Abstract

ROLE OF MEDICATED KSHARSUTRA TREATMENT FOR FISTULA IN ANO: A REVIEW ARTICLE

Dr. Deodatta Bhadlikar*, Dr. Devyani Bhadlikar, Dr. Shruti Saxena, Dr. Archana Pandey Jumle, Rahul Jumle

.

Abstract

Background: Fistula-in-ano is a common yet challenging anorectal condition characterized by the formation of an abnormal tract between the anal canal and perianal skin, often resulting from cryptoglandular infection. Conventional surgical treatments such as fistulectomy and fistulotomy are associated with high recurrence rates, postoperative complications, and potential damage to the anal sphincter, leading to incontinence. Objective: This review aims to explore the efficacy, methodology, and clinical advantages of the Ayurvedic technique of Ksharasutra therapy as a minimally invasive, sphincter-preserving alternative for the management of fistulain- ano. Methods: The preparation of Ksharasutra involves coating a surgical linen thread with a combination of Snuhi latex (Euphorbia neriifolia), Apamarga Kshara (Achyranthes aspera), and Haridra (Curcuma longa) in 21 layers, providing sustained caustic, antimicrobial, and healing properties. The therapy is performed on an outpatient basis, with weekly thread changes and progressive transection of the tract. Results: Clinical outcomes have demonstrated near 100% cure rates in both primary and recurrent fistula cases, with minimal recurrence (

Keywords: Ksharasutra therapy, Fistula-in-ano, Ayurveda, Apamarga Kshara, Snuhi latex, Haridra.