Alum (potassium aluminum sulfate) has a longstanding history of traditional use in South Asian and Middle Eastern folk medicine, including Ayurveda and Unani systems, for treating various anal and rectal conditions such as fissures and fistulae. Traditionally, alum is applied topically or used in sitz baths, with the belief that its astringent and antiseptic properties help reduce local inflammation, control minor bleeding, and promote wound healing. The astringency is thought to contract tissues, leading to a perception of reduced discomfort and faster healing of minor wounds or ulcers.

However, scientific validation for alum’s efficacy in treating anal fissure or fistula is limited. Available published research primarily consists of small, non-randomized studies, case reports, or extrapolation from its general wound-healing properties. There are a few small clinical studies or case series from India and other countries where alum preparations showed some benefit in symptom relief, but these studies often have methodological limitations and lack comparison to established medical or surgical treatments.

Overall, while alum continues to be used traditionally for these conditions, robust clinical trials or systematic reviews supporting its use are lacking. Its use is therefore justified primarily by tradition rather than by strong scientific evidence.