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!

Anal Fissure is a small tear in the anal area. This can happen due to injury while passing hard formed stool or even by repeated bowel motion. It may be very painful especially at the time of passing hard stool. 

Symptoms

Most commonly sought symptoms in Anal Fissure are as given below: 

  A noticeable tear in the skin close to the anus. 

  Cutting or burning pain in anal passage while passing stool which may persist for a considerable time

  Sometimes pain is so severe that patient stops eating in an attempt to avoid defecation to avoid pain

  Blood stains on stools may also be there

  If not treated in time; skin starts growing from the lower end of fissure to form a tag known as sentinel tag/sentinel piles.

  At times; sentinel tag may get inflamed.

Causes

  Passage of hard stool through anus. 

  Chronic Diarrhoea

  Trauma to the anus and anal canal like during childbirth

  Inflammation in anus because of crohn's disease or some other inflammatory disease 

Anal Fissure treatment: Diet: High fiber diet like green leafy vegetables, salads, fruits like papaya, chikku are advised. Resins with milk can also be taken in night. Adequate quantity of liquids especially butter milk is advised. Banana, apple etc. should be avoided. 

Graded Kshar Karma & Ksharsutra: Anal Fissure can be completely treated by Graded Kshar Karma and Ksharsutra treatment. In acute anal fissure; stool softener along with Graded Kshar Karma is advised. In this treatment; Graded Kshar - a specialized Ayurvedic medicine is applied in fissure region. This medicine debrides the fissure and induces healing. Usually pain subsides in a week or 10 days time period when fissure is still in healing phase.

Considering pain has subsided; some patients discontinue the treatment to further aggravate and complicate the problem. For complete healing of anal fissure usually 3-5 Graded Kshar Karma sittings are required at a weekly interval. In between these weekly sittings patients are advised to apply certain medicines in anal passage by themselves. If anal fissure has progressed to development of sentinel tag then Graded Ksharsutra TM treatment is the treatment of choice. 

In this treatment Graded Ksharsutra TM is ligated at the root of sentinel tag. Medicine released from Ksharsutra blocks the blood supply of sentinel tag and it sheds off in a week or 10 days time period. No hospitalization or bed rest is required in this treatment. Patient can continue his normal routine activities as usual during his treatment. So, you can say no to surgery in Anal fissure.

Anal Fissure - Say No To Surgery!

Anal fistula, a challenge for modern surgery, but can be cured with grade ksharsutra in Ayurveda (Indian system of medicine).  Anal fistula is a disease for which different methods of treatment have been advocated time to time, even today when we are talking about robotic surgery, this disease has no satisfactory method of treatment in modern surgery. The latest method of video assisted anal fistula treatment (VAAFT) is not satisfactory due to high incidences of recurrence after the surgery. But at Sushruta Anorectal Institute New Delhi; with the help of Graded KsharsutraTM all these patients of complex Anal fistula are being successfully treated.

In Ayurveda about 2000 yrs ago Acharya Sushruta has indicated ksharsutra treatment to treat fistula-in-ano. Late professor P J Deshpandey at the faculty of Ayurveda Institute of Medical Sciences B H U; had done extensive research in this field and established a treatment module to cure this disease. In 1990 Indian council of medical research has clinically evaluated this Ayurvedic treatment module at four premiere institutes in our country including AIIMS Delhi & PGI Chandigarh. Subsequently, it was concluded by I.C.M.R. that in the patients of fistula in ano, ksharsutra treatment is more effective& convenient as compared to modern surgery.

Ksharsutra is a thread coated with certain Ayurvedic medicines known for their antiseptic, debridement & healing properties. After u v sterilization this medicated thread (ksharsutra) is used under complete aseptic precautions in the patients. The patient is routinely investigated with special reference to any other associated disorder like hypertension, diabetes mellitus, tuberculosis etc. The next step lies in the proper identification& evaluation of the fistulous tract. It is mandatory to define the fistula tract wrt its depth, direction & branching pattern. This may be achieved by careful probing under expert hands using malleable probes& if required help may be taken from other investigations like x-ray fistulogram or MRI fistulogram. 

Once the tract has been clearly defined the Ksharsutra is placed in it with the help of certain instruments, under local anesthesia. This entire procedure is usually completed in ten to fifteen mins. As there is no cutting of tissues hence no bleeding, no pain & patients can go home after half an hr rest in the daycare room. The medicine-coated on the thread is gradually released in the tract. The cumulative effect of the coated drugs exerts a powerful debridement effect on the fistula tract & induces healing by the fresh & healthy granulation tissues. Thus Ksharsutra is the mechanism of drug delivery precisely at the tissues involved. 

Every seventh or tenth day the old sutra is replaced with a new Ksharsutra till there is a final cut through. It has been observed that the tract heals @ 0.5-1 cm per week. The post-operative complications like recurrence of the disease, fecal incontinence, bleeding is not seen with Ksharsutra treatment. Further, this therapy is performed as an OPD procedure. No general anesthesia & no hospitalization is required. Patient maintains his normal routine activities as usual during the treatment period. 

 At Sushruta Anorectal Institute; Rohini - New Delhi, we have been working on this disease including piles fissures & pilonidal sinus for the last 30 yrs. Here we have developed the concept of Graded KsharsutraTM which has given us a more effective & convenient way to treat anal fistula. At Sushruta Anorectai Institute we have treated on record thousands of patients of anal fistula from different states including overseas patients. We have records to prove that the patients of high anal complex fistula, those have been operated two or three times but failed to heal were successfully treated at this institute.

How to Treat Anal Fistula Naturally without Surgery

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!

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!

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! 

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