APAMARG KSHARA PRATISARAN (LOCAL APPLICATION) AT CHRONIC FISSURE BED FOLLOWED BY ANAL DILATION IN PARIKARTIKA WITH SPECIAL REFERENCE TO CHRONIC FISSURE IN ANO - A CASE REPORT

Fissure in ano can occur at any stage of life i.e. even children and infants can have fissure. The cause of fissure in ano is primarily constipation with passing of hard stool and secondary due to many diseases like chronic amoebic dysentery, diverticulitis, IBS, ulcerative colitis etc and even post haemorrhoidectomy or fistulectomy. The common site of fissure in ano is 6 o’clock i.e. midline posterior, lower half of anal which is commonly found in young adults and after delivery in females. The disease has been classified into two varieties viz. acute fissure in ano and chronic fissure in ano. Acute fissure in ano is a condition in which duration of symptoms are less than 6 months and inflammation of anal mucosa. In chronic causes the duration of symptoms are usually more than 6 months. Patient complaints with painful defecation, bleeding PR, constipation with chronic linear ulcer at fissure bed who advised for antibiotic, analgesic, anti-inflammatory as conservative treatment and finally diagnosed for application of Apamarga Kshara followed by anal dilation. Taking all pre operative measures, operative procedure was carried out under appropriate anaesthesia. Patient was observed postoperative 1st, 3rd, 5th, 7th, 14th, 30th, 60th days. The healing rate of application of Kshara was fast . No untoward effect was observed in any patient after cure.