An individual’s overall health is strongly shaped by dietary habits and lifestyle choices. In Ayurveda, food is regarded as a central factor in both the onset and treatment of Parikartika. Mentions of this condition appear as early as the Sushruta Samhita (1500 B.C.), with further elaborations in the Bruhatrayees and other classical works. Notably, Parikartika is not classified as an independent disease in these texts; instead, it is described as a complication (Vyapath) that may arise following therapeutic procedures such as Bastikarma and Virechana. In contemporary medicine, fissure-in-ano is one of the most common anorectal disorders. Research indicates that 30 - 40% of people experience proctologic issues at some point, with anal fissures accounting for 10 -15% of these cases. The hallmark features include sharp pain during and after defecation, rectal bleeding, and spasm of the anal sphincter. Ayurvedic descriptions of Parikartika emphasize symptoms such as Kartanavat Shoola and Chedanavat Shoola (cutting or tearing pain in the anal region), which closely mirror the clinical presentation of fissure-in-ano. Both conditions are characterized by severe pain (Teevra Shoola) and bleeding (Raktasrava). Ayurvedic management focuses on internal remedies and localized applications prepared with substances that are Madhura (sweet), Sheeta (cooling), and Snigdha (unctuous). Treatments such as Anuvasana Basti, Piccha Basti, medicated oil infusions (Madhura-Kashaya Dravya Siddha Taila Poorana), topical pastes (Lepa), and gauze applications (Pichu Dharana) are considered effective in reducing symptoms and supporting healing. Chronic fissure-in-ano often progresses to the formation of sentinel piles. Although Ayurvedic texts do not directly describe sentinel piles as a consequence of Parikartika, similarities can be drawn with conditions such as Shushkarsha, Bahyarsha, Vataja Arsha, and Janmottar-Kalaja Arsha. These references provide a conceptual basis for linking sentinel piles with Ayurvedic understanding of pathogenesis.
Dr. Bharathi D. Anvekar2 Dr. Sai Reshma Ch*1 (Sun,) studied this question.