Dr. Sanjivni Khanna

Anal fistulas or fistula-in-ano generally cause discomfort due pus or watery discharges and sometimes pain. This is a condition where a nodular swelling appears in area surrounding the anal opening. Intermittent pus discharged is noticed from this nodular swelling. Instead of a nodular swelling; there might be simply an opening in this region. An anal abscess is one of the most common causes for this condition. Here are ten things you should know about these anal fistulas:

1. It is curable through Ayurveda only: Till date many treatment options are tried to cure Anal Fistula which include Anal Fistula Surgery/ Glu technique/ cutting seton/ Colostomy/ Fistula plug/ VAAFT and many more. But all of these treatment methods have pretty high recurrence rate of about 20-25 %. However with Ksharsutra treatment for Anal Fistula; chances of recurrence are negligible. Other complications generally seen in surgery like bleeding, incontinence (inability to hold stool); are not seen with Ksharsutra Treatment. Clinical trials conducted by Indian Council for Medical Research (ICMR); at AIIMS New Delhi and PGI Chandigarh in 1992 have proved that Ksharsutra treatment is more convenient and more effective than Surgery in the patients of Anal Fistula. 
2. There are symptoms you can look out for: Some of the symptoms that indicate anal fistulas include appearance of a nodular swelling in area surrounding Anal opening. Intermittent pus discharge is also observed from this swelling. Usually pain subsides and opening closes after the discharges; and patient feels relief. But after certain interval of time again pus accumulates; swelling re-appears with some amount of pain which is again relieved after the discharge. This cycle is repeated at varying interval in the patient of anal fistula.
3. Medication can only provide temporary relief: Anti biotics and painkiller might give temporary relief from the symptoms. But after some time there will be again pus formation and associated swelling & pain in area surrounding anal opening. 
4. Anal fistulas can recur after surgical treatment: As discussed above all the treatment options tried by modern medicine (including most recent treatment VAAFT) have high incidence of recurrence (about 20-25%) Whereas there are negligible chances of recurrence after Ksharsutra Treatment for Anal Fistula. . 
5. Anal fistulas treated by Graded Ksharsutra do not recur: Ayurvedic treatment for anal fistulas is known as Kshar sutra therapy. This involves the use of medicated thread being ligated in Fistula Tract. The medicines present in this thread act as a strong debriding agent and induces healing of Fistula tract. In few weekly sittings of Ksharsutra change; Fistula gets healed completely and it do not recur. Pt. maintains his normal routine life during treatment period. 
6. Sitz bath can be beneficial: This involves sitting in a tub filled with warm water so that the affected site is submerged. An antiseptic and astringent agent like Triphala decoction may be added to the water if needed. A sitz bath soothes the skin and provides relief from pain. This also helps keep the area clean and thus reduces chances of infection. 
7. Oily and spicy foods should be avoided: When dealing with anal fistulas, you should try and take a diet that keeps your stool soft and regular. Hence use of oily and spicy foods should be reduced. Eat plenty of fiber and drink lots of water. Alcohol should also be avoided. 

Comparative Study: 

Ksharsutra vs Surgery in Anal Fistula Patients- 

1. Ksharsutra is done under Local Anesthesia. Hence complications of General Anesthesia are avoided. Surgical procedures are done under GA with all impending complications of General Anesthesia. 
2. Ksharsutra being a parasurgical procedure hence no bleeding/ cutting of tissue is involved. Surgery involves cutting/ bleeding. 
3. No hospitalization or bed rest is required in Ksharsutra Treatment. In Surgery hospitalization is must. 
4. In Ksharsutra; patient can continue his normal daily routine Surgery may require bed rest. 
5. Complications like incontinence (inability to hold stool) and recurrence are seen after surgery
6. Ksharsutra is a safe procedure and these complications are not seen. 
7. Ksharsutra Treatment is more economical as compared to VAAFT surgery. VAAFT Surgery is comparatively too expensive.

Maintaining good oral hygiene is the key for enhanced gum and dental health. Tooth erosion is characterised by decay of the outer and inner parts of the teeth. It occurs when certain sugar containing foods such as milk, candy and cakes leave behind residual quantities, thus causing small food particles to get stuck to and remain in the teeth. These are then digested by the bacteria in the mouth and converted to acids. The acids in combination with saliva form a layer called plaque causes tooth erosion.

To prevent tooth erosion, you can employ these simple methods:

1. Regular flossing: Flossing is an often neglected aspect of dental hygiene. Flossing helps in removing food residues stuck between the teeth that your toothbrush cannot clean. Use proper technique while flossing as improper technique can damage your gums.
2. Brushing twice a day: You should brush at least twice a day with toothpaste that contains fluoride. If possible, brush regularly after eating a meal.
3. Eat well balanced meals: Eat well balanced meals for your gums to receive proper nourishment. Include plenty of fruits and vegetables in your diet as they are rich in antioxidants and vitamins. These antioxidants and vitamins help maintain overall gum and dental health.
4. Fluoridated water: Drink fluoridated water, as it helps in preventing tooth erosion.
5. Use Mouthwash regularly: Use an antiseptic mouthwash to keep your mouth bacteria free. Bacteria in your mouth can lead to rapid tooth erosion.
6. Rinse your mouth: Rinse your mouth with water after every meal. Rinsing helps in removing food particles from your mouth that may contribute to tooth erosion.
7. Avoid junk food: Avoid snacking on junk foods as they contain hidden sugars that can increase your risks of tooth erosion. Avoid sugar based drinks as they can harm your teeth and cause cavities.
8. Dental sealants: A sealant is a coating that is applied on the tooth to prevent it from getting affected by plaque. They usually last for 8-10 years after which they need to be replaced.
9. Visit the dentist regularly: Visit the dentist on a regular basis for check-ups as any underlying issue that can create potential problems in the future may need to be resolved.

Most couples are surprised by the way the arrival of a baby alters their relationship and their entire lives. Whether it is your first or second child, your relationship with your partner is likely to suffer a jolt. Having babies can bring each other closer, but it can also chip away the basic constituent of the relationship.

Some of the most common relationship pitfalls that a relationship suffers from and their remedies are discussed below:

Deprivation of sleep

• It goes without saying that having children can be overwhelming as well as exhausting. The cumulative nature of the sleep deprivation leads to mood swings and makes it difficult to cope up with the regular stress.
• This stress accumulates and is likely to affect the relationship between the new parents.
• To help the condition, it is recommended to sleep while the baby is asleep so that your mind and body can relax.
• You can seek help from your family members too, if they can help you cope up with the regular chores.

Lack of intimacy

• It is no surprise that sexual intimacy would decline while being pregnant and it eventually vanishes after childbirth.
• Sexuality is a very personal and intimate connection between two people; sexual disconnection and dysfunction can become a crucial problem for many people.
• You should not view lack of intimacy as a sign of rejection as it may cause misunderstandings and the relationship may suffer.
• You can have other forms of intimacy such as touching or kissing or snuggling and take your time to connect with each other physically.
• Remember that sexual connection is not the only way of physical connection and you must try to explore them while being pregnant and after childbirth.

Sharing responsibilities

• When a new member comes to the family, it invariably leads to increase in responsibilities and this may cause a physical deprivation.
• It also causes resentments and glitches when one partner feels that he or she is executing more tasks than the other.
• This leads to miscommunication and physical intimacy is likely to suffer.
• Try to map out each other’s routine and see to it that each one has his or her own share of responsibilities.
• The transition that any couple undergoes while the woman is pregnant is certainly joyous and when the child comes to the family, it can be miraculous as well as challenging on the other hand. You cannot afford to let your love life sink, and therefore, both of you should come together to keep the love ignited.

In case you have a concern or query you can always consult an expert & get answers to your questions!