MANAGEMENT OF BHAGANDARA (FISTULA-IN-ANO) WITH KSHARASUTRA AND PANCHAVALKALA KASHAYA SITZ BATH: A CASE SERIES

Abstract

Sushruta Samhita describes Bhagandar (Fistula-in-Ano) as one of the Ashtamahagada (the eight major diseases). This disease is recurrent, which makes it more challenging to treat. So, it causes inconvenience in routine life. The concept of the Ksharasutra has been explained in the context of Nadi vrana (sinus) by Acharya Sushruta. Hippocrates has explained the application of plain silk thread for the Fistula-in-Ano. Ksharasutra, being a medicated thread prepared per the standard protocol, has been proven to be a big revolution in treating Fistula-in-Ano. The Ksharasutra plays an important role, and its efficacy has been explained in various studies. In the present case series, we present here 5 different Bhagandar manifestations, managed with shamana aushadhis, Ksharasutra, anulomana (laxative effect), and panchavalkala sitz bath. The patients were treated on an OPD basis with a weekly thread change. The patients recovered well with complete tract excision within 6-12 weeks. Treatment of Fistula-in-Ano with Ksharasutra is a simple technique with low complications, less reoccurrence, and is cost-effective. Thus, Ksharasutra is very effective with the minimum invasive surgical modality for managing Bhagandara (Fistula-in-Ano).