The Asoka tree (Saraca asoca) has a long-standing place in traditional Ayurvedic medicine, where various parts of the plant are used for a range of gynecological and inflammatory conditions. Its bark, in particular, is noted for its use in disorders involving bleeding and inflammation. In the context of anal fistula or fissure, the Asoka tree is sometimes included in polyherbal formulations in Ayurveda, more for its reputed anti-inflammatory and astringent effects than for any specific action on fistula or fissure pathology.

However, classical Ayurvedic texts such as the Charaka Samhita and Sushruta Samhita do not directly mention the use of Asoka specifically for anal fistula (bhagandara) or fissure (parikartika). Its inclusion in modern traditional practice appears to be based on its general wound-healing, astringent, and anti-inflammatory properties, which may theoretically benefit mucosal healing and inflammation associated with these anorectal conditions.

There is currently very limited scientific or clinical evidence to validate the use of Asoka tree specifically for anal fistula or fissure. Most studies focus on its gynecological uses, such as in menorrhagia. Some preclinical studies suggest anti-inflammatory and antimicrobial properties, but direct clinical studies for anal fistula or fissure are lacking. Thus, its use for these conditions is primarily justified by tradition, and the evidence supporting it is weak.