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DOI: 10.1055/a-2587-5592
Paeonia officinalis for Acute Anal Fissure: A Prospective, Single-Group, Open-Label, Pre–Post Comparison Study
Funding This study was supported by the All India Institute of Medical Sciences (AIIMS), Bhopal, as part of its Intramural Research (IMR) program.
Abstract
Background
Acute anal fissure (AF) causes significant pain and discomfort, sometimes requiring invasive treatment. This study evaluates the usefulness and safety of homeopathic Paeonia officinalis mother tincture (Q) in the management of acute AF.
Methods
An open-label, prospective, pre–post comparison cohort study was conducted on 34 participants diagnosed with acute AF. Paeonia officinalis Q was administered orally (10 drops in 50 mL of water, once daily) for 12 weeks alongside supportive care that included dietary advice. Outcome measures were: pain intensity assessed using a Visual Analog Scale (VAS; range: 0–10); level of strain during defecation using the Defecation Strain Score (DSS); Outcome Related to Impact on Daily Living (ORIDL) score for main complaint and overall well-being; and degree of healing of fissure (HoF) by visual clinical examination.
Results
VAS score reduced significantly from baseline (8.94 ± 0.81) at 12 weeks (0.11 ± 0.32), with a mean decrease of 8.82 ± 0.13 (p < 0.001), while DSS decreased from a median of 3 to 0 (change, 3; inter-quartile range [IQR], 2–3; p < 0.001). ORIDL scores for main complaint increased from 2 to 4 (change, 1; IQR, 1–2) and well-being from 3 to 4 (change, 1; IQR, 1–1; p < 0.001). By 12 weeks, fissures healed completely in 30 (88.2%) participants, with no serious adverse events reported.
Conclusion
Homeopathic Paeonia officinalis Q, combined with concomitant care advice, appears useful in reducing pain and straining while promoting fissure healing in acute AF patients. The potential influence of confounders limits attribution of positive outcomes to the homeopathic intervention alone.
Authors' Contributions
A.K.D. conceptualized and designed the study, oversaw its development and was responsible for data collection. Data analysis and interpretation were performed by A.K.D., M.S.Y. and D.J. The manuscript was collaboratively drafted by A.K.D., M.S.Y., D.J. and B. Md T., with all authors actively participating in the review process. The final version was approved by all contributors.
Publikationsverlauf
Eingereicht: 02. März 2025
Angenommen: 14. April 2025
Artikel online veröffentlicht:
20. August 2025
© 2025. Faculty of Homeopathy. This article is published by Thieme.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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References
- 1 Jonas M, Scholefield JH. Anal fissure. Gastroenterol Clin North Am 2001; 30: 167-181
- 2 Nelson RL, Manuel D, Gumienny C. et al. A systematic review and meta-analysis of the treatment of anal fissure. Tech Coloproctol 2017; 21: 605-625
- 3 Lund JN, Scholefield JH. Aetiology and treatment of anal fissure. Br J Surg 1996; 83: 1335-1344
- 4 Garg P. Local and oral antibiotics with avoidance of constipation (LOABAC) treatment for anal fissure: a new concept in conservative management. Indian J Surg 2016; 78: 80
- 5 Zaghiyan KN, Fleshner P. Anal fissure. Clin Colon Rectal Surg 2011; 24: 22-30
- 6 Giral A, Memisoglu K, Gültekin Y. et al. Botulinum toxin injection versus lateral internal sphincterotomy in the treatment of chronic anal fissure: a non-randomized controlled trial. BMC Gastroenterol 2004; 4: 7
- 7 Dixit AK, Yadav MS. Reducing pain and promoting healing in acute anal fissure with individualised homoeopathic treatment: a case series. Homoeopath Links 2023; 36: 294-302
- 8 Allen TF. Encyclopedia of Pure Materia Medica. Vol. VII.. Philadelphia: Boericke & Tafel; 1878: 276-280
- 9 El Charif MH, Doughan S, Kredly R, Kassas S, Azab R, Sbaity E. MEBO versus topical diltiazem versus a combination of both ointments in the treatment of acute anal fissure: a randomized clinical trial protocol. BMC Complement Med Ther 2021; 21: 75
- 10 Patankar R, Mishra A. A prospective non-comparative study to assess the effectiveness and safety of combination laxative therapy containing milk of magnesia, liquid paraffin and sodium picosulphate (Cremaffin-Plus®) in the management of constipation in patients with anal fissure/hemorrhoids/obstructive defecation syndrome. Int Surg J 2017; 4: 3899-3906
- 11 Reilly D, Mercer SW, Bikker AP, Harrison T. Outcome related to impact on daily living: preliminary validation of the ORIDL instrument. BMC Health Serv Res 2007; 7: 139
- 12 Jonas M, Neal KR, Abercrombie JF, Scholefield JH. A randomized trial of oral vs. topical diltiazem for chronic anal fissures. Dis Colon Rectum 2001; 44: 1074-1078
- 13 Gagliardi G, Pascariello A, Altomare DF. et al. Optimal treatment duration of glyceryl trinitrate for chronic anal fissure: results of a prospective randomized multicenter trial. Tech Coloproctol 2010; 14: 241-248
- 14 von Elm E, Altman DG, Egger M. et al The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370: 1453-1457
- 15 Blaquière HM. Guidelines in the homoeopathic treatment of ano-rectal disorders. Br Homeopath J 1971; 60: 269-275
- 16 Patil SG. Role of homoeopathy in the management of anal fissure. Int J Homoeopath Sci 2022; 6: 175-178
- 17 Jensen SL. Diet and other risk factors for fissure-in-ano. Prospective case control study. Dis Colon Rectum 1988; 31: 770-773