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Background: Parikartika, a Vata-Pitta predominant anorectal disorder described in classical Ayurvedic texts, closely parallels fissure-in-ano in contemporary surgical practice. It is characterised by linear ulceration of the anal canal mucosa presenting with severe defecatory pain, bright red rectal bleeding, burning, and pricking sensations. While modern management relies on conservative pharmacotherapy and surgical procedures such as lateral internal sphincterotomy, Ayurvedic medicine offers localised therapeutic modalities — among them, Matrabasti — with the potential for non-invasive, tissue-regenerative outcomes.

Objectives: To evaluate the clinical efficacy of Panchatikta Ghrita Matrabasti in the symptomatic relief and healing of Parikartika, and to document the safety profile of the intervention over a 14-day treatment period.

Materials and Methods: An open label clinical evaluation was conducted in 60 patients (aged 18–60 years) presenting with classical features of Parikartika with symptom duration of 7–15 days. Following a standardised sitz bath, patients received 20 ml of warm Panchatikta Ghrita Matrabasti administered per rectum through an infant feeding tube (No. 8) daily for 14 consecutive days. Assessment was performed using a validated six-parameter scoring scale encompassing pain (Shoola), rectal bleeding (Rakta Srava), burning (Daha), pricking sensation (Toda), tenderness, and difficulty in defecation (Mala Pravritti Krichrata), recorded at baseline, day 7, and day 14.

Results: Excellent relief (complete symptom resolution with fissure healing) was achieved in 42 patients (70.0%), moderate relief in 16 patients (26.7%), and mild relief in 2 patients (3.3%) who required an additional seven days of therapy. Complete cessation of rectal bleeding was observed in 95.8% of cases by day 3. Statistically significant improvement was documented across all six clinical parameters (p < 0.001, Wilcoxon signed-rank test). No adverse events were reported.

Conclusion: Panchatikta Ghrita Matrabasti demonstrates promising therapeutic efficacy as a conservative, minimally invasive treatment for Parikartika. The formulation's multi-modal pharmacological actions — Vata-shamana, Vedanasthapana, Shothahara, Jantughna, and Vrana Ropana — collectively address the pathophysiological mechanisms underlying fissure-in-ano. Larger randomised controlled trials with validated outcome measures and comparator arms are warranted to confirm these findings.

Keywords: Parikartika; Fissure-in-ano; Panchatikta Ghrita; Matrabasti; Ayurveda; Anorectal disorders; Vrana Ropana; Shalya Tantra