha Sanskrit Pratishthan Charaka Samhita, pp. 919, 931.

Shukla, A. V., & Tripathi, R. D. (2017). Charaka Samhita of Agnivesha, vol. II, Delhi, pp. 926.

Snell, R. S. (2018). Clinical Anatomy for medical students, Lippincott-Williams and Wilkins publication, pp. 362.

Sreerag M. V., & Dhule, M. (2021). Ayurvedic Management of Parikarthika (Acute Fissure in Ano) – A Case Study. Journal of Pharmaceutical Research International, 33(43B), 160–163. doi: 10.9734/jpri/2021/v33i43B32540.