The Approach of Traditional Persian Medicine to Treatment of Anal Fissure

  • Ghazaleh Mosleh Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
  • Majid Nimrouzi Department of Persian Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Parmis Badr Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Zohreh Abolhasanzadeh Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Amir Azadi Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  • Abdolali Mohagheghzadeh Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
Anal fissure; Persian medicine; Guideline


The common disorder of anal fissure is a painful linear crack in lining of anus. So-called Shiqaq-e-maghad in Persian medical manuscripts has different etiologically-oriented therapies. The aim of this study was to describe the therapeutic guideline for anal fissure in Persian Medicine. Six manuscripts including al-Hawi fi al-Tibb, Qanun fi-Tibb, Qarabadin Kabir, Tibb Akbari, Makhzan-al-Adviah and Exir-e Azam were searched using the keyword of Shiqaq-e-maghad. Although the exact etiology of anal fissure is still uncertain, it has been suggested that a local trauma may cause spasm in internal sphincter of anus leading to a local ischemia and anal fissure. Based on traditional viewpoint, dystemperament, defecation problem, hemorrhoid, inflammation, fullness of veins, and trauma are reasons of anal fissure needing four types of medication including anti-inflammatory drugs, emollients, wound healing agents, and selective remedies. Considering neglected points of traditional outlook will broaden the paths to cure anal fisher.


Derakhshan AR. Natural treatments for fissure in ano used by traditional Persian scholars, Razi (Rhazes) and Ibn Sina (Avicenna). J Evid Based Complementary Altern Med 2017;22:324-333.

Beaty JS, Shashidharan M. Anal fissure. Clin Colon Rectal Surg 2016;29:30-37.

Madalinski M, Kalinowski L. Novel options for the pharmacological treatment of chronic anal fissure--role of botulin toxin. Curr Clin Pharmacol 2009;4:47-52.

Avicenna H. The Canon. Soroush Press. Tehran 2008.

Kasper DL. Harrison's Principles of Internal Medicine. McGraw-Hill Professional. New York 2015.

Santander C, Gisbert JP, Moreno-Otero R, McNicholl AG, Maté J. Usefulness of manometry to select patients with anal fissure for controlled anal dilatation. Rev Esp Enferm Dig 2010;102:691-697.

Madalinski MH. Identifying the best therapy for chronic anal fissure. World J Gastrointest Pharmacol Ther. 2011;2:9-16.

Lund JN. Nitric oxide deficiency in the internal anal sphincter of patients with chronic anal fissure. Int J Colorectal Dis. 2006;21:673-675.

Büyükyavuz BI, Savaş C, Duman L. Efficacy of lanolin and bovine type I collagen in the treatment of childhood anal fissures: a prospective, randomized, controlled clinical trial. Surg Today 2010;40:752-756.

Brady JT, Althans AR, Neupane R, Dosokey EMG, Jabir MA, Reynolds HL, Steele SR, Stein SL. Treatment for anal fissure: Is there a safe option? Am J Surg 2017;214:623-628.

Etzioni DA. Current management of anal fissure. Semin Colon Rectal Surg 2011; 22:2-8.

Nelson RL, Thomas K, Morgan J, Jones A. Nonsurgical therapy for anal fissure. Cochrane Database Syst Rev 2012:15;1-136.

Antifissure Cream. Available from: (accessed 2016).

Minguez M, Herreros B, Benages A. Chronic anal fissure. Curr Treat Options Gastroenterol 2003;6:257-262.

Razi M. Al-Havi. Dare Ehia Attorath Al Arabi. Beirut 2001.

Aghili MH. Qarabadin-eKabir. Research Institute for Islamic and Complementary Medicine. Tehran 2007.

Shah-Arzani MA. Tibb-e Akbari. Jalaloddin Press. Qom 2007.

Aghili MH. Makhzan-ol Advia. Tehran University of Medical Sciences. Tehran 2009.

Nazem Jahan M. Eksire-e Azam.Institue of Historical Studies, Islamic and Complementary Medicine. Tehran 2008.

Parvizi MM, Nimrouzi M, Bagheri Lankarani K, Emami Alorizi SM, Hajimonfarednejad M. Health recommendations for the elderly in the viewpoint of traditional Persian medicine. Shiraz E-Med J 2018; 19:e14201.

Nimrouzi M, Zare M. Principles of nutrition in Islamic and traditional Persian medicine. J Evid Based Complement Altern Med 2014;19:267-270.

Prasad V, Dorle AK. Evaluation of Ghee based formulation for wound healing activity. J Ethnopharmacol 2006;107: 38-47.

Ghayempour S, Montazer M, Mahmoudi Rad M. Encapsulation of Aloe vera extract into natural tragacanth gum as a novel green wound healing product. Int J Biol Macromol 2016;93:344-349.

Marku D, Wahlgren M, Rayner M, Sjöö M, Timgren A. Characterization of starch pickering emulsions for potential applications in topical formulations. Int J Pharm 2012;428:1-7.

Ghodela NK, Prasad P, Kumar V, Dudhamal T. Wound healing potential of gums & oleo-gum-resins: a brief review. Global J Res Med Plants & Indigen Med 2017; 6:89-94.

Feyzabadi Z, Jafari F, Kamali SH, Ashayeri H, Badiee Aval S, Esfahani MM. Efficacy of Viola odorata in treatment of chronic insomnia. Iran Red Crescent Med J 2014;16:e17511.

Singh R, Gupta A, Joshi D, Nainwal N. Wild apricot (Prunus armeniaca) kernel oil: a strategic alternative to value added fatty acids. Int J Essen Oil Ther 2010;4:1-5.

Ali BH, Bashir AK, Tanira MO. Anti-inflammatory, antipyretic, and analgesic effects of Lawsonia inermis L. (henna) in rats. Pharmacology 1995;51:356-363.

Nayak BS, Isitor G, Davis EM, Pillai GK. The evidence based wound healing activity of Lawsonia inermis Linn. Phytother Res 2007;21:827-831.

Parmar NS, Parmar S, Anti-ulcer potential of flavonoids. Indian J Physiol Pharmacol 1998;42:343-351.

Shirazi M, Mohebitabar S, Bioos S, Yekaninejad MS, Rahimi R, Shahpiri Z. The effect of topical Rosa damascena (rose) oil on pregnancy-related low back pain: a randomized controlled clinical trial. J Evid Based Complementary Altern Med 2017; 22:120-126.

Francis JA, Raja SN, Nair MG. Bioactive terpenoids and guggulusteroids from Commiphora mukul gum resin of potential anti-inflammatory interest. Chem Biodivers 2004;1:1842-1853.

Su S, Wang T, Duan JA, Zhou W, Hua YQ, Tang YP, et al. Anti-inflammatory and analgesic activity of different extracts of Commiphora myrrha. J Ethnopharmacol 2011;134:251-258.

Banno N, Akihisa T, Yasukawa K, Tokuda H, Tabata K, Nakamura Y. Anti-inflammatory activities of the triterpene acids from the resin of Boswellia carteri. J Ethnopharmacol 2006;107:249-253.

Mosleh G, Badr P, Abolhassanzadeh Z, Hosseini SV, Mohagheghzadeh A, Azadi A. Potential effects and mechanisms of action of topical wallflower (Erysimum cheiri (L.) Cranz) administration in anal fissure. Res J Pharmacogn. In press.

Mosleh G, Badr P, Azadi A, Abolhassanzadeh Z, Hosseini SV, Mohagheghzadeh A. Wallflower (Erysimum cheiri (L.) Crantz) from past to future. Res J Pharmacogn. In press.

Fürst R, Zündorf I, Dingermann T. New knowledge about old drugs: the anti-inflammatory properties of cardiac glycosides. Planta Med 2017;83:977-984.

Nelson RL, Manuel D, Gumienny C, Spencer B, Patel K, Schmitt K. A systematic review and meta-analysis of the treatment of anal fissure. Tech Coloproctol. 2017; 21:605-625.

How to Cite
Mosleh G, Nimrouzi M, Badr P, Abolhasanzadeh Z, Azadi A, Mohagheghzadeh A. The Approach of Traditional Persian Medicine to Treatment of Anal Fissure. Trad Integr Med. 4(2):78-83.
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