Parikartika, a painful ano-rectal disorder described in Ayurvedic texts, is considered a Vyapat (complication) of procedures such as Virechana and Basti karma. Its clinical features—sharp anal pain, defecation-associated discomfort, sphincter spasm, bleeding, and burning sensation closely resemble fissure-in-ano in modern medicine. Conventional management includes analgesics, bulk laxatives, topical ointments, dietary modifications, and surgical interventions such as lateral sphincterotomy and fissurectomy. Ayurveda, however, offers cost-effective alternatives with promising outcomes, including Kashaya, varti, basti therapies, lepa kalpana, and sheeta ambu parisheka. This study evaluates the local efficacy of Ashwagandhadi lepa in managing Parikartika. The patient had history of parikartika during pregnancy which was treated earlier, but now it had re-occurred. By the end of treatment, the patient demonstrated significant symptomatic relief and was cured. Thus, Ashwagandhadi lepa proved to be an effective Ayurvedic intervention for Parikartika.
*1Dr. Arpit Surya, 2Dr. Jayaram Anumarlapudi, 3Dr. Ramya R. (Sun,) studied this question.