Fistula-in-ano: An Ayurvedic Perspective

31 Mar
Fistula-in-ano: An Ayurvedic Perspective

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:


Heavy diet


Suppression of natural urges


Unhygienic condition

Infection of the anal glands

Worm infestation

Ingestion of foreign bodies

Excessive horse  riding or bicycle riding

Abrasion by stone, cloth and ground


Excessive drinking of alcohol


Excessive coitus


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):

Local treatment:

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)

General treatment:

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)

Para-surgical  procedures:

Kshāra- sutra Therapy (Application of Alkaline Herbal Seton)

Rakta mokshan (Blood letting)

Agni karma (Thermal cauterisation)

Kshāra karma (Application of Ayurvedic herbal caustics)

Surgical procedures:

Bhedana karma- Fistulotomy

Chhedan karma- Fistulectomy

More Related Links…..:


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: