Parikartika: what Ayurveda means by it, and how it compares with an anal fissure

The names

Parikartika meaning in Ayurveda. Parikartikā means a cutting pain around the anus. It is the classical description closest to an anal fissure.

How Ayurveda describes it

The classical texts describe parikartikā as a cutting, burning pain around the anus.¹ It appears after hard stool and, in the classical accounts, as a complication of harsh purging or enemas.¹ Ayurveda links it with vāta, which brings dryness and sharp pain, with pitta, which brings burning, and with a disturbed apāna vāyu, the downward-moving current that governs release.

Care in the Ayurvedic view starts with softening the stool and settling vāta through diet, fluids and routine, with local measures and medicines chosen after examination.

How modern medicine describes it

An anal fissure is a small tear in the lining of the anal canal. It causes sharp pain on passing stool that can last for hours, sometimes with a little bright red blood.²³ It usually follows hard or large stool, and sometimes diarrhoea or childbirth.²

Pain makes the ring muscle tighten, which can reduce blood flow and slow healing.³ A tear lasting more than about six weeks is usually called chronic.³ Treatment starts with softer stool, fibre, fluids and warm baths, then prescribed ointments that relax the muscle; some chronic fissures need a procedure.³⁴ A fissure away from the usual position needs further checks.³

Where they agree, and where they differ

Both views agree that soft, regular stool is the foundation, and that the tear heals more easily once the pain-and-tightening loop is broken.

What the evidence does and doesn't show

• Shown: many recent fissures settle with softer stool and simple measures.²³
• Not shown: that pain alone can tell a fissure from piles; an examination is needed.
• Limited: clinical trials of Ayurvedic treatments have mostly been few, small or not well designed, so firm conclusions about parikartikā cannot be drawn. ⁵
• Not a substitute: throbbing pain with swelling or fever can mean an abscess and needs prompt care.

What this means for you

If passing stool hurts sharply and keeps hurting, the useful step is an examination to confirm a fissure, see whether it is recent or chronic, and plan how to keep stool soft. Note when the pain comes and how long it lasts, what the bleeding looks like, and any cream you have used.

Read next

• Anal fissure (fisher): sharp pain when passing stool: self-care, treatment and warning signs
• Piles or fissure? The difference
• arsha, the Ayurvedic word for piles, or all piles and back-passage concerns

A consultation with Dr. D.K. Sharma (BAMS) is ₹500, in person in Ludhiana or by video. The questions are about the pain, the bleeding, your bowel habit and what you have tried, so that you and Dr. Sharma can decide what to look into first. A personalised Dinacharya (daily-routine) guide follows.