Abstract

A CLINICAL CASE STUDY ON THE EFFICACY OF KADALI KSHARA SUTRA IN BHAGANDARA (FISTULA-IN-ANO)

Dr. Jai Prakash*, Dr. Ravi Anand, Prof. (Dr.) Deepali Sundari Verma

Abstract

Background: Bhagandara, described in Ayurvedic literature and clinically correlated with Fistula-in-Ano, is a chronic anorectal disorder characterized by persistent infection and discharge through an abnormal fistulous tract. Despite advances in contemporary surgical management, treatment may be challenging, particularly in fistulas involving a significant proportion of the anal sphincter, where preservation of continence remains an important consideration. Kshara Sutra therapy is an established Ayurvedic parasurgical procedure that facilitates gradual cutting and healing of the fistulous tract. Case Presentation: The present case study evaluates the clinical outcome of Kadali Kshara Sutra, prepared using alkali derived from Kadali (Musa paradisiaca), in the management of Bhagandara (Fistula-in-Ano). The medicated thread was introduced through the fistulous tract using a standard ligation technique and changed at regular intervals until complete tract cutting and healing were achieved. Clinical parameters, including pain, fistulous discharge, induration, wound status, and healing progression, were assessed during follow-up. Results: Progressive clinical improvement was observed during the treatment period, with a gradual reduction in pain, discharge, and induration. The fistulous tract underwent progressive cutting with simultaneous tissue healing, followed by satisfactory wound closure. No recurrence or clinically evident impairment of continence was observed during the available follow-up period. Conclusion: This case demonstrates the potential clinical utility of Kadali Kshara Sutra as a minimally invasive parasurgical approach in the management of Bhagandara (Fistula-in-Ano). The observed progressive tract cutting and healing suggest that Kadali Kshara Sutra may be a useful therapeutic option in appropriately selected cases. However, larger prospective studies with standardized outcome measures and longer follow-up are required to establish its efficacy and safety more conclusively.

Keywords: Bhagandara; Fistula-in-Ano, Kadali Kshara Sutra, Musa paradisiaca, Kshara Sutra, Ayurveda, Case Report.