An anorectal condition can be difficult to live with and often remains undiagnosed, due to it being perceived as an embarrassing ailment. Fistulas are conditions where two body parts, that are not meant to be connected, become linked as part of the disorder. Rectal fistulas can be painful and standard treatments are available, which can cure the condition. However, these treatments come with serious side effects.

Most people prefer Ayurvedic fistula treatments over the conventional medications for the lack of side effects as such. Ksar sutra is one such branch of treatment in Ayurveda, which has shown tremendous results against fistulas. Here is a look at all that you need to know about Kshar Sutra.

What does Kshar Sutra mean?
Kshar Sutra is a form of treatment, which uses threads laced with the juices of medicinal herbs to treat rectal fistulas.  Kshar  refers to the herbs and  Sutra  stands for the thread used for the treatment. It is a minimally invasive surgical procedure with almost no side effect or danger. The Kshar Sutra form of treatment was first discovered by Sushruta, Vagbhata and Charak. In recent times, BHU s Shalya Tantra Department has once again proved its efficacy in case of rectal disorders.

How is the treatment done?
Once the thread has been coated with the medicinal herbs, the same thread needs to be inserted into the fistula in ano. The patient is anaesthetized and the thread is inserted into the fistula using a probe. The thread is then taken out from the other side and the two ends of the thread are tied together. This thread is changed after every 7 days. This thread insertion effectively cuts the tract and unhealthy tissue is removed from the region.

Why is Kshar Sutra beneficial?
Benefits for this form of treatment include-

Lower risk of anal incontinence, which may occur in case of conventional medicine and surgery.
Lower risk of the anal canal getting narrower after the treatment is completed.
Minimally invasive treatment, which is why patients can resume normal life after just 3-4 days of recovery.
Apart from the treatment, patients should also follow a diet rich in fibre, fruits and vegetables. Drinking large quantities of water will also result in a better prognosis. Lastly, engaging in daily walks will also help you deal with the condition. 

Ksharsutra in the Treatment of Fistula in Ano, Anorectal Disorders!

If you think fissure and fistula are the same, you are mistaken. While the term fissure refers to the tear of the skin, fistula refers to the abnormal tube-like passages or connections between organs. Fissures get cured with or without treatment in a few days to few weeks, and do not lead to complications. On the contrary, fistulas when left untreated may lead to complications.

So, read on further to know about the distinction, how to recognize the symptoms and avail treatment.

What is anal fissure?
An anal fissure can occur due to various reason, such as prolonged diarrhea, anal sex, vaginal childbirth, rectum cancer, etc. For majority of the cases, it is usually due to constant constipation or strained bowel movements, that tear down the muscles controlling the sphincters to the inner rectum or the anal canal.

What is anal fistula?
Anal fistulas are not tears but abnormal abscesses near the anus, filled with pus. In fistula, a tunnel is formed under the skin which connects these abscesses to the infected glands. Fistulas are usually the results of present or previous abscesses. If ignored or left untreated, one single fistula can lead to the development of a more complex fistula, where the single fistula tract ends up creating multiple openings.

Symptoms of anal fissure and anal fistula
Some of the common symptoms of an anal fissure are excruciating pain in the anal area every time the bowel movement occurs, constant itching or burning sensation in and around the anus, bloody stool and visible tears and cracks around the anus.

For anal fistula, some of the very common symptoms are a throbbing pain in the anus, which continues to increase, difficulty in sitting down for longer period, swelling and redness around the anus, accompanied by skin irritation, discharge of blood and pus, and at times fever.

Treatment options
To completely cure anal fissure and fistula, it is the various surgical options that are the most effective ones. However, when diagnosed in its earliest form, medications like antibiotics, analgesics, and antipyretics can often help. It is solely depending on the location, type, and size or severity of the fistula or fissure, the treatments may vary from person to person and so does the recovery time.

Though, these conditions cannot be cured with dietary changes or exercise, following a healthy diet can boost healthy bowel movement, reducing chances of constipation or diarrhea that results in fissures.
Prevention is always better than cure. Therefore, it is essential that you visit the nearest medical facilities once you notice any signs of fissure or fistula , to avail the right treatment and get relief from the symptoms quickly.


Don't Confuse Fissure With Fistula!

There are glands inside the anus that secrete fluids. Sometimes these glands can get clogged. Pus builds up in the blocked clogs, which get infected. This is called an abscess. Unless the abscess is treated right away, it will keep growing. It eventually punches a hole through the skin near your anus to drain the infected tissues and pus. This tunnel that leads from the gland to the hole is called a fistula.

Usually, it is an abscess that causes a fistula. But sometimes a fistula can be caused by tuberculosis, a bowel illness or sexually transmitted diseases.

What are the symptoms of anal fistula?

The symptoms of anal fistula are-

  Pain while sitting down
  Soreness around the anus
  Swelling and redness
  Bleeding
  Painful defecation
  Fever
  Foul secretion from a hole near your anus

How is fistula diagnosed?

If you complain of any of the above symptoms, a doctor will perform a physical examination on you.

Sometimes a physical examination does not reveal a fistula because the fistula can close for a while and then open up again. So then your doctor might ask you to get the following tests done-

  A blue dye test
  Computerized tomography (CT Scan)
  Anorectal ultrasound
  Colonoscopy.

Treatment for anal fistula

Unfortunately, there are no medicines that can treat fistula. If you are diagnosed with fistula, you will require surgery. However, it is a minimally invasive surgery with no risks involved.

The surgery is performed under general anaesthesia. A fistula surgery can be done in the following ways-

  If the fistula is located beneath the sphincter muscles, the surgeon cuts the fistula open so that it can heal and new healthy tissues can develop there.
  If the fistula passes through the upper part of the sphincter muscles, then the surgeon runs a special stitch through the fistula (seton stitch) so that the fistula can drain properly and heal. It takes 6 weeks for the pus to drain and the wound to heal
  Sometimes, a doctor will simply plug the fistula so it does not seep pus.

General and specific complications of a fistula surgery

Though it is a safe surgery, some complications may arise, but rarely. These may be general or specific.

General complications-

  Bleeding and pain
  Scarring around the region of the surgery

Specific complications-

  Pain while urinating
  The involuntary passing of wind or lose faeces

An anal fistula is a painful condition that refuses to go away and the only way to cure it is surgery.

Can Medication Treat Anal Fistula? Find Out!

AV or arterio-venous fistulas are unusual linkages between arteries and veins. In general, pure blood passes from the arteries to the capillaries to the veins and becomes devoid of nutrients and oxygen (becomes  impure ) by the time it reaches the veins. The capillaries in between absorb the nutrients, to supply them to the tissues and organs lying beneath them. In the case of AV fistulas, the capillaries are bypassed and blood passes directly between the arteries and the veins. Thus, organs are deprived of nutrients.

This can be a severe condition, leading even to heart failure.

AV fistulas and dialysis

Sometimes, AV fistulas have to be deliberately created on the body, to treat for severe kidney ailments requiring dialysis.

What is the surgical procedure for creation of AV fistulas for dialysis?

Following are the steps-

  A vascular specialist checks your arteries and veins to make sure they are sturdy enough to be able to support an AV fistula.
  Then, with the help of wave techniques or an angiogram, the depth of your blood vessels is recorded.
  Anaesthesia is then used on the spot, which is chosen for your AV fistula. Local anaesthesia (anaesthesia of only that spot) is preferred over central anaesthesia (anaesthesia of the whole body).
  With the help of a small cut on the skin surface, the surgeon accesses your blood vessels and makes a connection between arteries and veins.

After this process is completed, dialysis takes usually some weeks to begin.

Why should you go for AV fistula?

Following are the advantages-

  Foreign chemicals or devices, which may cause invasion and damage to vital internal organs, are not introduced in your body.
  As only local anaesthesia is administered, you have to spend significantly less recovery time or  downtime  after surgery.
  There is less chance of the wound becoming infected.
  There is a reduced danger of clotting.

AV fistulas are in essence an unusual connection between your arteries and veins, leading to undernourished organs due to capillaries being bypassed. In some cases like dialysis, AV fistulas need to be created and closely monitored. There are several advantages to this, but you will also need recovery time after the procedure is over.

AV Fistula - Its Surgery & Creation Of AV Fistula For Dialysis!

Fissure in Ano, also known as Anal Fissure, is basically a small longitudinal cut in skin that lines the opening of the anus. Fissures cause bleeding and severe pain in the bowel movements. These are very common in the general public, but often confused with other pain. A fissure can happen at any point in your lifetime and can have equal general distribution.

Types of Fissure in Ano:

  Acute Fissure: Fissure in Ano less than 6 weeks of duration is known as Acute Fissure.

  Chronic Fissure: Anal Fissure with more than 6 weeks of duration is known as Chronic Fissure. 

Causes of Fissures in Ano:

  Anal fissures are basically caused by stretching of the anal muscles beyond its capability.

  In adults, it is caused by the passing of large stools, constipation or by prolonged diarrhea.   In older adults it is caused by the less flow of blood to that area.

  It is also caused by sexually transmitted infections (syphilis, chlamydia, herpes) and it results in fissures.

  Anal sex can also be the cause of fissures.

Symptoms of Fissures in Ano:

  Tear in the skin around the anus

  Small lump of skin, or skin tag next to the tear

  Pain during bowel movement

  Stools with blood or pus

  Itching and burning in the anal area 

Preventions During Fissures in Ano:

  One should drink enough water.

  One should have high fibre diet so that one does not suffer from constipation.

  Be careful and hygienic after anal defecation.

  In case of suspected fissure or any kind of pain, use a lubricating ointment.

  Sit in lukewarm water

Treatment for Fissures in Ano

Surgical treatments are not recommended, but there are some other measures that can be taken and are listed as follows:

  Some prescribed medication to lower the severity of pain.

  Nitroglycerin ointment may help heal the fissure.

  Having a rich fiber diet as a lifestyle change.

  Drink enough water as that helps in softening the stool.

  Sometimes Stool softeners may be required to soften the bowel movement.

When Anal Fissure does not heal with all of the above listed things, then a surgery may be required:

  Lower most part of the internal anal sphincter is divided laterally. With this acute fissure heals of its own. In chronic cases one may require to undergo fissurectomy.

  The surgery decreases the anal pain and spasm, allowing the fissure to heal.

  If a sentinel pile is present, it is removed to heal the fissure. 

It is important to note that any kind of treatment requires 6-10 weeks to recover. However, the pain may disappear just after 2-4 days after the surgery. One must consult a doctor before going for any treatment. This surgery can also be performed with LASER,where there is less trauma and early recovery is posssible.

Fissure In Ano

Fistula-in-Ano is a type of an abnormal hollow cavity that is lined with granulation tissue. It connects a primary opening inside the anal canal to the second opening in the perianal skin. There are certain conventional surgical methods like Fistulotomy and Fistulectomy, which have been used but they involve certain complications like delayed healing, narrowing down of the blood vessels or other tubular organs. Modern surgical techniques also come up with similar kinds of issues. Thus modern surgery cannot provide satisfactory modes of treatment for this problem.
Kshar Sutra is basically an ayurvedic parasurgical treatment that involves management of Anorectal disorders for treating Fistula-in-Ano. The technique is minimally invasive in nature.

Following are some of the tips related to the Ayurvedic Treatment Of Fistula-in- Ano with Kshar Sutra:

1. Safe and Extremely Cost-Effective:
This type of surgery uses a thread, also known as Kshar Sutra, especially prepared by herbal chemical cauterization. Cauterization is the medical practice of getting part of the body burnt, for either removing or closing off a particular part to cure diseases like Fistula-in-Ano. Hence, people can safely go for this treatment procedure because there is absolutely no risk element involved. Moreover, as the use of thread is involved in treating the problem, so basically, the minimum expense is involved. So patients need not pay much.

2. Customized Treatment:
Usually, three kinds of Kshar Sutra get used, depending upon the number of coatings and the quality of materials implemented. Coatings are created with ayurvedic herbs and treatment for each and every patient
takes place in a customized manner depending upon their individual requirements.

3. No Side-Effects:
As the coatings for the Kshar Sutra involve the use of ayurvedic herbs, so there is absolutely no chance of any side-effect as herbs are completely natural, having antiseptic, debridement and healing properties.

4. Can Get Rid of Other Disorders:
While undergoing the Kshar Sutra treatment for Fistula-in-Ano, patients are even routinely investigated with a special type of reference for any other associated disorder like Hypertension, Tuberculosis, Diabetes Mellitus, etc.
So, Kshar Sutra not only helps people to get relief from the problem of Fistula-in-Ano but also assists in getting rid of other associated problems.

5. Maintenance of Diet as Part of Ayurvedic Management:
Those patients, who suffer from the painful disease of Fistula-in-Ano, Ayurveda instructs them to maintain a healthy diet in the form of fruits and vegetables. On the contrary, they must avoid the excess amount of spicy foods, along with items that cause constipation and even make sure to not have too much garlic, and potato.

6. Keep Yourself Hydrated:
Drinking plenty of water is extremely essential as this helps to clear off the channels and also allow people to flush off stools and toxins from the body.

Treatment Of Fistula-In-Ano With Ksharsutra!

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