Kshara Sutra Therapy for Bhagandara (Fistula-in-Ano): A Study
Journal name: Ancient Science of Life
Original article title: Clinical Evaluation of Kshara sutra Therapy in the management of Bhagandara( Fistula- in-Ano)- A prospective study
The ANSCI is a peer-reviewed, open-access journal focused on Ayurveda and traditional medicines. It publishes original research, reviews, and literary studies linking traditional knowledge with modern science, covering disciplines like botany, ethnomedicine, pharmacology, and clinical research.
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Original source:
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Dr. Hemanta Kumar Panigrahi, Mr. Rakesh Rani, Dr. M.M. Padhi, Dr. (Prof) G.S. Lavekar
Ancient Science of Life:
(A quarterly multi-disciplinary scientific research journal in Ayurveda)
Full text available for: Clinical Evaluation of Kshara sutra Therapy in the management of Bhagandara( Fistula- in-Ano)- A prospective study
Year: 2009
Copyright (license): CC BY-NC-SA
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Summary of article contents:
Introduction
Fistula-in-ano, also known as Bhagandara in Ayurveda, is a prevalent surgical condition characterized by abnormal openings between the anal canal and the skin. Various classifications have been proposed to categorize these fistulas based on their complexity and anatomy, distinguishing between low and high (simple and complex) types. High fistulas are particularly challenging to treat due to their potential to involve significant divisions of anal sphincter muscles, leading to incontinence. The study introduces Kshara Sutra therapy, a combination of surgical and para-surgical techniques aimed at effectively managing this condition while minimizing complications.
Kshara Sutra Therapy: A Promising Approach
Kshara Sutra therapy, utilized in this study of 50 patients aged 18 to 54, demonstrates a groundbreaking non-invasive treatment for fistula-in-ano. The therapy involves the application of a specific medicated thread (Kshara Sutra) within the fistulous tract, promoting gradual chemical erosion of the tissue surrounding the fistula while allowing for healthy granulation tissue formation. The results indicated a low overall recurrence rate of only 5.88%, with minor incontinence reported in some cases but no recorded major incontinence. This approach minimizes damage to the anal sphincter, making it a viable option for managing both low and high anal fistulas, contrasting the conventional surgical techniques, which often risk significant morbidity.
Conclusion
The Kshara Sutra therapy emerges as an effective treatment modality for fistula-in-ano, offering a lower recurrence rate and minimal impact on anal continence compared to traditional surgical interventions. This study emphasizes the importance of a meticulous surgical approach, including preoperative evaluation and proper patient preparation, to enhance outcomes. The promising results suggest that Kshara Sutra therapy could become a preferred method for treating anal fistulas, particularly high varieties, where conventional techniques typically falter, thereby enhancing patient quality of life.
FAQ section (important questions/answers):
What is Bhagandara in relation to anal health?
Bhagandara refers to Fistula-in-Ano, a common surgical problem characterized by an abnormal connection between the anal canal and the skin around the anus.
How effective is Kshara Sutra therapy for treating anal fistulas?
Kshara Sutra therapy is effective, with a low recurrence rate of only 5.88% observed in the study, and minimal impact on anal sphincter integrity.
What were the main findings of the Kshara Sutra study?
The study found that Kshara Sutra therapy had low recurrence rates, minimal incontinence, and led to successful healing in 68% of patients with low anal fistulas.
What is the typical patient demographic treated with Kshara Sutra therapy?
Patients treated typically ranged in age from 18 to 54 years, with a majority of cases occurring between 20 to 50 years of age.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Kshara Sutra Therapy for Bhagandara (Fistula-in-Ano): A Study�. 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 derived from various plants, notably Apamarga, used in Ayurvedic medicine for its therapeutic properties. In the context of Kshara Sutra therapy, it plays a crucial role in treating fistula-in-ano by chemically aiding the cutting of the fistulous tract while promoting granulation tissue formation.
2) Sutra:
Sutra, meaning 'thread' in Sanskrit, signifies a string or line of text that conveys a comprehensive message. In Kshara Sutra therapy, it relates specifically to the medicated thread used to treat anal fistulas, acting as a ligature that combines surgical and medicinal effects for effective healing.
3) Ksharasutra (Ksarasutra, Kshara-sutra):
Ksharasutra is specific to the treatment method involving Kshara-impregnated sutures used in the surgical management of fistula-in-ano. This innovative approach intertwines surgical precision with the healing attributes of plant-based Kshara, providing a distinct option among conventional techniques for fistula therapy.
4) Bhagandara (Bhagamdara):
Bhagandara is the Ayurvedic term for fistula-in-ano, a common condition associated with abnormal connections in the anal region. Understanding this term is essential for Ayurvedic practitioners, as it frames the context for employing traditional methods like Kshara Sutra in managing the disease effectively.
5) Science (Scientific):
Science in this context refers to the systematic study and application of theories and practices, particularly within Ayurveda. The research surrounding Kshara Sutra therapy embodies the scientific evaluation of traditional remedies, blending ancient wisdom with contemporary medical assessment for managing conditions like Bhagandara.
6) Post:
Post refers to the period following a surgical procedure. In the study of Kshara Sutra therapy for anal fistulas, the post-operative phase is critical for recovery, where patient monitoring and management protocols are essential to ensure successful healing and assess any complications like incontinence.
7) Tuberculosis:
Tuberculosis (TB) is a bacterial infection that primarily affects the lungs but can also manifest in other areas. Its relevance in this study is founded in the exclusion criteria for patients with anal fistulas, as a history of TB might complicate treatment and healing processes.
8) Triphala (Tri-phala):
Triphala is a polyherbal formulation revered in Ayurveda, composed of three fruits. It's often utilized for its digestive benefits and detoxifying properties, playing a supportive role in pre-operative protocols to ensure bowel clearance and reduce postoperative complications like constipation following Kshara Sutra therapy.
9) Jatyadi:
Jatyadi refers to an Ayurvedic herbal formulation used for external applications. In the context of treating fistulas, Jatyadi Tail, which includes a blend of herbs, is instilled into the anal canal post-operatively to promote healing and soothe inflammation, thereby facilitating recovery.
10) Repair:
Repair in this context pertains to the surgical or therapeutic methods employed to restore normal function to the affected tissue or organ. In the study of Kshara Sutra therapy, repair techniques focus on addressing the fistula while preserving sphincter functionality and minimizing complications.
11) Prakriti (Prakrti):
Prakriti refers to the individual constitution or bodily type as defined in Ayurveda. Acknowledging a patient's Prakriti is fundamental in customizing treatment plans, such as Kshara Sutra therapy, ensuring that healing practices align with the patient's specific physiological characteristics and overall health.
12) Shalya (Salya):
Shalya is a branch of Ayurveda focused on surgical techniques and interventions. Within this study, the principles of Shalya are applied to the Kshara Sutra method, showcasing a blend of traditional surgical knowledge with herbal remedies, aiding in managing conditions like Bhagandara effectively.
13) Sushruta-samhita (Susruta-samhita):
Sushrutasamhita is an ancient text foundational to Ayurvedic surgery, detailing surgical techniques and treatments. Its historical insights contribute significantly to modern approaches, like Kshara Sutra therapy, which incorporates age-old wisdom in managing complex ailments such as fistulas, ensuring a well-rounded surgical approach.
14) Inflammation:
Inflammation is the body's defensive response to injury and infection, often significant in the context of fistula development. Understanding inflammation's role helps in formulating treatment strategies, such as Kshara Sutra therapy, targeting inflammation reduction while ensuring that healing progresses in the affected areas.
15) Discussion:
Discussion represents the section where the results of the study on Kshara Sutra therapy are analyzed and interpreted. Here, the efficacy, complications, and overall impact of the treatment method on patients are assessed, allowing insights and conclusions to be drawn about the practice's viability.
16) Bhaishajya (Bhaisajya):
Bhaisajya translates to 'medicine' in Sanskrit, encompassing all forms of healing substances in Ayurveda. It emphasizes the importance of employing herbal and natural remedies, such as Kshara and Jatyadi, for therapeutic interventions, underscoring the holistic aspects of treatment strategies to manage conditions like Bhagandara.
17) Knowledge:
Knowledge in the Ayurvedic context signifies the understanding of medicinal properties, health principles, and treatment methodologies. The effectiveness of Kshara Sutra therapy relies heavily on the practitioner's knowledge, ensuring health practitioners can apply these techniques judiciously and with precision, enhancing patient outcomes.
18) Ayurveda (Ayus-veda):
Ayurveda is an ancient Indian system of medicine centered around achieving health and wellness through balance in body, mind, and spirit. The principles of Ayurveda, underscored in this study, guide treatment methodologies like Kshara Sutra therapy, advocating for holistic patient care and natural healing.
19) Apamarga:
Apamarga, or Achyranthes aspera, is a plant used in Ayurveda, possessing numerous health benefits, including its alkaline properties. It is a primary ingredient in Kshara Sutra therapy, known for its efficacy in managing fistulas due to its chemical properties that facilitate healing of the affected tissue.
20) Turmeric:
Turmeric, known for its anti-inflammatory and antimicrobial properties, is a vital component in Ayurvedic formulations. In Kshara Sutra, turmeric powder is blended with Kshara, enhancing the therapeutic effects of the sutra while promoting healing through reduction of inflammation and infection at the surgical site.
21) Incision:
Incision refers to the surgical cut made during procedures to access underlying tissues. In the context of Kshara Sutra therapy, while the approach is minimally invasive, understanding the significance of incision techniques aids in appreciating the precision required for effective management of anal fistulas.
22) Guggulu:
Guggulu, derived from the resin of Commiphora mukul, is an important herb in Ayurveda known for its anti-inflammatory and healing properties. Its inclusion in treatment protocols enriches Kshara Sutra therapy by supporting tissue repair and inflammation reduction, enhancing overall therapeutic outcomes for patients.
23) Hemanta (Hemamta):
Hemanta is referenced as an author's name, indicating the researcher behind the study. The contributions of Dr. Hemanta Kumar Panigrahi demonstrate the intersection of modern studies and traditional knowledge in evaluating the effectiveness of therapies like Kshara Sutra in managing anal fistulas.
24) Yantra (Yamtra):
Yantra means 'instrument' or 'machine' in Sanskrit, often referring to tools used for specific functions. In this study, the term could denote therapeutic tools or methods employed during Kshara Sutra application, emphasizing the importance of correct instrumentation in achieving successful treatment outcomes.
25) Mishra (Misra):
Mishra is commonly recognized as a surname, likely referring to a contributor or author in the Ayurvedic field. It signifies the legacy of scholars who have contributed to the understanding and development of Ayurvedic practices, including techniques like Kshara Sutra for treating fistula-in-ano.
26) Ambika:
Ambika is another name associated with an author in Ayurveda, enriching the scholarly contributions to the field. This name underscores the collaborative effort in traditional medicine, highlighting the shared knowledge and techniques that have evolved over centuries, now applied in therapies like Kshara Sutra.
27) Ratna:
Ratna, meaning 'gem' in Sanskrit, often denotes something precious or valuable. In this context, it suggests the recognition of valuable traditional knowledge and practices within Ayurveda, signifying the esteemed methods utilized in Kshara Sutra therapy as gems of healing for anal fistulas.
28) Bhava:
Bhava refers to the emotional state or essence and is crucial in understanding patient perspectives in Ayurveda. It underlines the importance of treating not just physical ailments like fistulas but also considering the emotional and psychological components of healing through therapies like Kshara Sutra.
29) Snuhi:
Snuhi, or Euphorbia neriifolia, is a medicinal plant utilized in Ayurveda for its healing properties. In Kshara Sutra therapy, Snuhi latex may be integrated into formulations, enhancing the overall efficacy of treatment by promoting healing and reducing tissue damage during the surgical process.
30) Pearl:
Pearl has no direct reference within the text but metaphorically signifies value and beauty, reflecting the commendable outcomes of well-applied Kshara Sutra therapy. Here, it emphasizes the desirable results achieved in enhancing patient quality of life when treating conditions like Bhagandara effectively.
31) Vali:
Vali refers to the author, showing scholarly contributions to the field of Ayurveda. Highlighting contributors like Dr. Vali recognizes the continuous evolution of Ayurvedic practices, aiding in the adaptation of traditional therapies like Kshara Sutra to contemporary medical challenges.
32) Nadi (Nadin):
Nadi translates to 'flow' or 'channel' in Ayurveda, often relating to bodily 'channels' for energy or therapies. In the context of Kshara Sutra, it alludes to the importance of proper circulation in the healing process and the therapeutic techniques employed to enhance patient recovery.
33) Diet:
Diet plays a significant role in Ayurvedic medicine, governing overall health and recovery. The dietary recommendations for patients receiving Kshara Sutra therapy underline the necessity of nutrition in supporting healing mechanisms while ensuring optimal recovery from surgery and management of anal fistulas.
Other Science Concepts:
Discover the significance of concepts within the article: �Kshara Sutra Therapy for Bhagandara (Fistula-in-Ano): A Study�. Further sources in the context of Science might help you critically compare this page with similair documents:
Bhagandara, Fistula in ano, Statistical analysis, Chronic constipation, Recurrence Rate, Kshara Sutra Therapy, Incision and Drainage, Surgical technique, Duration of Illness, Sphincter Muscle, Incidence of Fistula.