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!

Anal Fistula - What Causes It? 
An anal fistula refers to a small infected tunnel connecting the anus to the outer skin. Your body eliminates solid waste products or feces through the anus. When any of the glands inside the anus becomes infected or blocked, an abscess may form, which in turn results in formation of anal fistula. In about 50% of the cases, abscesses develop into fistulae. What are the causes for anal fistula? Anal fistulae occur primarily due to the formation of an abscess or infection in the anus. If the abscess does not heal completely after the pus has been drained away, a fistula can develop. 

Other factors responsible for the occurrence of anal fistulae are- 

Crohn s disease- a chronic condition where the digestive system becomes inflamed. 
Diverticulitis- an inflammation of the small pouches that develop along the intestinal walls. 
Hidradenitis suppurativa- a chronic painful skin condition which causes scarring and abscesses on the skin. Apart from these, people with HIV or infected with Tuberculosis disease also develop anal fistulae. If you ve had a surgery around the anus, then post-surgery complications may lead to infection or abscess on the skin. 
What are the symptoms to watch out for? 
The commonly observed signs and symptoms of anal fistulae include- 

Irritation or discomfort on the skin around the anus 
Occasional throbbing pain, especially while seated, moving around or having a bowel movement 
Nodular swelling around anal region 
Intermittent Discharge of blood or pus from an opening near anal orifice. 
How does Ayurveda treat anal fistulae? 
Ayurveda recommends Ksharsutra treatment for complete healing of Anal Fistula. 

In this procedure; Ksharsutra   a medicated thread is placed in Fistula tract. Medicine released from Ksharsutra debrides the fistula tract and induces healing. This medicine remains active for about 5-7 days so this thread needs to be changed with a new thread at weekly interval. No. of Ksharsutra changes required for complete healing of Fistula depends on length depth and branching pattern of fistula. It has been observed that Fistula heals at the rate of 0.5 to 1 cm per Ksharsutra changes so for a fistula tract of 3 cm length about 4-5 weekly thread changes are necessary for complete healing. Clinical trials conducted by Indian Council of Medical Research at AIIMS New Delhi have proved that Ksharsutra treatment is more convenient and more effective than Surgery in case of Anal Fistula. In this way Ksharsutra is the best way to treat Anal Fistula without Surgery.

Anal Fistula - What Causes It?

An Anal fistula (also known as fistula-in-ano) is a small tunnel that can develop between anal canal and the skin near the anus often resulting from an untreated or inadequately treated perianal abscess. No medicinal treatment shows complete cure of anal fistula except few conditions like tubercular fistula. Early surgery, short & straight fistula tract and anal fistula treatment with ksharasutra give promising results with high rate of success.

Fast facts on Anal fistula:

Essentially surgical intervention required.
Recurrence is common.
Should be planned for surgery as early as possible, late cases are mostly complicated.
Anal fistula treatment with ksharasutra shows high rate of success.
What Causes Anal fistula?

Abscess in buttock and/or around the anus.
Long standing anal fissure.
Traumatic injury to the perianal region.
Tuberculosis.
Crohn s disease.
AIDS.
Not maintaining local hygiene.
What are the symptoms of Anal fistula?

Discharging wound at perianal region or buttock which is repeatedly swelling, discharging some amount of pus and/or blood and resolving. The swelling is often associated with pain and fever.
There may be single or multiple wounds.
Passing of flatus through the tunnel like wound.
Anal fistula is notoriously famous for its recurrence even after repeated surgery. An anal sphincter sparing or minimal invasive surgery should always be the choice of patient as well as surgeon. Two stage seton fistulotomy and multistage anal fistula treatment with ksharasutra have shown promising result with lowest rate of reported recurrence and complications like incontinence of stool.

Benefits of treatment with ksharasutra:

Very less incidence of recurrence.
Least chance of post operative stool incontinence.
Minimal invasive procedure.
Minimal blood lost.
Cutting of tract and its healing goes on simultaneously.
Can be performed in elderly patients.
Can be performed in diabetic patients.
Less hospital stay
Patient can continue normal life after a sitting of ksharasutra replacement.

Anal Fistula - Know The Symptoms & Ayurvedic Treatments For It!

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. Ayurveda has perfect surgical techniques which can help you root out this problem without leaving any chances of recurrence.

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 Management & Kshar Sutra in Fistula-in-Ano:

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.



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.

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.

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 of garlic, chillies and potato.
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.

Fistula-In-Ano - Ayurvedic Management & Surgery (Ksharsutra) For It! 

Anal fistula presents itself as a nodular swelling in perianal region. Off and on pus discharge is also seen from this swelling. When pus gets accumulated it gives rise to pain which subsides once the pus discharges out. Usually surgery (Fistulectomy/ VAAFT/ MAFT/ Laser etc.) is advised to manage Anal Fistula. But it is not a good choice as the chances of recurrence of Fistula are very high after these procedures. Whereas Anal Fistula can be completely treated by Graded KsharsutraTM Treatment. 

Clinical trials conducted by Indian Council of Medical Research (ICMR) at AIIMS - New Delhi and PGI - Chandigarh; have confirmed that Ksharsutra treatment is more convenient and more effective than surgery in patients suffering from Anal Fistula. 

What is Graded KsharsutraTM Therapy? How does it Works?

The Ksharsutra therapy is a specialized procedure of Ayurvedic surgery. Ayurvedic surgeon has to first evaluate the anal fistula by clinical examination and if required MRI Fistulogram may be done. Graded KsharsutraTM treatment involves the use of a specialized medicated thread which is placed in Fistula tract. Before placing the Graded KsharsutraTM; it is mandatory to define the fistulous tract properly by careful probing and MRI Fistulogram. 

Medicine released from Graded KsharsutraTM debrides the fistula tract and induces healing. This medicine works for 5-7 days. So, old Ksharsutra needs to be replaced by a new one at a week or 10 days interval till fistula heals completely.

Why Graded KsharsutraTM Therapy Better Than Surgery/VAAFT?

  In appox. 20% cases fistula recurs after surgery however chances of recurrence of Fistula after Graded KsharsutraTM Therapy are predictably NIL.

  Fistula surgery is done under spinal or general anesthesia. So, anesthesia related complications like headache, backache, effect on brain, urinary retention etc. are usually seen while Graded KsharsutraTM is done under local anesthesia which is comparatively safe and there is no complication in it.

  Complications like stool incontinence (inability to hold stool) etc. are seen in surgery. Such complications are not seen in Graded KsharsutraTM Therapy.

  Other complications like pain, bleeding, infection etc. are also seen after surgery. There is no fresh tissue injury in Graded KsharsutraTM so such complications are not seen.

  Hospitalization is necessary in surgery for Anal Fistula. However, Graded KsharsutraTM Therapy is an OPD procedure and hospitalization is not necessary.

  Surgery is followed by bed rest. Bed rest is not required in Graded KsharsutraTM Therapy and patient can continue his normal daily routine activities as usual during this treatment.

  Graded KsharsutraTM Treatment is also more economical and convenient than Surgery. 

Therefore, patients suffering from Anal Fistula are advised to SAY NO TO SURGERY and opt for a better treatment i.e. Graded KsharsutraTM.

Anal Fistula - Why Is Graded Ksharsutra Therapy Better Than Surgery/VAAFT?

An anal fissure or fissure-in-ano is a small, cut in the skin in anal passage which results because of trauma to skin by passing hard stool in this region. Sometimes pain is so severe that patient tends to avoid passing stool in an attempt to stay away from pain.

Symptoms of Anal Fissure: 

  Pain in anal region while passing stool; it may be burning/pricking/Itching in nature.

  Bleeding may or may not be there.

  If untreated for long time; a skin tag known as Sentinel tag or Sentinel Piles develops from the lower end of fissure.

Causes 

The causes related to the emergence of an anal fissure include:

  Passing hard stool which causes frictional injury to inner lining of anal passage.

  Repeated bowel movement or diarrhea

  Trauma to anal canal like by enema nozzle 

Why non surgical treatment is better than Surgery:

Usually surgery (Lateral sphincterotomy) is advised in a view to relieve spasm in anal region so that Fissure starts healing but there are certain complications like stool incontinence etc. associated with this procedure which makes non surgical approach better than surgical intervention. Some of the reasons which make non surgical approach better than surgery for anal fissure are as follows: 

  Acute anal fissure can be conveniently treated by Graded Kshar Karma Treatment. In this treatment a specialized Ayurvedic medicine is applied in fissure region which debrides the fissure and promotes healing. In this way fissure heals completely. So, no need for any surgery at this stage and thus no complication like bleeding, pain, stool incontinence, etc.

  When Fissure is not treated at this stage; a skin tag known as sentinel piles develops from the lower end of fissure. This condition also can be managed by Graded Ksharsutra TM Treatment. In this treatment, Graded Ksharsutra TM - a specialized medicated thread is ligated at the root of sentinel piles and sentinel tag gets detached in 3-5 days. No hospitalization or bed rest is required in this treatment. So, at this stage also fissure can be managed without surgery.

  Delayed healing and Recurrence of Anal fissure are other complications seen after Anal Fissure surgery. Such complications are not seen in Graded Kshar Karma and Ksharsutra Treatment.

  In some case stool incontinence (inability to hold stool; which is far worse than Anal fissure itself) is also seen after Anal Fissure surgery. However, there is no harm to stool control in Graded Kshar Karma and Ksharsutra Treatment.

  No hospitalization or bed rest is required in Graded Kshar Karma and Ksharsutra treatment. Hospitalization and bed rest for a considerable time period is necessary in surgery.

  Graded Kshar Karma and Ksharsutra are more economical than surgery. With this discussion; it is for sure that non surgical treatment for Anal Fissure is far better than Surgery.

Anal Fissure - Non Surgical Treatment Is Better Than Surgery!

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