Don’t ignore the pain

The literal meaning of Bhagandara (Fistula) is Darana, which means splitting or bursting up. This indicates that bursting of ripened) abscesses results into communicating track between anal region with surrounding perianal structures. Bhagandara is therefore correlated to the Fistula-in-Ano and is defined as “An inflammatory track which has an external opening in perianal skin and an internal opening in the anal canal or rectum, which is lined by unhealthy granulation and fibrous tissue”.

Fistula diseases, while not as common as some other medical conditions, can have a significant impact on a person’s quality of life. 

Types of Fistula Diseases

Fistula Diseases are categorized based on their location and severity:

1. Anal Fistula: This type of fistula occurs between the anal canal or rectum and the skin surrounding the anus.
2. Complex Fistula: These fistulas have multiple tracts, are deeper, or may involve other organs, making them more challenging to treat.

Symptoms of Fistula Diseases

1. Abnormal Discharge: Depending on the type and location of the fistula, patients may experience discharge of pus, stool, urine, or other fluids through an abnormal opening.

2. Pain or Discomfort: Pain may be present, particularly during bowel movements or urination, depending on the location of the fistula.

3. Recurrent Infections: Fistulas can lead to persistent infections due to the continuous flow of bodily fluids.

4. Skin Irritation: The skin around the fistula site may become red, swollen, and irritated.

5. Fever and Chills: In some cases, especially if there is an infection associated with the fistula, patients may experience systemic symptoms.

Causes of Fistula Diseases

1. Infection or Abscess: An untreated infection or abscess can lead to the development of a fistula as the infection tries to find a way to drain.
2. Inflammatory Bowel Diseases (IBD): Conditions like Crohn’s disease and ulcerative colitis can increase the risk of fistula formation due to chronic inflammation in the digestive tract.
3. Trauma or Injury: Severe injuries or surgical complications can sometimes result in the formation of a fistula.
4. Complications of Surgery: In some cases, surgical procedures in the abdomen or pelvic area can lead to fistula formation.
5. Radiation Therapy: Radiation treatment for cancer can cause tissue damage and, in rare cases, lead to the development of a fistula.

Prevention of Fistula Diseases

Preventive measures for Fistula Diseases may include:

• Ensuring proper hygiene in the anal area to prevent infections.
• Timely treatment of anal abscesses to avoid the development of fistulas.
• Managing underlying health conditions like inflammatory bowel disease.
• Following a high-fiber diet to maintain regular bowel movements and prevent constipation.

Ayurvedic Treatment For Fistula Diseases

Fistula Treatment in Ayurveda will be discussed below as per different classics.

Sushrutha Samhitha:

Non-suppurative stage – treatment measures of vrana chikitsa (wound management) such as apatarpana (light diet) and virechana (purgation) have to be followed.
Suppurative stage – Snehana (oleation) and Avagaha swedana (sudation of immersing the part in medicated liquid in the tub) of the perianal region.
If the pitika (abscess) does not resolve, then exploration of the tract (fistulotomy) is to be done followed by Kshara application (medicated caustic paste) or Agnikarma (cauterization) should be done in the explored bed of uthe lcer. Postoperatively, irrigation of medicated oils (Yashtimadhu taila or Anu taila) over the ulcerative lesions and Sitz bath is advised for the patient.

In conditions where it is chronic, recurrent episodes, the tract is partially fibrosed and is not patent, or patients who are unwilling for surgery, irrigation of the tract with medicated oils (Bhagandara nashana taila) is advised.

Charaka Samhitha:

Charaka opines the treatment for the non-suppurative stage of fistula as mentioned above by Sushrutha and says to do raktamokshana (bloodletting) to prevent suppuration followed by Vata patradi lepa (medical paste poultice application) over the affected site.

In the suppurative stage, fistulotomy is done and then Kshara application or Agnikarma is to be performed.

Chakradatta, advises lepa or paste applications in the suppurative stage such as Rasanjanadi lepa or Kushtadi lepa; and also application of Snuhi dugdhadi varti.

Vagbhata advises Vamana (emesis), Virechana (purgation) ,and Raktamokshana (bloodletting) therapies when the abscess is in nthe on-suppurative phase. Once the abscess suppurates, incision and drainage (bhedana karma) followed by Kshaara application and Agnikarma procedures.

Ksharasutra ligation for fistula ablation is explained by Vagbhata in the context of “Parikshepi Bhagandara” (high anal complex fistula) and is the direct reference available.

Ksharsutra Treatment For Fistula Diseases

Kshara Sutra is a seton thread medicated with organic alkalis, such as Apamargakshara(Achyranthesaspera), Arkakshara(Caltropisgigantea) or Snuhikshara (Euphorbia lingularia). The alkali is repeatedly coated on the seton thread 21 times. Apart from this, natural antibiotic like haridra powder, guggulu, etc are also used to make Ksharasutra. The mechanical action of the threads and the chemical action of the drugs coated, collectively do the work of cutting, curetting, draining, and cleaning the fistulous track, thus promoting healing of the track/ wound. This also acts both as the antiseptic and fibrotic agent to induce healing. The process of healing starts from deeper tissues and moves towards the periphery. This can be applied and changed periodically till the thread cuts the fistulous tract. Since the sphincter heals by fibrosis, there is no incontinence.

Under local anaesthesia, the kshara sutra is inserted into the tract and the two ends of the thread are tied forming a loop. The alkalis coated on the thread are continuously released throughout the length of the track there by cutting, curetting, draining cleansing and healing the track. This therapeutic action of the thread lasts for seven days. The old thread is then replaced with a new thread following the same procedure. Depending on the length of the tract and the extent of damage, the kshara sutra may be changed up to 5 times. The changing of the thread is a simple procedure taking about 10 to 12 minutes and requires no anaesthesia.

Why Choose Sandhya Medicity

Our medical facility stands out due to our commitment to excellence in Ayurvedic healthcare. We combine ancient wisdom with modern medical practices to ensure the best possible outcomes for our patients.

Sandhya Medicity offers a range of Ayurvedic treatments for Fistula that are natural, safe, and effective. Our treatments are designed to not only alleviate the symptoms but also to target the core issues, promoting lasting recovery and improved quality of life for our patients.

Moreover, our practitioners take a personalized approach, understanding the unique conditions and needs of each patient. This allows us to create individualized treatment plans that address the specific concerns and factors contributing to Fistula, ensuring a more successful healing journey.

With a focus on holistic healing and natural remedies, Sandhya Medicity provides a caring environment where patients can expect comprehensive support and guidance throughout their treatment process. Our goal is to empower individuals with effective solutions that bring relief and restore their well-being.

Choosing Sandhya Medicity means opting for a place where expertise, compassion, and personalized care converge to offer you the best in Ayurvedic treatment for Fistula.