Abstract

BHAGANDARA (FISTULA-IN-ANO) IN AYURVEDA AND MODERN SURGERY: A COMPARATIVE REVIEW OF CONCEPTS AND APPROACHES

Dr. Vivek Khetwal*, Dr. Pankaj Kumar Sharma, Dr. Sunil Kumar Gupta, Dr. Devesh Shukla

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Abstract

Bhagandara (fistula-in-ano), one of the Ashtamahagada described by Acharya Sushruta, is a chronic and recurrent anorectal disease that continues to challenge surgeons and physicians alike. It presents as a pus-discharging tract connecting the anal canal with the perianal skin, producing pain, swelling, recurrent abscess, and impaired quality of life. In Ayurveda, the disease is understood through dosh-dushya involvement, nidana (etiology), and samprapti (pathogenesis). Sushruta has provided detailed classification, prognosis, and management strategies that include Kshara Karma, Agni karma, Kshara Sutra therapy, and the use of herbal preparations modern medicine attributes fistula-in-ano mainly to cryptoglandular infections, Crohn’s disease, tuberculosis, and trauma. Parks’ classification remains the gold standard in describing fistulas, and modern treatment modalities include fistulectomy, fistulotomy, seton placement, LIFT, VAAFT, FiLaC.

Keywords: Bhagandara, Fistula-in-ano, Kshara Sutra.