Evaluation of Jatyadi Taila Pichu as an Intra-Anal Drug Delivery Modality in the Management of Parikartika (Acute Fissure-in-Ano): An Integrative Review with Pilot Clinical Study

Parikartika is a painful anorectal disorder described in Ayurvedic classics and closely resembles acute fissure-in-ano. It is characterised by severe pain, bleeding, constipation, and sphincter spasm. Modern colorectal surgical literature emphasizes intra-anal topical therapy to reduce sphincter tone and improve anodermal perfusion, thereby promoting healing. Ayurveda advocates Taila Pichu as an effective Sthanika Chikitsa that provides sustained intra-anal drug delivery. Classical Ayurvedic texts also describe Pakvasaya as an important route for systemic absorption and therapeutic action of drugs through Virya, Vyavayi, and Sukshma properties. This review examines the anatomical, physiological, pharmacological, and Ayurvedic basis of Pichu and integrates pilot clinical evidence evaluating Jatyadi Taila Pichu in acute fissure-in-ano. Clinical findings demonstrated statistically significant improvement in pain, bleeding, constipation, and sphincter tone, with complete healing within 28 days. These findings validate Pichu as a safe, effective, and rational conservative treatment modality.