Ayurvedic treatment for fistula.

A tunnel that will not close.

An anal fistula — Bhagandara in Ayurveda — is an abnormal tunnel between the inside of the anal canal and the skin near the anus. It usually begins as an infection of a small gland inside the anus, which forms an abscess; when the abscess bursts or is drained, the track it leaves behind can stay open.

Because the track keeps draining, a fistula does not heal on its own. It can be simple — a single, short track — or complex, with branches or a deeper course. Finding the track and its opening is the first step of treatment.

Common symptoms

• A boil or swelling near the anus that bursts, heals a little, and returns
• Discharge of pus, blood or fluid that stains undergarments
• Pain and throbbing, often worse when sitting or during stool
• Irritation or itching of the surrounding skin
• Sometimes fever and a feeling of being unwell when an abscess forms

Causes

• An infected anal gland that formed an abscess — the commonest cause
• An abscess that was drained or burst without the track healing
• Long-standing constipation or diarrhoea, and poor local hygiene
• Less often, conditions such as tuberculosis or inflammatory bowel disease

Kshara Sutra: the classical answer.

Ayurveda’s classical treatment for fistula is Kshara Sutra — a thread coated with herbal alkaline medicines, described in the Sushruta Samhita, that is passed through the track and tied. Over the following weeks the thread slowly cuts through the track while its medicines clean and heal it from the inside, and the thread is changed at intervals. It is practised widely across India today.

Alongside the thread come medicines, dressing and care of the bowel. Which method suits a given fistula depends on its type and course, and Dr. Sahoo decides after examining the track. Treatment aims to relieve symptoms and address the root cause; results vary from person to person.

• What to expect
• An examination to find the track, its opening and its course
• Several visits over the course of treatment, at intervals the doctor sets
• Most people carry on with daily life between visits; what to do at home is explained in full

Types of fistula

The course of the track decides how much treatment is needed.

• Simple — A single, short track — usually the quickest to treat.
• Complex — Branching, deep or recurrent tracks, which take longer and need closer follow-up.

Do’s and don’ts.

• Do:
• Keep the stool soft and regular with fibre, fruit and plenty of water
• Keep the area clean — wash gently with water after stool, and keep it dry
• A warm sitz bath as the doctor advises
• Come for every follow-up: the thread changes are the treatment
• Don’t:
• Do not squeeze or press a boil near the anus, and do not self-drain it
• Avoid very spicy, fried and heavy food, and alcohol
• Do not sit for long stretches without a break
• Do not stop treatment when the discharge eases — the track must heal fully

When to see a doctor urgently

Please do not wait if you notice:

• Fever with pain, swelling or discharge — an abscess may be forming
• Severe, throbbing pain or a swelling that is growing quickly
• Difficulty passing urine or stool because of the pain
• Heavy bleeding

Frequently asked questions.

Does Ayurveda really work for fistula?

Kshara Sutra is a classical Ayurvedic para-surgical treatment for fistula-in-ano, practised widely across India. How well and how quickly it works depends on the type and complexity of the track and on the person; the doctor will tell you honestly what to expect for yours.

How long does the treatment take?

It depends on the length and course of the track. A simple fistula takes less time; a complex one more. The doctor gives you a timeline after examining it, and reviews it at each visit.

Can a fistula come back?

Recurrence is possible with any fistula treatment, more so with complex tracks. Completing the full course and keeping the bowel regular lowers that chance.

Can I work during treatment?

Most people carry on with daily life between visits, with some care about sitting, diet and hygiene. The doctor will tell you what to avoid.

A note on results

Treatment aims to relieve symptoms and address the root cause. Results vary from person to person.

A boil that keeps returning? Do not wait for the next one.

Book a consultation, or call the clinic. The earlier a fistula is examined, the simpler its treatment tends to be.

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