Rectal Fistula: Personal Experience In Treating, Limitations

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa B.A.M.S
Kshara Sutra or ligation of thread medicated with herbal alkalis is the best treatment option for those suffering from Bhagandara or Anal fistula. Kshara Sutra not only helps in cleansing and healing the fistula tract but also prevents its recurrence. 

A well equipped Kshara Sutra theatre is needed for conducting this treatment, since it is a form of miniature surgical process or a para-surgical measure.

Since I don’t have that set-up I prefer referring the patients of Bhagandara or anal fistula to those physicians in my circle who have kshara-sutra set-up. Generally those specialized in Shalya tantra (Ayurvedic surgery) and having special training in Kshara Sutra are inclined to practise this speciality in their clinics or hospitals. Though I should admit I have assisted few cases in the early part of my practise.
Read related: Anal Fistula: Ayurvedic Concept, Types, Treatment

I have seen good results from Kshara Sutra in anal fistula, also in haemorrhoids and sinus problems. Overall I would recommend Kshara Sutra treatment as a one shot remedy for those suffering from fistula in ano.

There are some patients who are not convinced of undergoing this treatment. Some don’t have time and many don’t want to put their money on the procedure. Some are lazy enough to maintain the disease with some effective oral medications. In this category of patients I have prescribed effective medicinal compounds complimented with a good diet, effective applications and Sitz bath, which has given good results in terms of healing.

Though many times it is difficult to go in a classic way and treat the patient on the lines of treatment protocol suggested in treatises. Though Raktamokshana is said to be the first and foremost approach in Bhagandara, I have neither conducted nor do seen practitioners (at least not in my circle) do it. Virechana is an effective treatment even when Kshara Sutra is not conducted. When I prescribe medicines I make sure that at least the prescription comprises of a good laxative which not only keeps the intestines clean but also detoxifies the body regularly. My prescription also contains disease modifying medicines and immune-modulators (Rasayanas).
Read related: Anal Fistula: 25 Diet And Lifestyle Tips To Avoid Repeated Infection

Limitations in handling Anal Fistula (Bhagandara) in Ayurvedic way
Well, with Kshara Sutra being practised effectively and comprehensively, Ayurveda is giving good results in the management of anal fistula. The availability of wide array of herbal combinations and ready-made formulations, both classic and proprietary has made the job of dealing ano-rectal diseases easy. I personally have not seen many failures. Relapses are seen when the medicines are not taken as per suggestion. We need to remember that unless the tract is totally healed there are good chances of recurrences and also formation of new fistulas. The disease occurs in a sensitive zone which is constantly exposed to infection from stools. This makes comprehensive healing a challenge and should be combined by thorough sterile measures which need to be taken care of by the patients.

Just Before Finishing –
Anal fistula or fistula-in-ano or Bhagandara is an annoying condition and a common ano-rectal disorder encountered in clinical practice. The wisdom of Ayurveda has very much to offer towards comprehensive healing of anal fistula. Treatments like Kshara Sutra are nothing short of boon for the ailing patients. In many of them they not only help in eradicating the disease and restoring the health of the patients, but also ensure that they do not allow the disease to recur, provided the maintenance is really good and disciplined from the patients perspective. At the same time, one can be damn assured of getting treated in the best natural way, straight from the nature, since Ayurveda, its treatments and medicaments are magical remedies derived straight from the herbs available in the lap of Mother Nature.

Hit the fistula in a natural way through Ayurvedic natural remedies, the best and most effective way of keeping our butt’s healthy!!
Click to Consult Dr Raghuram Y.S. MD (Ayu)

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