Evidence supporting the use of: Gotu kola
For the health condition: Anal Fistula or Fissure

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Synopsis

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

Gotu kola (Centella asiatica) has a long history of use in traditional medicine systems, particularly Ayurveda and Traditional Chinese Medicine. It is valued for its purported wound healing, anti-inflammatory, and connective tissue-repairing properties. In the context of anal fistula and anal fissure, gotu kola is traditionally used to promote the healing of wounds and ulcers, reduce inflammation, and support vascular health. Several traditional texts and herbal compendia mention its use for various types of wounds, including chronic or non-healing wounds, which are seen as analogous to anal fissures and fistulas. Mechanistically, the plant’s triterpenoid saponins (like asiaticoside) are thought to stimulate collagen synthesis and angiogenesis, both relevant to mucosal and skin healing.

Modern scientific studies on gotu kola have largely focused on general wound healing and venous insufficiency. Some small clinical trials and animal studies indicate improved healing rates in chronic wounds and burns. However, direct clinical evidence for its effectiveness in treating anal fistula or fissure is lacking. Most support for its use in these specific anorectal conditions is extrapolated from its broader wound healing effects, as well as documented anti-inflammatory action. Thus, while its use is rooted in tradition and plausible biological mechanisms, robust scientific validation for anal fistula or fissure specifically is limited, meriting a modest evidence rating.

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