Synopsis

Source of validity: Traditional
Rating (out of 5): 1

Calotropis gigantea, commonly known as "akra" or "arka," has a long-standing place in traditional Indian medicine (Ayurveda) for the management of various conditions, including anal fistula (bhagandara) and anal fissure (parikartika). Traditional Ayurvedic texts mention the use of the latex, leaves, or root bark of Calotropis gigantea in formulations such as Ksharasutra therapy, which is a medicated thread treatment utilized for fistula-in-ano. The rationale is based on the plant's purported antimicrobial, anti-inflammatory, and caustic properties, which are thought to help in debridement and wound healing. However, despite its prevalent use in traditional medicine, scientific validation for these specific uses is very limited. A few animal studies and in vitro investigations have documented the general wound healing or antimicrobial potential of Calotropis gigantea extracts, but there is a lack of robust clinical trials or controlled studies specifically demonstrating efficacy in anal fistula or fissure in humans. Thus, the evidence supporting its use is primarily traditional and anecdotal, and should be considered with caution due to the plant’s known toxicity and irritant effects.

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