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Proficiency of Khanduchakka Ghrit in the management of Parikartika: A case report

Background: Fissure-in-ano is a common anorectal disease. It is mainly of two types: acute and chronic. Chronic fissure-in-ano is difficult to treat and most of the time, it is associated with sentinel tag, which guards the fissure from healing, resulting in nonhealing ulcer, which calls for surgical intervention. Khanduchakka (Ehretia laevis) is a folklore plant that is used popularly by the tribal people for the healing of the nonhealing ulcers. Using that reference in this research work, Khanduchakka Ghrit was used as a local application for managing chronic fissure-in-ano and its efficacy was evaluated. Materials and Methods: In this case report, a patient with chronic fissure-in-ano was treated by Khanduchakka Ghrit, which was used as a local application, after all the mandatory investigations, and its efficacy was evaluated on the basis of clinical parameters such as pain, bleeding, itching, and healing. Results: The patient showed significant results in the clinical parameters evaluated. She got relief in pain, itching, bleeding per rectum, and fissure within 20 days. Even on follow-up assessment, no signs of recurrence were reported. Conclusion: From the aforementioned case, it was concluded that simply applying Khanduchakka Ghrit over a chronic fissure-in-ano is able to heal it. This study revealed that it not only acts as a Ropana (healing agent) but also acts as a Lekhandravya (scrapping agent), which helps in removing slough present at fissure bed and simultaneously helps in the healing of chronic fissure-in-ano.