Plumbago zeylanica, commonly known as Chitrak, has a long history of use in traditional Ayurvedic medicine for various conditions, including disorders of the digestive and excretory systems. In the context of anal fistula and fissure, its use is primarily based on traditional practices rather than robust scientific evidence. Ayurvedic texts often recommend formulations containing Plumbago zeylanica root paste for local application or as part of herbal mixtures to promote wound healing, reduce inflammation, and act as an antimicrobial agent. The plant is believed to possess krimighna (antimicrobial), deepana (digestive stimulant), and lekhana (scraping) properties, which are thought to help in cleaning and healing the anal region. Some traditional preparations, like Ksharasutra therapy for fistula, may use Chitrak in their herbal coatings.

However, scientific validation is limited. There are only a few laboratory studies suggesting antimicrobial and wound-healing properties of Plumbago zeylanica extracts, but these are not specific to anal fistula or fissure, nor have they been confirmed in rigorous clinical trials. Therefore, while its use persists in traditional medicine, the overall evidence base is weak and primarily anecdotal.