Abstract

TRANSFORMATIVE IMPACT OF APAMARGA KSHARASUTRA IN TREATING BHAGANDARA (FISTULA-IN-ANO): A COMPELLING CASE REPORT

Dr. Ankita Padhi, Prof. (Dr.) Ranjan Kumar Kasta and Dr. Tapan Kumar Nayak

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Abstract

Background: Bhagandara (Fistula-in-ano) is a challenging anorectal disorder characterized by persistent pain and pus discharge. Traditional surgical interventions often pose significant risks, including fecal incontinence. Ksharasutra, an ancient Ayurvedic technique, offers a promising alternative with both chemical and mechanical action to treat the condition effectively. A 40-year-old male presented with a six-month history of pain and pus discharge from the perianal region. Clinical examination revealed an external opening at the 3 o'clock position, 4 cm from the anal verge, and an internal opening at the same position in the anal canal at the dentate line. Diagnosed with Bhagandara, the patient underwent treatment with Apamarga Ksharasutra after giving informed consent. Method: The procedure involved local anesthesia with 2% xylocaine jelly and probing to confirm the fistulous tract. Apamarga Ksharasutra, composed of Snuhi Ksheera, Apamarga Kshara, and Haridra powder, was ligated into the fistulous tract. Weekly changes of the Ksharasutra were performed using the Rail-Road technique until the fistulous tract was completely excised. Results: The initial 4 cm tract was successfully cut through in 21 days, with the Ksharasutra changed weekly. The patient experienced minimal discomfort, which subsided after sitz baths. Follow-up over three months showed no signs of recurrence, and the patient’s quality of life improved significantly. Conclusion: This case highlights the transformative impact of Ksharasutra in managing Bhagandara. The treatment not only ensures effective excision and healing but also minimizes the risks associated with traditional surgical methods. The success of this case underscores the potential of Ksharasutra as a superior and validated method for treating fistula-in-ano, meriting further recognition and implementation in clinical practice.

Keywords: Apamarga Kshara sutra, Ayurveda, Bhagandar, Fistula-in-Ano.