Role of Karanjadi Ghrita for the Management of Bhagandara (Fistula-in-Ano)
Journal name: Ayushdhara
Original article title: Role of Karanjadi Ghrita for the Management of Bhagandara (Fistula-in-Ano)
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Amar Kumar
Associate Professor, Department of Shalya Tantra, J D Ayurvedic College & Hospital, Aligarh, U.P., India
Dezi Kumari
PG Scholar, Department of Rachna Sharir, J D Ayurvedic College & Hospital, Aligarh, U.P., India
Rajendra Kumar
PG Scholar, Department of Samhitha and Siddhanta, Govt. Ayurvedic College, Patna, Bihar, India
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: Role of Karanjadi Ghrita for the Management of Bhagandara (Fistula-in-Ano)
Year: 2022 | Doi: 10.47070/ayushdhara.v9i3.878
Copyright (license): CC BY-NC-SA 4.0
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Summary of article contents:
Introduction
Fistula-in-ano, referred to as Bhagandara in Ayurveda, is recognized as a serious ailment due to its complications and high recurrence rates. This condition manifests as a channel that develops between the anal canal and the perianal skin, typically resulting from anal gland infections. The persistent nature of this disease, compounded by modern sedentary lifestyles, has made effective management challenging. Traditional treatments, such as Kshara Sutra therapy, have been utilized for years but can lead to notable post-procedural complications, including pain, burning sensations, and inflammation. In this study, the focus was on evaluating the effectiveness of Karanjadi Ghrita, a local application, in alleviating complications arising from Kshara Sutra treatment in patients diagnosed with Bhagandara.
Efficacy of Karanjadi Ghrita in Post-Surgical Healing
Karanjadi Ghrita was identified as a promising adjunct therapy to Kshara Sutra for managing the symptoms associated with Bhagandara. The ingredients of Karanjadi Ghrita possess notable cleansing and healing properties, enhancing the healing process of the fistulous tract while mitigating severe post-procedural complications. This healing agent is characterized by its Tikta and Kashaya qualities, which aid in ulcer healing through Shodhana (cleansing) and Ropana (healing) actions. The clinical study demonstrated that patients receiving Karanjadi Ghrita application showed a significant reduction in pain, burning sensations, discharge, and itching when compared to those receiving only Kshara Sutra therapy.
Comparison with Standard Kshara Sutra
The clinical trial involved two groups: one receiving standard Kshara Sutra alone and the other receiving Kshara Sutra in conjunction with Karanjadi Ghrita. The results indicated that the combination therapy yielded better outcomes in managing symptoms and reducing discomfort. Both groups showed improvements, but the group that received Karanjadi Ghrita had significantly fewer complications and reported better overall patient comfort levels. The average unit cutting time (UCT) for both groups was similar, indicating that the primary benefits of Karanjadi Ghrita are linked to enhancing patient comfort and reducing post-surgical complications rather than accelerating healing time per se.
Conclusion
The study concludes that the combination of Karanjadi Ghrita with standard Kshara Sutra therapy offers superior management of Bhagandara, providing significant relief from pain, burning sensations, and other discomforts associated with the condition. This research suggests that local application of Karanjadi Ghrita can effectively mitigate the adverse effects of traditional Kshara Sutra treatment, improving patient outcomes without compromising healing efficiency. Therefore, implementing Karanjadi Ghrita in standard treatment protocols for fistula-in-ano may represent a substantial advancement in Ayurvedic surgical practices, leading to enhanced patient satisfaction and lower rates of recurrence.
FAQ section (important questions/answers):
What is Bhagandara in Ayurveda and its significance?
In Ayurveda, Bhagandara refers to fistula-in-ano, which is recognized as a significant condition due to its complications and high recurrence rates. It is categorized among the eight major diseases because of persistent pain and discharge, making management crucial.
How does Karanjadi Ghrita aid in treating Bhagandara?
Karanjadi Ghrita has cleaning and healing properties, reducing post-treatment complications such as pain, burning sensations, and inflammation. Its properties help soothe the ulcer and promote quicker healing after Kshara Sutra therapy, making it beneficial for fistula management.
What were the main findings of the clinical study?
The study found that Karanjadi Ghrita combined with Kshara Sutra significantly reduced pain, burning sensations, and discharge compared to Kshara Sutra alone. The application showed fewer complications, faster wound healing, and no instances of fecal incontinence.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Role of Karanjadi Ghrita for the Management of Bhagandara (Fistula-in-Ano)�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Kshara (Ksara):
Kshara refers to an alkaline substance used in Ayurveda for its therapeutic properties, particularly in the Kshara Sutra therapy applied for treating Bhagandara (fistula-in-ano). It helps by inducing Chedana (cutting), Bhedana (splitting), and Shodhana (cleansing) actions.
2) Bhagandara (Bhagamdara):
Bhagandara is the term used in Ayurveda for fistula-in-ano, a condition causing pain, discharge, and uncomfortable symptoms near the perianal area. The disease is intricate due to its recurrence and is listed among the eight major diseases (Asta Mahagada) in Ayurvedic texts.
3) Ghrita (Ghrta):
Ghrita, or medicated ghee, is used in various Ayurvedic treatments for its healing, soothing, and anti-inflammatory properties. Karanjadi Ghrita, a specific type, was studied for its effectiveness in managing Bhagandara with significant benefits like reducing pain and inflammation.
4) Karanjadi:
Karanjadi Ghrita is an Ayurvedic preparation using ingredients like Karanja, Chameli, Patola, and other medicinal plants. Its therapeutic benefits are particularly notable in managing post-Kshara Sutra complications in Bhagandara, promoting healing and reducing inflammation and pain.
5) Sutra:
Sutra generally means a thread or string, but in the context of Kshara Sutra, it refers to a medicated thread used in Ayurvedic surgery for treating fistula-in-ano (Bhagandara) by gradually cutting and healing the fistulous tract.
6) Pain:
Pain is a primary symptom associated with Bhagandara (fistula-in-ano), often exacerbated post-procedure. The study observed that the use of Karanjadi Ghrita significantly reduced pain when applied in conjunction with Kshara Sutra therapy.
7) Ksharasutra (Ksarasutra, Kshara-sutra):
[see source text or glossary: Ksharasutra]
8) Burning_sensation:
Burning sensation is a common complication post-Kshara Sutra procedure in Bhagandara treatment. The clinical study demonstrated that using Karanjadi Ghrita, which has cooling (Sheeta Veerya) properties, significantly alleviated this discomfort.
9) Kumar:
Amar Kumar is one of the authors of the study, contributing to the research on the role of Karanjadi Ghrita in the management of Bhagandara, analyzing its efficacy alongside the Kshara Sutra therapy.
10) Discussion:
Discussion within the study involves comparing traditional Kshara Sutra therapy with the combined use of Karanjadi Ghrita. It addresses the benefits, challenges, and statistical analysis on pain, burning sensation, discharge, and other symptoms.
11) Disease:
Bhagandara (fistula-in-ano) is a challenging disease in Ayurveda characterized by painful ulcers, pus discharge, and potential recurrence. The study explores effective management options using Karanjadi Ghrita and Kshara Sutra.
12) Kumari:
Dezi Kumari, a contributing author of the study, played a role in researching and documenting the therapeutic effects of Karanjadi Ghrita in managing Bhagandara.
13) Dosha (Dosa):
Dosha refers to the three fundamental bodily humors in Ayurveda: Vata, Pitta, and Kapha. Imbalance in these Doshas can lead to various health issues. The study examines Pitta Dosha's aggravation in Bhagandara treatment.
14) Pitta:
Pitta is one of the three Doshas in Ayurveda, associated with metabolism, heat, and energy transformations in the body. The study indicates that Karanjadi Ghrita helps in managing Pitta-aggravated conditions like burning sensation in Bhagandara treatment.
15) Karma (Karman):
Karma in this context refers to the therapeutic actions in Ayurveda. The study discusses the use of Kshara Karma (alkaline action) and its effects on Pitta Dosha in Bhagandara treatment.
16) Drug:
Various drugs are used in the management of Bhagandara, including the herbal components of Karanjadi Ghrita which display Shodhana (cleansing) and Ropana (healing) qualities to aid in treatment post-Kshara Sutra therapy.
17) Inflammation:
Inflammation is a typical symptom in Bhagandara treatments, especially post-procedural. Ingredients of Karanjadi Ghrita have anti-inflammatory properties that help reduce this symptom effectively.
18) Pittadosha (Pittadosa, Pitta-dosha):
Pitta Dosha governs heat and metabolism in the body. In Bhagandara treatment, procedures like Kshara Sutra can aggravate Pitta, but Karanjadi Ghrita helps mitigate this, reducing burning sensations and inflammation.
19) Ayurveda (Ayus-veda):
Ayurveda is the traditional Indian system of medicine that emphasizes balance in the body's Doshas. The study applies Ayurvedic principles, using treatments like Kshara Sutra and Karanjadi Ghrita for managing Bhagandara.
20) Apamarga:
Apamarga Kshara, derived from the plant Apamarga (Achyranthus aspera), is a key component in the Kshara Sutra therapy for Bhagandara. It aids in cutting through the fistulous tract and has strong Shodhana properties.
21) Medicine:
Medicine in the study refers to both herbal formulations like Karanjadi Ghrita and the procedural use of Kshara Sutra for the effective management of Bhagandara and alleviation of its symptoms.
22) Shodhana (Sodhana):
Shodhana means cleansing, a principle in Ayurveda to remove toxins and impurities. Karanjadi Ghrita possesses Shodhana properties, making it effective in cleaning and healing the fistulous tract in Bhagandara treatment.
23) Chedana:
Chedana refers to the cutting or excision action in Ayurvedic surgery. Kshara Sutra involves Chedana properties to facilitate the effective treatment of Bhagandara by cutting through the fistulous tract.
24) Haridra:
Haridra, or Turmeric (Curcuma longa), is an ingredient often used for its anti-inflammatory and antibacterial properties. It's included in Kshara Sutra treatments to aid in healing and inflammation reduction in Bhagandara.
25) Sariva (Shariva):
Sariva is a medicinal plant known for its cooling and anti-inflammatory properties, used in Karanjadi Ghrita to manage the Pitta Dosha aggravation and reduce the burning sensation in Bhagandara treatments.
26) Pidika:
Pidika refers to a boil or abscess, which in the context of Bhagandara manifests as painful boils near the anus. These become fistulas once they burst, necessitating treatments like Kshara Sutra and Karanjadi Ghrita.
27) Vrana:
Vrana means a wound or ulcer. In Bhagandara (fistula-in-ano), the fistulous tract is treated as a type of Vrana that requires Shodhana (cleansing), Ropana (healing), and Lekhana (scraping) for proper management.
28) Guda:
Guda refers to the anal or rectal region in Ayurveda. Bhagandara affects the Guda, leading to painful and discharging fistulas, which require treatment methods like Kshara Sutra and Karanjadi Ghrita for management.
29) Manjishtha (Manjistha, Mamjishtha):
Manjistha is a valuable herb in Ayurveda used for its anti-inflammatory and detoxifying properties. It's an ingredient in Karanjadi Ghrita, aiding in the healing process of Bhagandara by reducing inflammation and promoting Shodhana.
30) Toxicity:
Toxicity refers to the harmful effects of infections commonly seen in Bhagandara. The ingredients in Karanjadi Ghrita, like Neem and Haridra, have properties that help reduce bacterial growth and toxicity, promoting healing.
31) Lekhana:
Lekhana refers to the scraping or excising action in Ayurvedic treatments. Kshara Sutra and certain herbs in Karanjadi Ghrita exhibit Lekhana properties, helping in removing unhealthy tissue to facilitate healing in Bhagandara.
32) Karanja (Karamja):
Karanja (Pongamia pinnata) is a medicinal plant used in Karanjadi Ghrita for its anti-inflammatory, antibacterial, and healing properties, making it effective in managing post-Kshara Sutra complications in Bhagandara treatment.
33) Ropana:
Ropana means healing or promoting granulation tissue formation. Karanjadi Ghrita contains herbs with Ropana properties, aiding in the quicker and more effective healing of the fistulous tract in Bhagandara.
34) Shalya (Salya):
Shalya refers to surgery in Ayurveda. Shalya Tantra is the Ayurvedic surgical discipline, under which treatments like Kshara Sutra fall. This study evaluates the application of Shalya practices in managing Bhagandara effectively.
35) Kutaki:
Kutaki is a bitter herb used in Karanjadi Ghrita for its Chedana (cutting) and Shodhana (cleansing) properties, assisting in the treatment and healing of Bhagandara by keeping the fistulous tract open and clean.
36) Darana:
Darana refers to tearing or breaking of tissues. In Bhagandara (fistula-in-ano), Darana signifies the formation of fistulas due to the bursting of Pidikas (boils) around the Guda (rectal region).
37) Tikta:
Tikta (bitter) refers to one of the six tastes in Ayurveda. The Tikta taste prevalent in herbs like Neem and Karanja used in Karanjadi Ghrita has Shodhana (cleansing) and Ropana (healing) properties, aiding in Bhagandara treatment.
38) Basti:
Basti refers to the bladder or pelvic region in Ayurveda. In the context of Bhagandara, the involvement of areas around the Basti indicates the severe and complicated nature of the disease, requiring treatments like Kshara Sutra.
39) Patna:
Patna is a city in Bihar, India, where the research was conducted. The Government Ayurvedic College in Patna served as the location for the clinical study on the effectiveness of Karanjadi Ghrita and Kshara Sutra in treating Bhagandara.
40) Bhaga:
Bhaga typically refers to the perineum but also includes regions like Guda (rectum) and Basti (bladder). In Bhagandara, the disease affects the Bhaga region, leading to complex, painful, and dischargeable fistulas.
41) Fever:
Fever is one of the symptoms mentioned in Ayurvedic texts, like Sushruta Samhita, associated with Bhagandara, especially during the suppurative stage of boils or abscesses around the perianal area.
42) Ashta (Asta, Astan, Ashtan):
Asta Mahagada refers to the eight major diseases in Ayurveda. Bhagandara is considered one among the Asta Mahagada due to its severe complications and recurrence potential, which makes it challenging to treat.
43) Curcuma longa:
Curcuma longa, commonly known as Turmeric, is used in Kshara Sutra for its anti-inflammatory and antimicrobial properties. It helps in managing infection and inflammation in Bhagandara post-procedural complications.
44) Sushruta-samhita (Susruta-samhita):
Sushruta Samhita is an ancient Ayurvedic text authored by the surgeon Sushruta. It provides detailed descriptions of surgical techniques, including the management of Bhagandara using interventions like Kshara Sutra and herbal Medications.
45) Dahaprashamana (Dahaprasamana, Daha-prashamana):
Dahaprashamana refers to alleviating burning sensations. In the study, Karanjadi Ghrita, with its Sheeta Veerya (cooling) properties such as Sariva and Chandana, effectively serves this function in post-Kshara Sutra care.
46) Krishnasariva (Krsnasariva, Krishna-sariva):
Krishnasariva, known for its cooling and anti-inflammatory properties, is an ingredient in Karanjadi Ghrita. Its addition helps manage the Pitta Dosha and burning sensations in the treatment of Bhagandara.
47) Antibiotic (Antibacterial):
Anti-bacterial properties are essential in treating infections like those in Bhagandara. Ingredients in Karanjadi Ghrita, such as Neem and Haridra, offer anti-bacterial actions that help reduce infection and promote healing.
48) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
[see source text or glossary: Shalya-tantra]
49) Daruharidra (Daru-haridra):
Daruharidra, or tree turmeric, has antimicrobial and anti-inflammatory properties, making it a significant component of Karanjadi Ghrita in the study for treating Bhagandara, reducing inflammation and aiding in healing.
50) Tridoshahara (Tridosahara, Tridosha-hara):
Tridoshahara refers to balancing all three Doshas (Vata, Pitta, and Kapha). Karanjadi Ghrita, used in the study, contains several herbs that help maintain this balance, proving effective in the holistic treatment of Bhagandara.
51) Tuberculosis:
Tuberculosis is listed under exclusion criteria for the study of Karanjadi Ghrita in Bhagandara, as the complexity of TB-related fistulas necessitates different treatment protocols.
52) Madhuyashti (Madhuyasti, Madhu-yashti):
Madhuyasti, or Licorice, is used in Karanjadi Ghrita for its soothing, anti-inflammatory properties. It helps in reducing symptoms like pain and burning sensation in the management of Bhagandara post-Kshara Sutra treatment.
53) Siddhanta (Siddha-anta, Siddhamta):
Siddhanta refers to established principles or theories in Ayurveda. The study relies on Ayurvedic Siddhanta, like Kshara Sutra therapy and the use of herbal Ghritas, to manage complex conditions like Bhagandara.
54) Tridosha (Tridosa, Tri-dosha):
Tridosha theory in Ayurveda encompasses Vata, Pitta, and Kapha. Treatments like Karanjadi Ghrita aim to balance these doshas, helping to manage Bhagandara by addressing all underlying doshic imbalances.
55) Pittahara (Pitta-hara):
Pittahara refers to substances that alleviate Pitta Dosha. Several ingredients in Karanjadi Ghrita have Pittahara properties, effectively reducing the Pitta-aggravated symptoms like burning sensation in Bhagandara treatments.
56) Splitting:
[see source text or glossary: Splitting]
57) Vidradhi:
Vidradhi refers to abscesses or boils. The study compares treatments for Paittic Vidradhi (Pitta-type abscess), using Karanjadi Ghrita to heal and manage symptoms effectively in conditions like Bhagandara.
58) Samhita:
Samhita refers to classical Ayurvedic texts like the Sushruta Samhita, which outlines treatments for Bhagandara using methods like Kshara Sutra and herbal Ghritas for effective management and healing.
59) Bhedana:
[see source text or glossary: Bhedana]
60) Krishna (Krsna):
[see source text or glossary: Krishna]
61) Kashaya (Kasaya):
Kashaya (astringent) is one of the six tastes in Ayurveda that aids in healing. Many ingredients in Karanjadi Ghrita have Kashaya Rasa, helping in Shodhana (cleansing) and Ropana (healing) of the fistulous tract in Bhagandara.
62) Tantra (Tamtra, Tantrism):
Tantra in this context refers to a system or technique in Ayurveda. Shalya Tantra is the surgical branch focusing on treatments like Kshara Sutra and Karanjadi Ghrita for managing conditions like Bhagandara.
63) Patola:
Patola leaves, used in Karanjadi Ghrita, have anti-inflammatory and antimicrobial properties. Their inclusion helps reduce pain, inflammation, and promote healing in Bhagandara treatment post-Kshara Sutra.
[Note: The above list is limited to 75. Total glossary definitions available: 80]
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