Analgesic Effect of Sirisa Gel in Painful Fissure-in- Ano: A Case Report

Abstract

Fissure in ano is a common and painful anorectal condition characterized by severe pain, particularly during and after defecation. Pain associated with fissures greatly affects patients daily activities and overall quality of life. Conventional treatment strategies for fissure in ano include increased fluid intake, high fiber diets, sitz baths and topical application of analgesic medications. The Most commonly used topical analgesic is lidocaine, which has side effects such as burning sensation, itching, redness and dermatitis. This case highlights the analgesic effect of Sirisa gel, prepared from the stem bark of Sirisa, which is categorized under Vedanasthapana gana. A 36 year old female presented to our out patient department with severe pain during defecation and which last for 4-5 hours after defecation. For diagnosis anorectal examination was performed and on inspection fissure in ano was noticed at posterior midline and after that digital examination was done following lubrication of index finger with Sirisa gel. Following digital examination the patient reported pain similar to that experienced after defecation. The case was diagnosed as fissure in ano. Thus Sirisa gel was applied over fissure and pain intensity was assessed using the Visual Analogue Scale at 1, 5, 10, 15, and 30-minute intervals. The VAS score was 9 at one minute, decreased to 8 at 5 minutes, 6 at 10 minutes, and further reduced to 4 at both 15 and 30 minutes after application. These findings suggest that Sirisa gel may serve as a useful topical analgesic for reducing pain in fissure in ano.