Synopsis

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

Tannins are polyphenolic compounds found in many plants and have been used traditionally for their astringent, anti-inflammatory, and antimicrobial properties. In the context of anal fistula and fissure, tannin-containing preparations—such as sitz baths with oak bark (Quercus spp.) or other tannin-rich herbs—have been employed in traditional medicine systems, including Ayurveda and European folk medicine. These topical applications are believed to promote wound contraction, decrease local inflammation, and reduce exudation by precipitating proteins in the skin and mucosa, forming a protective barrier that can aid healing. However, while there is anecdotal and historical support for their use, robust scientific studies specifically evaluating tannins for the treatment of anal fistula or fissure are lacking. Most available evidence is either extrapolated from their general wound-healing effects or based on low-quality trials and case series. Modern clinical guidelines do not include tannin preparations as a standard treatment for these conditions. Therefore, the use of tannins for anal fistula or fissure is justified primarily by tradition and not by strong scientific evidence.

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