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How to Treat Anal Fistula Naturally without Surgery

Written and reviewed by
M.S. (Ayurveda), Bachelor of Ayurveda, Medicine and Surgery (BAMS)
General Surgeon, Delhi  •  33years experience
How to Treat Anal Fistula Naturally without Surgery

Anal fistula, a challenge for modern surgery, but can be cured with grade ksharsutra in Ayurveda (Indian system of medicine).  An anal fistula is a disease for which different methods of treatment have been advocated from 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 the 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 without surgery.

Symptoms to Watch out for Anal Fistula

The commonly observed signs and symptoms of anal fistula includes: 

  1. Irritation or discomfort on the skin around the anus 
  2. Occasional throbbing pain, especially while seated, moving around or having a bowel movement 
  3. Nodular swelling around the anal region 
  4. Intermittent Discharge of blood or pus from an opening near the anal orifice. 

Other Factors Responsible for Anal Fistula

Some other alternative factors also responsible for anal fistula problem, to the right cause of the problem can be helpful to treat anal fistula without surgery.

  1. Crohn’s disease- a chronic condition where the digestive system becomes inflamed. 
  2. Diverticulitis- an inflammation of the small pouches that develop along the intestinal walls. 
  3. Hidradenitis suppurativa- a chronic painful skin condition that 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 surgery around the anus, then post-surgery complications may lead to infection or abscess on the skin. 

Anal Fistula Treatment without Surgery in Ayurveda

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 fistula disease.

In 1990 Indian council of medical research has clinically evaluated this Ayurvedic treatment module at four premier 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 ( treatment for fistula without surgery)  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 postoperative complications like a recurrence of the disease, fecal incontinence, bleeding are not seen with Ksharsutra treatment. Further, this therapy is performed as an OPD procedure. No general anesthesia & no hospitalization is required. The patient maintains his normal routine activities as usual during the nonsurgical treatment period.  

Ksharsutra Treatment vs Surgery in Anal Fistula Patients

Check out the difference between surgical and nonsurgical treatment ( ayurvedic treatment for fistula ana without surgery).

  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 a must. 
  4. In Ksharsutra ( treatment for fistula without surgery); the 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.

 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 Anorectal 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, have been operated two or three times but failed to heal were successfully treated at this institute.

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