Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Plantago, particularly Plantago ovata (psyllium husk), has a long history of traditional use in the management of anal fissures and fistulas, primarily for its bulk-forming laxative properties. In both Ayurvedic and Western herbal medicine, Plantago is recommended to soften stools and reduce straining during defecation, which is a key factor in the healing of anal fissures and the management of fistulas. Softer stools decrease trauma to the anal mucosa, potentially facilitating healing and reducing pain. Several clinical guidelines for fissure management suggest the use of stool softeners or bulk-forming agents, and psyllium is commonly cited among these options.

However, direct scientific studies specifically investigating Plantago’s efficacy in treating anal fissures or fistulas are limited. Most evidence is extrapolated from its general effects as a fiber supplement—namely, improving stool consistency and bowel regularity. One small clinical trial and some case series have included Plantago as part of broader management strategies for anal fissures, with reported symptom improvement, but there is scant high-quality, targeted research. Thus, its use is justified by tradition and general clinical practice, with moderate indirect support from studies on fiber supplementation and bowel health, but lacking robust, condition-specific scientific validation.

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