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Pilonidal Sinus Tips

What Is The Natural Way Of Treating Pilonidal Sinus?

Dr. Vijay Dagar 86% (23 ratings)
BAMS, Ksharsutra
Ayurveda, Delhi
What Is The Natural Way Of Treating Pilonidal Sinus?

Pilonidal sinus is a painful disorder in which an individual has a tunnel developed at the cleft of buttocks which may at times be filled with pus and turn into a cyst. Such a cyst may contain hair, debris or dirt. Since it occurs in such a sensitive area it may become infected easily.

Causes:
There is no one definite cause behind Pilonidal sinus. Doctors have pointed out several reasons for its occurrence which include:

  1. Hormonal changes and imbalance seen after puberty
  2. Friction caused by clothing, poor sitting posture and other such activities
  3. Ingrown hair
  4. Lack of hygiene causing accumulation of debris and dead skin cells in the buttock cleft

Symptoms:
The main symptoms of Pilonidal sinus have been stated below-

  1. Fever
  2. Bleeding/pus release from the abscess
  3. Irritation and pain above the cleft
  4. Swelling and redness of the sinus
  5. Sore skin around the cleft
  6. Pain while sitting
  7. Discomfort due to pus accumulation

Treatment of Pilonidal Sinus:
Though Pilonidal sinus is not a life-threatening disease, its consequences can be quite painful. Hence, it must be treated on priority to avoid its re-occurrence. Ayurveda provides a permanent solution to Pilonidal sinus through kshar sutra treatment which involves not only the removal of the existent infection but development of healthy tissue preventing the recurrence of the disorder.

The Kshar Sutra treatment for Pilonidal sinus includes the following steps-

  1. The Pilonidal sinus is first examined to understand its extent and depth.
  2. Based on the observation, the duration of the treatment is determined.
  3. A kshar sutra or medical thread ( a linen thread coated with a medicinal latex) is then inserted into the Pilonidal sinus.
  4. The kshar sutra is replaced every week and this treatment continues for about 3-4 weeks till the wound is healed.

Kshar sutra is a non surgical, non-invasive treatment for Pilonidal sinus. It not only heals infection but promotes growth of new tissue. This natural method of treatment has seen high success rates in curing Pilonidal sinus.

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Pilonidal Sinus - Graded Ksharsutra Therapy Is Better Than Surgery/Z-Plasty!

Dr. S K Singh 95% (831 ratings)
M.S. (Ayurveda), Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Delhi
Pilonidal Sinus - Graded Ksharsutra Therapy Is Better Than Surgery/Z-Plasty!

Pilonidal refers to a nest of hairs and sinus stands for a tunnel like structure with two openings communicating with each other. A Pilonidal Sinus (PNS) presents as a nodular swelling or an opening in lower spinal region with hairs and dead cells in the sinus cavity. Intermittent watery or pus discharge is also noticed from this swelling.

Symptoms:

Pilonidal sinus mostly happens to people with hairy skin. Hairs invade in the skin in natal cleft and act as a source of infection. As a result cyst formation is there with swelling and intermittent pus discharge. The symptoms Pilonidal Sinus include:

• A painful swelling in lower spinal region

• Pain and swelling subsides once the pus is discharged and again appears when pus formation is there. This cycle goes on.

• Hair protruding out from the lesion may be seen

• One or more sinus openings can also be seen

Pilonidal Sinus Treatment:

Pilonidal Sinus very seldom heals with treatments through medicine; whether it is allopathic, homeopathic or ayurvedic, they tend to show only temporary relief. The problem does not get eradicated completely. Under most of these circumstances, surgeons recommend patients to undergo surgeries like Z-plasty. Even after surgery, there are high incidences of recurrence so it is not a good choice for Pilonidal Sinus treatment.

Other complications like pain, hospitalization and longer process of recovery are also commonly seen. However, Pilonidal Sinus can be completely treated by Graded Ksharsutra Treatment. In this treatment; Graded Ksharsutra - a specialized Medicated thread is placed in sinus cavity which is replaced at weekly intervals till the sinus heals completely.

Here are few reasons why Graded KsharsutraTM is considered to be better than Surgery

• As it is a non-surgical procedure, so hospitalization or bed rest may not be required.

• In Ksharsutra therapy there is no cutting of tissues hence the chance of post operative bleeding are not there whereas after surgery; the chances of post operative bleeding or infection are always there.

• Ksharsutra therapy is done under Local Anesthesia which is always safer than general anesthesia/ Spinal Anesthesia required during surgery.

• Patients can continue his normal routine activities as usual during this treatment which is not the case after surgery for Pilonidal Sinus.

• Delayed healing and Recurrence of Pilonidal Sinus are the complications seen after Pilonidal sinus surgery. Such complications are not seen with Graded KsharsutraTM Treatment.

• Graded KsharsutraTM is more economical and more convenient than surgery.

Hence, it is being concluded that Graded KsharsutraTM Treatment is the best treatment for Pilonidal Sinus.

5532 people found this helpful

Pilonidal Sinus - Ayurvedic Remedies For Treating It!

Dr. Pooja Roy 90% (25 ratings)
BAMS
Ayurveda, Delhi
Pilonidal Sinus - Ayurvedic Remedies For Treating It!

Pilonidal Sinus/ Cyst is characterized by: 

  • Small nodular swelling in the lower spinal region with occasional discharges that may stain undergarments. Sometimes mild pain may also be noticed. 
  • It is usually seen in adults of college/ school going age & with hairy skin. 

Pilonidal Sinus/ Cyst seldom heal with medicinal treatment. Any medication whether allopathic, Ayurvedic or homeopathic may show some temporary relief but do not eradicate the problem. In most of the patients having pilonidal sinus/ cyst, surgeons usually recommend surgical procedures like Z-plasty etc. Even after surgery the chances of recurrences are always there. Post operative pain, hospitalization and chances of recurrence are the factors which suggest that surgery is not the appropriate method of treating pilonidal sinus/ cyst. 

TREATMENT OF CHOICE (AYURVEDA) - 
In Ayurveda, a parasurgical treatment known as Ksharsutra therapy is an effective treatment for pilonidal sinus/ cyst. Treatment method includes proper identification of sinus tract wrt. to its depth, direction and branching pattern. This could be achieved via sinogram or skilled probing. Once the sinus tract has been properly identified, a super specialized medicated thread i.e. Graded ksharsutra™ is placed in the tract. The medicine from the medicated thread is gradually released which leads to debridement of the sinus tract which means unhealthy tissue, pus, hairs are expelled out from the tract. The proper and complete debridement of the tract induces healing of the sinus which subsequently heals. The medicine coated thread remains effective for 7-10 days after which it has to be replaced by a new thread.

Usually, in a sinus of approx. 5 cm length, 6-8 sittings of medicated thread replacement are required at a weekly interval. Ksharsutra therapy being a non surgical opd procedure doesn't involve any hospitalization or bed rest and patients can resume their routine work immediately after treatment. Graded ksharsutra™ treatment is the treatment of choice for Pilonidal Sinus as chances of recurrence are seldom seen. The facility of Graded ksharasutra™ is available only at Sushruta Anorectal Institute.

Pilonidal Sinus/ Cyst Treatment FAQs

Question 1 - What is Pilonidal Sinus/ Cyst Disease?

Answer - Pilonidal Sinus disease is seen as a small nodular swelling in the lower spinal region with occasional discharges of pus & blood. It is most commonly found in people with hairy skin. Some times mild pain may also be noticed. The main problem is that it keeps on developing again and again after short period of remission. As the problem aggravates, the size of the swelling & pus discharges also increase. It is usually not noticeable in the beginning till it keeps recurring again and again. It is advisable not to get it operated as the chances of recurrence after surgery are pretty high, where as in Ayurveda with the help of Graded ksharsutra™, this problem can be completely cured without surgery. *(There is no guarantee of specific results and the results can vary.)

Question 2 - What are the Causes of Pilonidal Sinus Disease?

Answer -Pilonidal sinus is also known as the jeep riders back problem. The problem was first recorded on a large scale during world war II in the soldiers who rode jeeps and motorbikes on a frequent basis. Though, the reason behind the occurrence of the issue is really not known it is believed that in growing hairs and hairs penetrating the skin are main cause. The problem is more common in people who have hairy skin. Home remedies for Pilonidal Sinus? Answer - Pilonidal Sinus is an infective condition usually seen in hairy skin individuals. As such there is no home remedy for Pilonidal Sinus. So instead of wasting time in searching for home remedies; you should plan for complete treatment i.e. Ksharsutra Treatment for Pilonidal Sinus as soon as possible.

Question 3 - What are the ways of identifying a Pilonidal Sinus and Recognizing Signs of Infection?

Answer -The main problem with identifying Pilonidal Sinus Infection is; it cannot be done till it grows to a certain extent. At first, it appears like a normal boil on the skin. When it does not go away with time; pus starts discharging out of it. We have demarcated a few of the signs that may help you in detecting the problem.

  1. Sensation of pain while sitting or standing in the low back region.
  2. The cyst appears swollen
  3. Pus and blood mixed watery discharge from the cyst
  4. eddened skin near the cyst
  5. Cyst forming again and again
4794 people found this helpful

Know About The Surgery For Pilonidal Sinus!

Dr. Prafull Arya 87% (463 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery
General Surgeon, Ludhiana
Know About The Surgery For Pilonidal Sinus!

Pilonidal Sinus refers to the small channel in your skin. When the channel is filled with pus or fluid, it leads to the formation of cysts or an abscess. A pilonidal cyst usually occurs at the top of the buttock crease near the tailbone, and consists of dirt, debris, and hair. When the cyst becomes infected or inflamed, it causes severe pain and discomfort.

Pilonidal sinus mostly affects men in their puberty. This condition is usually seen among people who sit for longer periods. For instance- truck/cab drivers, or desk-job workers, etc.

What causes Pilonidal sinus?

Pilonidal sinuses are most often caused due to the following factors-

  1. Dense Hair on back
  2. Hormonal changes during puberty
  3. Friction from wearing tight clothes
  4. Prolonged sitting

These factors prompt the hair growing in the region to burrow back beneath your skin. Your body considers the retracted hair as a foreign particle and launches an immune response. The cyst forms due to this response.

In certain cases, the patient may develop multiple sinuses which connect under the skin.

Identifying the early signs of Pilonidal sinus-

The first noticeable sign of Pilonidal sinus disease may be a small dimple near the tailbone. The symptoms become more prominent and troublesome once the channel gets infected or develops cysts/abscess. People with infectious sinus encounter the following symptoms-

  1. Swelling of the sinus
  2. Low-grade fever
  3. Pain while standing or sitting
  4. Redness or soreness around the affected area
  5. Discharge of pus or blood
  6. Foul odor
  7. Hair sticking out of the lesion
  8. Formation of multiple holes/sinus tracts in the skin

Risk factors associated with Pilonidal sinus-

There are a few factors that increase your chances of developing pilonidal cysts. The common risk factors are-

  1. Inactive lifestyle
  2. Obesity
  3. Excess hair on the body
  4. People in their twenties

Surgical treatment for Pilonidal Sinus-

Diagnosis of Pilonidal sinus does not require a lab test. The doctor will clinically diagnose the condition before recommending the treatment method. Although Pilonidal sinus usually goes away on its own, you will need to undergo a surgery if the cysts are infected. There are few common techniques of Pilonidal sinus surgery:

  1. Simple drainage of pus: needs painful daily dressings for months, has high recurrence rate.
  2. Excision of Sinus and Keep the wound open to let it heal slowly with cumbersome daily dressings, has more than 40% recurrence rate. Still popular mode.
  3. Excision of Sinus and closure with Limberg’s Flap, no wound, recurrence rate low. Popular.
  4. Excision of Sinus and closure with special Flap Advancement Technique, no wound, Patient can go home next day. No recurrence so far in author’s( Dr Prafull Arya) long series. So the results are long-term.

Pilonidal sinuses are nonthreatening but bothersome chronic infective disease. One needs to maintain good hygiene and an active lifestyle to avoid getting affected by it.

Once you have it, you need to meet an experienced surgeon specialising in pilonidal sinus surgery.

1967 people found this helpful

Kshar Sutra Treatment For Pilonidal Sinus!

Dr. Ritesh Chawla 92% (1132 ratings)
B.A.M.S, M.D In Ayurvedic Medicine
Ayurveda, Amritsar
Kshar Sutra Treatment For Pilonidal Sinus!

pilonidal sinus, as indicative of the name, is a narrow channel or a hole located in between the buttocks (underneath the skin). A characteristic feature of the pilonidal sinus is the presence of hair (the hair ruptures the skin and gets embedded within the sinus). A pilonidal sinus or a cyst is also known to contain skin debris, dirt. An infection of the pilonidal cyst may trigger the release of blood and pus from the cyst which is often foul smelling and associated with an excruciating pain.

Risk factors

The pilonidal sinus is more common among the young adult males (often below 40 years) than their female counterparts.
● the condition can also affect individuals who are more into a sedentary lifestyle (can be personal or professional).
● people who are obese or those who have a family history of pilonidal sinus are a higher risk of suffering from the condition.
● pilonidal sinus can also affect people with a deep and hairy natal cleft (the cleft located between the buttocks and extends from below the sacrum up to the perineum).

Symptoms

The symptoms and discomfort experienced in the case of a pilonidal sinus include

The infected cyst appears sore, red, and swollen. One experiences pain and discomfort while in a standing or a sitting position. The hair often protrudes out of the abscess. In some people, there may be the appearance of multiple sinus tracts, piling on the agony. In some case, pilonidal sinus may be accompanied by fever (not commonly observed).

Pilonidal sinus and ayurveda

Conventional treatments such as surgery, lancing, or the use of phenol injections are there to treat pilonidal sinus. However, the medications come with their share of side effects and complications (such as infection at the site of incision, slow healing, bleeding, to name a few). The ayurvedic treatment that uses herbs is 100% safe and effective. Many people with pilonidal sinus and cyst have been completely cured and treated without any deleterious side effects or complications. The main aim of the ayurvedic treatment is to restore the balance between the three doshas (vata, kapha, pitta), the vitiation of which triggers a diseased condition.

Pilonidal sinus also termed as nadi vrana in ayurveda is best treated by kshar sutra therapy. In kshara sutra therapy, threads are smeared with ayurvedic herbs before using them to treat the disease (the thread is placed inside the pilonidal sinus and replaced with a new one after every 7 days). The entire kshara sutra therapy takes between 4-8 weeks (depending on the severity of the condition) to complete. The kshara sutra therapy treat the pilonidal sinus along with the formation of new tissues.

Talking about the diet, throughout the treatment, one should avoid spicy, greasy, and fast foods. Enrich the diet with fruits and green vegetables. Consume plenty of fluids (water, soup, coconut water, fresh fruit juice).
More than exercise, it is important that you walk daily (at least 2kms per day).
 

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Pilonidal Sinus - Symptoms You Must Not Ignore!

Dr. S K Singh 95% (831 ratings)
M.S. (Ayurveda), Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Delhi
Pilonidal Sinus - Symptoms You Must Not Ignore!

Pilonidal Sinus is the small channel in the skin near the tailbone that may sometimes be filled with pus or fluid. This accumulated pus leads to the formation of abscess or cyst. Pilonidal cysts occur near the coccyx or tailbone, right at the top of the buttock crease.

Pilonidal sinus consists of dirt, hair and debris that penetrates your skin, becomes embedded and thereby causes infection. Once the cyst gets infected, you may see blood or pus oozing out of the channel, which causes severe pain. Pilonidal sinus usually affects men and young adults (after puberty). This type of skin disease is mostly observed in people who sit for prolonged period, such as desk-job workers, truck drivers etc. 

What are the causes and symptoms? 
Doctors suggest, pilonidal sinus or cysts is caused due to factors such as - hormonal changes during puberty, friction resulting from wearing tight clothes, prolonged sitting, hair growth etc. The hair growing in the region is forced to burrow back beneath your skin. In certain cases, the patient may develop multiple sinuses which connect under the skin. 

The signs and symptoms of pilonidal sinus include- 

  1. Pain when standing or sitting for long 
  2. Swelling of the cyst 
  3. Redness and soreness around the affected skin 
  4. Formation of multiple holes (sinus tracts) in the skin
  5. Foul odor 
  6. Blood or pus oozing out of the abscess 
  7. Hair sticking out of the lesion 

Pilonidal sinus can be embarrassing and painful, if left untreated for long. 

What is the treatment for this condition? 
Usually Surgery/ Z-Plasty is advised for Pilonidal sinus but it is not a right choice as after surgery incidence of recurrence are very high. This disease can be completely treated by highly specialized Ayurvedic Ksharsutra Treatment.

In this treatment Ksharsutra – a medicated thread is placed in sinus tract. Medicine released from the thread debrides the sinus tract and induces healing. This medicine remains active for 5 – 7 days so this thread needs to be changed with a new Ksharsutra at weekly interval. Healing rate of sinus is 0.5 to 1 cm per week and No. of weekly thread change (duration of treatment) will depend on length of Sinus tract. That is to say for complete healing of a 3 cm long sinus tract about 4-5 weekly Ksharsutra changes are necessary. In case you have a concern or query you can always consult an expert & get answers to your questions!

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Pilonidal Sinus - Signs & Symptoms To Watch Out For!

Dr. Vijay Dagar 86% (23 ratings)
BAMS, Ksharsutra
Ayurveda, Delhi
Pilonidal Sinus - Signs & Symptoms To Watch Out For!

Pilonidal sinus disease results in the small tunnel formation in the skin. It occurs at the cleft on top of the buttocks. Such a sinus gets filled with dirt, hair and debris. It has a tendency of becoming infected and may ooze out pus as a result. Once this happens, the sinus may emit a rotten odour if not treated. People who spend a majority of their time seated are at a greater risk of suffering from pilonidal sinus.

Signs and Symptoms of Pilonidal Sinus
You need to be aware of certain signs and symptoms of such a disorder so that you can begin treatment as soon as the problem occurs. Here are some of them-

  1. Extreme pain while sitting or standing
  2. The reddened sore skin around the area
  3. Swelling of the sinus growth
  4. Pus and blood draining from the cyst, which causes a foul smell
  5. Hair growth from the sinus
  6. The appearance of more than just one hole or sinus on the skin.
  7. In rare cases, a mild fever may also accompany the appearance of the cyst.

Ayurvedic Treatment for Pilonidal Sinus
Conventional forms of treatment for Pilonidal sinus are reliable, but they may cause a few side effects. This is why patients suffering from the condition often consider Ayurveda. The main objective of such treatment is to bring balance between the three doshas, namely, Kapha, Pitta and Vata.

Pilonidal sinus is also referred to as Nadi Vrana in Ayurveda. The best way to treat the condition is through Kshara Sutra Therapy. In this form of the treatment, the threads used are first smeared with beneficial herbs.

This thread is then placed inside the sinus. After 7 days the thread is changed with a new one. This procedure may take anywhere between 4 and 8 weeks. This treatment is not only used to treat the sinus but also helps with the formation of new tissues.

Apart from the medication, patients suffering from such a sinus will need to maintain a proper diet and lifestyle. For instance, ditching oily and greasy foods and incorporating fruits and green vegetables into the daily diet can be immensely helpful against Pilonidal sinus. Apart from the diet, patients should also lead an active life to minimize risk of the disorder. Walking a couple of kilometres every day will also help you fight complications from the same. In case you have a concern or query you can always consult an expert & get answers to your questions!

4094 people found this helpful

Pilonidal Sinus And Its Treatment In Ayurveda!

Dr. S K Singh 95% (831 ratings)
M.S. (Ayurveda), Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Delhi
Pilonidal Sinus And Its Treatment In Ayurveda!

Pilonidal Sinus: This disease is characterized by a nodular swelling in lower back region near the tail bone. Sometimes pus or blood mixed watery discharge along with mild pain is noticed. This disease is usually seen in young individuals with hairy skin. Pilonidal sinus is caused by the deposit of tuft of hairs, debris. Pilonidal means nest of hair, and this sinus occurs in the cleft that is at the top of buttocks. The tube-like structure is shaped randomly and contains bunch of hairs. When infected, it causes pain, and one can see pus oozing, with a foul odor. Also called Jeep-Bottom, this disease can cause bleeding, and cyst in the skin covering the tailbone of the back. People who spend a lot of time sitting, and driving for long hours are also prone to have this problem. 

Symptoms: The symptoms include pain during sitting and standing, pus and blood oozing from the cleft, hair protruding from the lesion, swelling of the cyst, and external sinus opening that is visible at the base of the spine. If you are in your early 20’s or 30’s, you will know you are spending more than half a day, which can lead to this condition. 

Ksharsutra Therapy: In Ayurveda, Ksharsutra therapy is very effective and best as compared to the modern surgery used to treat pilonidal sinus. A medicated thread that is of alkaline nature is used. Under local anesthesia the track is identified properly, and Ksharsutra is placed in to the track. The medicine coated on the thread has selective debridement action (it does not harm healthy tissues but removes all dead and pathological tissues). This is how it ensures the healing of sinus tract by healthy granulation tissue. The medicine of thread is over in a week so it needs to be replaced with a new Ksharsutra. The healing rate is 0.5 cm to 1 cm per sitting. That is to say if a sinus tract is 4 cm long; it may take 4-6 visits at weekly intervals for complete healing. 

So it is always advisable to the patients suffering from Pilonidal sinus not to go for surgery which has high incidence of recurrence. They should opt for highly specific Graded Ksharsutra treatment with negligible chances of recurrence. 

5766 people found this helpful

पिलोनिडल साइनस

Dr. Motilal Sharma 86% (47 ratings)
BAMS, CERTIFICATE COURSE IN KSHAR-SUTRA SURGERY , National Academy of Ayurveda, New Delhi
Ayurveda, Jodhpur

Pilonidal sinus - (रीड्ड की हड्डी के पास नासूर)
दोस्तो आज हम रीड्ड की हड्डी के पास होने वाले नासूर के बारे में चर्चा करेंगे.

परिचय(introduction)-
Pilonidal sinus एक ऐसा रोग हैं जिसमें रोगी के natal clefts के बीच mid sacrococcygeal line में एक या अनेक छिद्र बन जाते हैं जिसमें शुरू में itching होती हैं तथा बाद में वहां सें seropurulent discharge होता रहता हैं तथा रोगी को बैठने पर दर्द होता हैं
इसे jeep disease भी कहते हैं

कारण(causes)-
Pilonidal sinus के बहुत से कारण हो सकते हैं जिनमें से प्रमुख कारण इस प्रकार हैं -
1. अधिक समय पर एक ही जगह पर बैठे रहना
2. साइकिल, मोटर साइकिल,गाडी का अत्यधिक चलाना या बैठना
3. Hairy व fatty body होना

लक्षण(symptoms)-
1. रीड्ड की हड्डी के पास एक या अधिक छिद्र बनना तथा उसमें से seropurulent foul discharge होना
2. बैठने पर दर्द होना
3. भारीपन लगना

चिकित्सा -
आयुर्वेद में इसकी एक मात्र चिकित्सा क्षार सूत्र ही हैं औषधि चिकित्सा से इसको ठीक करना मुश्किल हैं
विभिन्न रोगियो में किये गये क्षार सूत्र चिकित्सा प्रयोग से ये सिद्ध हुआ हैं कि क्षार सूत्र चिकित्सा इसके उपचार की एक महत्वपूर्ण चिकित्सा हैं

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क्षारसूत्र विधि से पिलोनिडल साइनस का ईलाज जोधपुर में

Dr. Motilal Sharma 86% (47 ratings)
BAMS, CERTIFICATE COURSE IN KSHAR-SUTRA SURGERY , National Academy of Ayurveda, New Delhi
Ayurveda, Jodhpur
क्षारसूत्र विधि से पिलोनिडल साइनस का ईलाज जोधपुर में

Pilonidal sinus - (रीड्ड की हड्डी के पास नासूर)-
दोस्तो आज हम रीड्ड की हड्डी के पास होने वाले नासूर के बारे में चर्चा करेंगे.

परिचय(introduction)-
Pilonidal sinus एक ऐसा रोग हैं जिसमें रोगी के natal clefts के बीच mid sacrococcygeal line में एक या अनेक छिद्र बन जाते हैं जिसमें शुरू में itching होती हैं तथा बाद में वहां सें seropurulent discharge होता रहता हैं तथा रोगी को बैठने पर दर्द होता हैं
इसे jeep disease भी कहते हैं

कारण(causes)-
Pilonidal sinus के बहुत से कारण हो सकते हैं जिनमें से प्रमुख कारण इस प्रकार हैं -
1. अधिक समय पर एक ही जगह पर बैठे रहना
2. साइकिल, मोटर साइकिल,गाडी का अत्यधिक चलाना या बैठना
3. Hairy व fatty body होना

लक्षण(symptoms)-
1. रीड्ड की हड्डी के पास एक या अधिक छिद्र बनना तथा उसमें से seropurulent foul discharge होना
2. बैठने पर दर्द होना
3. भारीपन लगना

चिकित्सा -
1. आयुर्वेद में इसकी एक मात्र चिकित्सा क्षार सूत्र ही हैं औषधि चिकित्सा से इसको ठीक करना मुश्किल हैं
2. विभिन्न रोगियो में किये गये क्षार सूत्र चिकित्सा प्रयोग से ये सिद्ध हुआ हैं कि क्षार सूत्र चिकित्सा इसके उपचार की एक महत्वपूर्ण चिकित्सा हैं

3. 98.5 % cure rate हैं इस चिकित्सा की

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