Low Anal Fistula Managed by Asphota Ksharasutra Application – A Case Report

Abstract

Fistula in ano is a track lined by unhealthy granulation tissue, which opens externally to the skin around the anus and internally to anal canal or rectum. Low anal fistula is a common type as per Milligan Morgan classification of fistula in ano, in which the internal opening of the track is below the anorectal ring. As per the signs and symptoms mentioned, the condition is correlated with Bhagandara mentioned in the ayurvedic classics. Ksharasutra therapy is the renowned mode of treating conditions like fistula and sinuses. Asphota is the drug mentioned under Ksharagana (a group of drugs possessing caustic properties) of Acharya Vagbhata, which is the synonym of Aparajitha (Clitoria ternatea Linn.). Ksharasutra made using Kshara prepared out of Asphota is used to treat low anal fistula in a 27-year-old male patient and found to be effective in using the condition, by assessing the unit cutting time and healing time. It is found as having better unit cutting time compared to conventional Apamarga Ksharasutra and the patient did not faced any side effects or complications during the period of treatment.