Anal Fistula

An anal fistula (fistula in ano) is an abnormal channel from the anus or rectum usually to the skin near the anus but occasionally to another organ, such as the vagina

Causes of Fistula in Ano

• Anal or rectal injury
• Infections, such as Crohn’s disease or tuberculosis, diverticulitis, ulcerative colitis.

Symptoms and Diagnoses

A fistula may be painful, or it discharges pus. A doctor can usually see one or more openings of fistula or can feel the fistula beneath the surface. A probe may be inserted to determine its depth and direction. Looking through an anoscope inserted into the rectum and exploring with the probe, a doctor may locate the internal opening.

Treatment

Kshara sutra is the choice of treatment in Anal Fistula. The patient is anaesthetized with local anesthesia, then a malleable probe is passed through the external opening of the fistula to the internal opening in the anal canal and probe is gently taken out through anal opening to outside along with a Kshara Sutra in the groove of the probe. Later both ends of the Kshara Sutra is tied together. The Kshara Sutra is replaced by a new one after an interval of one week. The Kshara Sutra gradually cuts and heals the tract. Finally the whole fistulous tract heals after cutting.

Advantages of Kshara Sutra Therapy –

• It helps is cutting, curetting, draining and healing of the fistulous track.
• It destroys and removes unhealthy tissue and promotes healing of the fistulous track due to caustic action.
• Controls infection by the microbicidal action.
• Separation of debris and cleaning the wound.
• Facilitate in drainage of pus in fistulous tract and help in healing.
• Cutting through the tissues and laying the track open.
• Simple and safe par surgical procedure.
• Cost-effective and ambulatory.
• Minimal recurrence rate.
• Systemic diseases are also undergoing this procedure.
• Procedure can easily performed for patients having history of Diabetes, hypertension (high blood pressure), heart attack, history of Angioplasty and Bypass surgery
• No surgical complications like incontinence, stenosis and stricture.

Pilonidal Sinus

• Pilonidal disease is an infection caused by a hair that injures the skin at the top of the cleft between the buttocks.
• A pilonidal abscess is a collection of pus at the infection site; a pilonidal sinus is a chronic draining wound at the site.
• Pilonidal disease usually occurs in young, hairy men. To distinguish it from other infection, a doctor looks for pits-tiny holes in or next to the infected area. A pilonidal sinus can cause pain and swelling.

Treatment

Kshar sutra and kshar karma is the choice of treatment for pilonidal sinus.

Application of Kshara in Pilonidal Sinus

After excision of Pilonidal sinus, the Kshara applied over the wound and wait for 2 minutes. Later neutralize with lemon juice and pack with Jatyadi / Yastimadhu taila or ghrita. It performs functions like incision, excision etc.It cleans and dries the wound. The application of Kshara helped Debridement (the medical removal of dead, damaged, or infected tissues to improve the healing potential of the remaining healthy tissue). Of Pilonidal Sinus and thus help by the formation of healthy granulation tissue for the healing of the wound from the base.