Treating simple fistula-in-ano (Bhagandara) for a short duration Ksharasutra application- A case Report

Abstract

In Ayurveda, Bhagandara is mentioned as one among Ashtamaharoga because of its callous attitude. Sushruta recommends a multi-dimensional approach in the treatment which has been found very effective in the management of Bhagandara. Among these Ksharasutra has emerged safe and non-recurrence therapy, accepted globally. Though effective, it causes pain and discomfort to the patient during the treatment period and needs longer duration. In contrary one can limit the Ksharasutra application avoiding long duration. In the case presented here was provoked by a serendipity research, in which a 72 years male patient diagnosed as Bhagandara was subjected to Ksharasutra application under local anaesthesia. The changing of Ksharasutra was repeated every week for 3 to 4 sittings. After the third sitting any mode of discharge was absent which indicated the absence of infection. For some reason patient discontinued the treatment. He came after 2 years for some other complaints, on P/R examination no sign of fistula was observed. On history he revealed the applied thread got worn out by itself after 3 weeks of last application, subsequently the fistula got healed. This accidental finding provoked similar trials on 2 more patients, which proved to be successful one of such cases is discussed.