combined effect of topical application of ayaparnakera varthi and internal administration of vara churna in acute fissure in ano

An anal fissure is a common medical condition characterized by a small tear or crack in the lining of the anus. Acute fissure- in- Ano refers to sudden onset of symptoms often caused by trauma during bowel movements or passing hard stools. The main symptoms are sharp cutting pain & burning sensation during and after defecation, bright red blood on the toilet paper or in the stool and spasm of anal sphincters. Treatment for acute fissure in Ano focuses on relieving symptoms and promoting healing. Conservative measures include use of stool softeners, laxatives, topical analgesics, ointments etc.

Signs and symptoms of fissure- in- Ano has close resemblance with the features of parikarthika. According to Ayurveda parikarthika is mentioned as a complication of atisara, improper administration of vasthi, vamana and virechana.Treatment for parikarthika as per charaka samhitha are pichavasthi, anuvasan vasthi,parisheka,pichu and local administration of Sneha dravya which relieve vata and pitta.

In Ayurveda classics Ayaparna (Eupatorium triplinerve Vahl) has the properties of vrana sodhana ropana, rakthasthambana,anulomana etc;Kera taila has proven actions such as anti-inflammatory,anti-bacterial and relieving muscle spasm.Vara churna is having anulomana (mild laxative) property. It also has anti-inflammatory, anti-microbial and wound healing actions. Keeping these factors in view ayaparna kera varthi and varachurna is used to evaluate the effect in acute fissure in Ano. The present study design will be open clinical study which will be done among 27 participants in the age group 18-60years selected from shalyatantra department of Government Ayurveda College Hospital Kannur. The study population will be consecutively selected in a single group and varthi will be applied and vara churna will be given internally.

Treatment will be done on 14 consecutive days and assessment will be done based on objective parameters such as length of ulcer, anal sphincter spasm & subjective parameters such as pain, bleeding,burning sensation and constipation, before treatment on 0th day, in between treatment on 8th day ,after treatment on 15th day and follow up on 30th day.