Ayurvedic Management Of Parikartika WSR Fissure in ANO: A Case Study

 

Dr. Suresh Malakari Dhayagonde ¹, Dr. Sayaji Desai ²

 

¹ M.D (Scholar), Department of shalya, Yashwant Ayurvedic College, Kolhapur, India

² M. D (Shalya), Assistant Professor, Department of Shalya, Yashwant Ayurvedic College, Kolhapur, India

 

1. INTRODUCTION

Prevention and cure is two major aims of Ayurveda. Even after curing its deal with stop the recurrence of disease, which is called as apunrbhava. Faulty diet and fast lifestyle give rises to many Gastro as well as Ano_Rectal disease. Pari Kartika is most common Anorectal disease. It’s mostly seen in middle-aged patients, were pitta dosh prominent.

Ayurvedic samhita mention parikartika under complication of panchakarma, example vaman, virechana. Kashinath and Gorakhnath (1996) There is also description of parikartika under complication of some disease like arsha, atisaar, grahani. Guda_daha, sarakta mala_prawrutti, malavshmbha, aanaha are symptoms of parikartika. Most common symptoms of parikartika mentioned in samhita is kartanawat and chedenwat school at guda pradesha.

In morden, parikartika can compare with fissure_in_ano. Fissure can define as it is break or tear the skin of anal canal. Got and Peter (1998) Pain at anal region, in anal area burning sensation, stool streaked with blood are common symptoms of fissure_in_ano. Williams et al. (2004)

 

2. CASE REPORT

A 20 yrs. old male patient came to our opd attached with college with chief complaints of –

·        Burning sensation at anal region (guda daha)

·        stool streaked with blood (sarakta mala_prawrutti)

·        constipation (malavshmbha)

·        distention of abdomen due to flatus (aanaha)

 

3. HISTORY

The patient informs to us that had this disease since last 5 yrs. Previously its mild but day by day, it’s become mild to moderate and sometime unbearable too. Since last 10 days he suffering from Guda_daha, sarakta mala_prawrutti, malavshmbha, aanaha. He took modern treatment for 5 days from nearest GP, but does not get satisfy with result. Finally, he decided to take Ayurvedic treatment. For Ayurvedic treatment he visits to our opd of Ayurvedic hospital.

 

3.1. DASAHVIDHA PARIKSHANA

 

Table 1

Table 1: showing dashavidha parikshan of rugna.
Nadi – 99/ min	Shabda – prakrut.
Mala - sarakta mala_prawrutti, malavshmbha.	Sparsha – prakrut.
Mutra – sometime mutra_daha.	Druka – upanetra.
Jivha – sama.	Akruti – krusha.
Agni – kshudhamandhya.	Bala – heen.
Raktadaab (BP) – 90/70 mm/hg.

 

4. MATERIAL AND METHOD

4.1. METHOD

Center of study: Yashawant Dharmarth Rugnalaya, Kodoli.

Type of study: simple random single case study.

 

 

 

 

 

 

4.2. MATERIAL

 

Table 2

Table 2: Table showing medicine used in case study
SR.NO	DRVYA	DOSE	DURATION	ANUPANA
1	Trifala gugul	250 mg	2 bid	Koshna Jal
2	Shankha_vati	125 mg	1 tds	Koshna Jal
3	Jatyadi oil	2.5 ml	Twice a day	For local application as pichu
4	Kankshi (alum)	5 gm	At morning	For awagahan.

 

Table 3

Table 3: showing mode of action of drug
S.NO	DRUG	MODE OF ACTION
1	Trifala gugul  tripathi (2011)	Shotagha, malasarak, prevent constipation, heeling fissure
2	Shankha vati  Tanjore (1986)	Pacify vata and kafa, shoolagha, pittaghan.
3	Jatyadi oil  tripathi (2011)	vranaRopak, vatashamak, lubrication.
4	Kanshi awagaha	Vranaropak, dahashamak,

 

5. DISCUSSION

Hetu

·        Low intake of water.

·        Prolong seating

·        Eating dry foods and bakery products

·        Late night sleep

·        Stress.

 

5.1.  SAMPRAPTI sutar AND Gadve (2015)

Vata and pitta dosha involved in parikartika. Ruksha guna of vata and ushan guna of pitta together causes all symptoms like pain, burning sensation etc.

Patient is working in shop and doing work of packing of chips. The summer season going on. Patient avoid to drink water because he don’t want loos his time for urination too.

Ruksha guna of vata is become more prominent due to patient consume less water. It’s also cause dehydration in patient. Jal has snighdha guna so due to less water and grisham rutu ruksha guna increases. Prolong seating do kafa_prakop and ultimately do margavarodha to vata dosha. Due to this anaha symptoms occur. Late night sleep aggravated to pitta and vata too. Outside food like vada paav increase all symptoms.

 

            Hetu sevan

       |

        Srtotodushti

        |

       Straining during defecation

        |

                                        Constipation, burning sensation at anal region, bleeding with stool

         |

                               Parikartika

 

6. OBSERVATION AND RESULT

 

Table 4

Table 4: showing changes in symptoms
Symptoms	0th day	1st day	2nd day	3rd day	5th day
Guda daha	+++	+++	++	+	0
sarakta mala_prawrutti	+++	++	+	0	0
Malavshmbha	++	++	0	0	0
Aanaha	+++	+++	+	0	0

 

The patient had started improvement on the 1st day of treatment. Most of symptoms disappears on 3rd days and get total cure at the end of 5th day.

 

7. CONCLUSION

There are plenty of medicine available in modern pathy for parikartika, but all give just temporary relief. Ayurvedic management give quick and permanent result in such disease. This is simple case study which prove that Ayurved give fast and permanently result.

 

CONFLICT OF INTERESTS

None. 

 

ACKNOWLEDGMENTS

None.

 

REFERENCES

Got, M.D, Peter, H. (1998). New theraphy coming for anal fissure ; the frensno bee frensno,CA: Mcclateyco.p.ez, "life"section.

Kashinath, s. Gorakhnath, c. (1996). charak samhita 23th edition, uttarakhanda, siddhi stan, adhaya no.6, shlok 61-62, chukhmba publication Varanasi. 1027.

Tanjore, m. s. (1986). A Krishan swami mahadick Rao sahib,Turanagratanamala, Tanoji maharaja serfoji's saraswati mahal library press,thanjavur,. shankhavati kalpana.292.

Sutar, P.S., and Gadve, B.N. (2015). A case study on management of parikartika wsr to fissure in Ano ; world journal of pharmacy and pharmasutical science, 10(6),1694.

Tripathi, B. (2011). sharangadhar samhita, sharagdharacharya rachit, madhaym_khanda, chapter-7 ; vatak kalpana, Varanasi, 206.

Tripathi, B. (2019). sharangadhar samhita, sharagdharacharya rachit, madhayam_khanda, chapter-9 ; grut tail kalpana, Varanasi, 206.

Williams, N.  Bulstrode, C.  Christopher, R. Russell, G. (2004).  Baily & loves short practise of surgery 24th edition, 1253-1254.