"Yashtimadhu Ghrita Pichu in Parikartika: A Clinical Insight"

Abstract

Fissure-in-ano, described in classical Ayurvedic texts under the broader clinical umbrella of Parikartika, is a common and painful anorectal condition. It is characterised by a linear tear in the anal mucosa, most often caused by the passage of hard stool, and presents with sharp, cutting or burning pain along with bleeding during and after defecation. This clinical study evaluated the efficacy of Yashtimadhu Ghrita (a medicated ghee preparation of Glycyrrhiza glabra Linn.) applied locally as a Pichu (medicated tampon) in 30 patients diagnosed with Parikartika. Eight clinical parameters — Gudashool (pain), Gudadaha (burning), Gudakandu (itching), fresh bleeding, Malavashthamba (constipation), sphincter tone, ulcer status, and spasm — were graded before and after treatment. All parameters showed a statistically significant reduction in severity following treatment (Wilcoxon signed-rank test, p < 0.001 for each), with an overall mean symptom relief of 83.7%. Twenty-six of thirty patients (86.7%) showed marked improvement and the remaining four (13.3%) showed moderate improvement; no patient remained unchanged or showed only mild relief. These findings support the classical description of Yashtimadhu Ghrita as an effective local application for fresh wounds and suggest its clinical utility in the management of Parikartika.