Fistula is a deadly disease which occurs most commonly on the rectum. A yellow liquid gets formed on the area which is very painful. Anal fistula is generally treated through surgery but it is known to recur after some time. You need to be very conscious of this fact when looking to get your condition treated. Ayurvedic remedies for fistula are known to cure the disorder for good. Several techniques and therapeutic procedures are available in Ayurveda that eliminate the problem from its root.
Bhagandara is the name by which fistula is known as in Ayurvedic practice. Three kinds of the disease are recognised with different treatments. One of the important therapies for curing fistula in Ayurveda is Kshar Sutra. This involves cutting up some tissues and these take time to heal. Before performing this procedure, several herbs are given to the patient such as Kadali Kshar, Apamarg Kshar, Nimb Kshar, Papaiya Ksheer and Snuhi Ksheer.
Although Ksheer Sutra is a slow process on the whole but it is getting global recognition gradually as a very effective treatment for fistula. The great advantage in undergoing this treatment is that the patient does not need to be admitted to a hospital. He can carry on with his regular everyday work without any trouble.
Another Ayurvedic treatment for fistula is known as Enema. In this treatment, hot bath is given to the patient suffering from it. Lower body parts are involved in this therapy. A few other types of fomentation is also recommended. The patient needs to be constantly checked for any signs of suffering for diseases such as hypertension, diabetes, TB or any other.
Agnikarma is another treatment for fistula in Ayurveda. This involves use of hot iron or caustic agent for destroying the affected tissues.
The main reason for rise of this disease these days is the unhealthy lifestyle which people have started to lead. It is expected that with Ayurvedic remedies for fistula treatment becoming popular, the lifestyle recommended by the holistic system of medicine will also gain ground.
दर्द के होने पर लोग उपचार लेते हैं और फिर लापरवाह हो जाते हैं , इसलिये यह छोटा सा घाव धीरे धीरे जगह बना हुआ गुदा के अन्दरूनी छोर तक जा पहुचता है और फिर तकलीफ देन शुरु करता है / कई बार यह देखा गया है कि जैसा इस घाव का मिजाज बाहर से अन्दर के रुख की वजह से बनता है तो ठीक उल्टा यह गुदा से बाहर की तरफ भी बनता है / लोग इस स्तिथि मे अक्सर भ्रम में पड़ जाते हैं और वे समझते हैं कि शायद गुदा में दर्द अन्दरूनी बवासीर के कारण हो रहा है , जबकि यह भगन्दर के घाव के कारण होता है /
बहर हाल भगन्दर का इलाज जैसे ही पता चले, शुरू कर देना चाहिये / आयुर्वेद का इलाज और Homoeopathy तथा प्राकृतिक उपचार इस तीनों के समन्वित चिकित्सा व्यवस्था से भगन्दर अवश्य ठीक हो जाते हैं / लेकिन इसके लिये चिकित्सक चाहे वह अकेला हो जिसे तीनों चिकित्सा विग्यान का अनुभव हो या यह न हो सके तो तीनों चिकित्सा विधाओं के experts से तालमेल करके चिकित्सा व्यवस्था अगर करते हैं तो भगन्दर अवश्य ठीक हो जाता है /
Surgical intervention से भगन्दर ठीक भी होते हैं और नही भी / कई बार कुछ साल ठीक होने के बाद फिर दुबारा तकलीफ हो जाती है , इसलिये सरजरी कराने का निर्णय मरीज की अपनी इच्छा पर निर्भर है /
अगर ETG AyurvedaScan परीक्षण रिपोर्ट पर आधारित डाटा को लेकर “भगन्दर” का औषधि और अन्य तरीके को शामिल करके इलाज करते हैं , तो अव्श्य फायदा होता है /
आयुर्वेद का क्षार सूत्र अथवा क्षार कर्म द्वारा भी भगन्दर का सटीक इलाज हो जाता है, इसके लिये किसी expert क्षार सूत्र चिकित्सक की सेवायें लेना चाहिये
What is a fissure?An anal fissure is a small tear in the skin that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. An anal fissure typically causes pain and bleeding with bowel movements.
Anal fissures most often affect people in middle age, but fissures also are the most common cause of rectal bleeding in infants. Most anal fissures heal within a few weeks with treatment for constipation, but some fissures may become chronic
COMMON CAUSES OF ANAL FISSURES
Anal fissures can be caused by trauma to the anus and anal canal. The cause of the trauma can be one or more of the following:
Straining to have a bowel movement, especially if the stool is large, hard, and/or dry
Insertion of foreign objects into the anus
Other causes of anal fissures (other than trauma) include:
Longstanding poor bowel habits
Overly tight or spastic anal sphincter muscles (muscles that control the closing of the anus)
Scarring in the anorectal area
Presence of an underlying medical problem: such as Crohn’s disease and ulcerative colitis; anal cancer; leukemia; infectious diseases (such as tuberculosis); and sexually transmitted diseases (such as syphilis, gonorrhea, Chlamydia, chancroid, HIV)
Decreased blood flow to the anorectal area
SYMPTOMS OF ANAL FISSURE
Signs and symptoms include:
Pain during, and even hours after, a bowel movement
Blood on the outside surface of the stool
Blood on toilet
A visible crack or tear in the anus or anal canal
Burning and itch that may be painful
Discomfort when urinating, frequent urination, or inability to urinate
RISK FACTORS FOR ANAL FISSURES
Factors that may increase your risk of developing an anal fissure include:
Infancy. Many infants experience an anal fissure during their first year of life, although experts aren’t sure of the reason.
Aging. Older adults may develop an anal fissure partly because of slowed circulation, resulting in decreased blood flow to the rectal area.
Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing.
Childbirth. Anal fissures are more common in women after they give birth.
Crohn’s disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing
PREVENTION OF ANAL FISSURES
For fissures in adults:
Keep the anorectal area dry
Wipe the area with soft materials, a moistened cloth, or cotton pad; avoid rough and scented toilet paper
Promptly treat all occurrences of constipation and diarrhea
Avoid irritating the rectum
AYURVEDA TREATMENT FOR ANAL FISSURES
Ayurveda advises internal medication as well as topical ointment application in the treatment of anal fissures. To avoid further irritation to the damaged tissue, medicines which soften the stools and promote healing of the tissues are utilized. Ointments which are natural anti-bacterial and anti-septic are used for topical application.
COMPLICATIONS OF ANAL FISSURES
Complications of anal fissure can include:
Anal fissure that fails to heal. An anal fissure that doesn’t heal can become chronic, meaning it lasts for more than six weeks.
Anal fissure that recurs. If you’ve experienced anal fissure once, you have an increased risk of another anal fissure.
A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter). This makes it more difficult for your anal fissure to heal. An unhealed fissure may trigger a cycle of discomfort that may require medications or surgery to reduce the pain and repair or remove the fissure.
Bhagandara (Fistula-in-ano): An Ayurvedic PerspectiveDefinition of Bhagandara (Fistula-in-ano):
(Bhaga= Vagina, Darana= tear, spitting)
ते तु भगगुदबस्ति प्रदेशदारणाश्च ‘भगंदरा’ इत्युच्यन्ते ।
अभिन्ना: पिडका:, भिन्नास्तु भगंदरा: ।। (Su. Ni. 4/3)
This creates a tear in the area of Bhaga (Vagina), Guda (Anal canal & rectum) and Basti (Urinary bladder), so this is called Bhagandara.
Particularly, in the earliar stage when this is not open, called ‘Pidakaa’ (furuncle). Later on it will get burst and forms the Bhagandara (Fistula-in-ano).
Probable Causative Factors:
Suppression of natural urges
Infection of the anal glands
Ingestion of foreign bodies
Excessive horse riding or bicycle riding
Abrasion by stone, cloth and ground
Excessive drinking of alcohol
According to Dosha Involvement:
Ayurvedic classical texts have classified Bhagandara mainly in eight entities according to doshik involvement.
शतपोनक भगंदर (Shatponak Bhagandara)- Vāta dosha dominance
उष्ट्रग्रीव भगंदर (Ushtragriva Bhagandara)- Pitta dosha dominance
परिस्रावी भगंदर (Parisravi Bhagandara)- Kafa dosha dominance
शम्बूकावर्त भगंदर (Shambukavarta Bhagandara)- Tridosha dominance
उन्मार्गी भगंदर (Unmargi Bhagandara)- Aāgantuja /Traumatic
परिक्षेपी भगंदर (Parikshepi Bhagandara)- Vāta Pitta dosha dominance
ऋजु भगंदर (Rhiju Bhagandara)- Vāta Kafa dosha dominance
अर्शो भगंदर (Arsho Bhagandara)- Pitta Kafa dosha dominance
According to opening:
Sushruta (School of Ayurvedic Surgery) again classified each type of Bhagandara according to its opening whether presents externally or internally. He used the terms,
पराचीन (Parachina) or बहिर्मुखम् (Bahirmukham) – blind external and,
अवाचीन (Avachina) or अंतर्मुखम् (Antarmukham) – blind internal.
According to modern contrive:
According to modern texts, fistula-in-ano can be divided in two groups broadly, on whether the internal opening is below or above the ano-rectal ring respectively.
Low level fistula
High level fistula
Low level fistula can be further subdivided into subcutaneous type, submucous type, intersphincteric type, trans-sphincteric type and supra- sphincteric type.
High level fistula can be further subdivided into extrasphencteric or supralevator type, trans-sphencteric type and pelvi-rectal fistula.
Symptoms of Bhagandara (Fistula-in-ano):
The main symptoms are boil around the anus, anal discharge and pain in anal region.
Management (treatment) of Bhagandara (Fistula-in-ano):
Aālepa (Paste of Ayurvedic herbal drugs)- for local application
Upanāha (Warm poultice)- for local application
Pariseka (Pouring of Ayurvedic decoctions)- for local application
Swedana (Hot fomentation)- for local application
Rakta vistravana (Blood letting)
Varti application (Application of wick of cotton cloth mix with Ayurvedic herbal oils)
Follow the ‘Ayurvedic life style’ (look forward on the home page of this site)
Apatarpana (Making the body thin by fasting)
Vamana & Virechana (Ayurvedic Panchkarma Therapy/Ayurvedic Detoxification Programme)
Kshāra- sutra Therapy (Application of Alkaline Herbal Seton)
Rakta mokshan (Blood letting)
Agni karma (Thermal cauterisation)
Kshāra karma (Application of Ayurvedic herbal caustics)
Bhedana karma- Fistulotomy
Chhedan karma- Fistulectomy
AYURVEDA TREATMENT OF FISTULAKshara Sutra is utilized in the treatment of fistula in Ayurveda.
Kshara Sutra is a seton thread medicated with organic alkalis,such as Apamargakshara(Achyranthesaspera), Arkakshara(Caltropisgigantea) or Snuhikshara (Euphorbia lingularia). The alkali is repeatedly coated on the seton thread 15 – 21 times. Apart from this, natural antibiotic like haridra powder, guggulu, etc are also used to make Ksharasutra. The mechanical action of the threads and the chemical action of the drugs coated , collectively do the work of cutting, curetting, draining, and cleaning the fistulous track, thus promoting healing of the track/ wound. This also acts both as the antiseptic and fibrotic agent to induce healing. The process of healing starts from deeper tissues and moves towards the periphery. This can be applied and changed periodically till the thread cuts the fistulous tract. Since the sphincter heals by fibrosis, there is no incontinence.
Under local anaesthesia, the kshara sutra is inserted into the tract and the two ends of the thread are tied forming a loop. The alkalis coated on the thread are continuously released throughout the length of the track there by cutting, curetting, draining cleansing and healing the track. This therapeutic action of the thread lasts for seven days. The old thread is then replaced with a new thread following the same procedure. Depending on the length of the tract and the extent of damage, the kshara sutra may be changed up to 5 times. The changing of the thread is a simple procedure taking about 1 to 2 minutes and requires no anaesthesia.
BENEFITS OF KSHARA SUTRA
The procedure does not require hospitalization for more than 4 to 5 hours
The patient requires minimal bed rest and can resume daily activities within 12 – 24 hours
No painful dressings required
The drugs coated on the Kshar-Sutra are slowly and gradually released into the track and the wound, leaving no abscess overseen. These abscess are drained out by the action of the drugs.
The sphincteric muscles are not dissected and hence the possibility of incontinence is ruled out.
COMPLICATIONS OF FISTULA
Depending on the effectiveness of the treatment, fistula may result in infection or incontinence of stools.
RECURRENCE OF FISTULA
The reoccurrence rate of fistula treated with kshara sutra ligation procedure is less than 2%. This is because the medicines on the thread gradually and continually curate the payogenic membrane and fibrous tissue in the track and thus leave no pus pockets undrained.
In some cases, the fistula can reoccur despite having surgery. After having a fistulotomy, the reoccurrence rate rises to 21%. After an advancement flap procedure, the reoccurrence rate may be as high as 36%.