Ayurvedic Treatment for ANAL FISTULA

Ayurvedic Treatment for ANAL FISTULA has internal medications and external Ayurvedic surgical methods. The internal medications fix the root cause, prevents recurrence and relapses. The external medications and surgical procedures correct the tract and heal it properly. A small tunnel that connects an infected gland inside the anus to an opening on the skin around the anus is known as an anal fistula.

  • Signs and symptoms of anal fistula
  • Causes of anal fistula
  • Pathophysiology of anal fistula
  • Diagnosis of anal fistula
  • Treatments of anal fistula
  • Prognosis of anal fistula
  • Complications of anal fistula
  • Bhagandara in Ayurveda
  • Nidana- Causes of Bhagandara
  • Purvaroopam (Premonitory Symptoms) of Bhagandara
  • Samprapthi (Maturation) of Bhagandara
  • Lakshana of Bhagandara
  • Prognosis of Bhagandara
  • Chikitsa (Treatment) of Bhagandara
  • Commonly used medicines for Bhagandara
  • Diet desirable to prevent Bhagandara
  • Yoga
  • Research articles link

Signs and Symptoms

  • Pain, redness and swelling around the anus are the main symptoms
  • Also will have bleeding, painful bowel movements
  • Fever
  • Foul-smelling discharge of fluid through the anus 

Causes

The causes include the clogging of glands in the anus which later gets infected by bacteria. It is also caused by surgery or injury. Inflammatory bowel conditions like Crohn’s disease and ulcerative colitis are the cause of fistula.

Types

  • Intersphinteric (45%)
  • Trasphincteric
  • Suprasphincteric
  • Extrasphincteric

Pathophysiology

The anal fistulas develop from the anal crypts which when become infected leads to abscess formation. When the abscess gets opened fistula is formed. It can have multiple tracts.

Diagnosis

  • Local examination around the anus
  • Contrast tests like barium enema, blue dye test to identify fistula located in the upper rectum
  • Computerized tomography, MRI, Anorectal ultrasound are also used for diagnosis.
  • Goodsall’s rule is a guideline for internal opening, the path of the fistula tract.

Treatments

  • Initially, treatments aim to include draining of local infection, eradication of fistulous tract and avoid the recurrence while preserving the functioning of the sphincter.
  • Surgical management includes,

Fistulotomy

            Fistulectomy

Seton technique

LIFT procedure

Prognosis

For fistula in ano, the prognosis is good after surgery. The recurrence rate is nearly 7- 21% depending on the site and complexity of the fistula.

Complications

The complication includes infection and incontinence after surgery. Recurrence is also noticed in the fistula.

Disease and Ayurveda

An anal fistula is described as Bhagandara in Ayurveda. Bhagandara is a condition that is developed from bursting a painful abscess in the anal region.

Nidana- Causes

The causes include;

  • Excess intake of food which are kashaya rasa (astringent taste), rooksha (dry) and incompatible foods
  • Trauma by Krimi (worms), asthi (bones) or improper use of enema nozzle
  • As a cause of haemorrhoids
  • Sinful acts are also said a cause

Purvaroopam- Premonitory Symptoms

The premonitory symptoms include,

  • Pain in pelvic regions
  • Itching sensation in the anal region
  • Swelling
  • Burning sensation in the anal region

Samprapthi Maturation

Due to nidana sevana doshas get vitiated and localizes in guda pradesha (anal region). This leads to the formation of a pidaka (abscess). Later on the vitiation of blood and mamsa (muscle tissue) causing the formation of a tract that gets deeper. From this, there will be the subsequent flow of pus.

Lakshana Signs and Symptoms of different types of Bhagandara

  1. Sataponaka Bhagandara
  2. Due to vitiated vata dosha
  3. There will be severe pain.
  4. When the pidaka opens it presents frothy brownish red discharge
  5. It will have multiple openings
  6. Also, discharge faeces and urine happens through the opening.
  7. Ushtragreeva Bhagandara
  8. Due to vitiated pitta
  9. Lesions get ripened quickly with hot discharge
  10. The shape of the blisters resemble the neck of a camel
  11. Parisravi Bhagandara
  12. Due to vitiated kapha dosha
  13. Associated with itching and thick white discharge. Less pain
  14. Shambukavarta Bhagandara
  15. Due to tridoshaja dushti and associated with symptoms of all doshas
  16. Unmargi Bhagandara
  17. Due to foreign body trauma like bone-in food
  18. There will be the discharge of blood and pus
  19. There will be the formation of worms and discharge of faeces, urine or pus through the opening

Parikshepi, Riju, and Arsobhagandara are types due to vitiated vata-pitta, vata-kapha and pitta-kapha respectively.

Prognosis

Bhagandara is considered as one among Ashtamahagada (eight severe diseases) and all types are Krichrasadhya (difficult to treat) except sannipataja and agantuja type which are incurable.

Chikitsa- Treatment

General treatment includes Snehana (oleation), sudation by sits bath followed by chedana (cutting), Agni karma (cauterization), or ksharakarma (chemical cauterization) considering doshas.  Agni karma and Ksharakarma are very effective in curing the disease and their recurrence rate after this treatment is also very less. Ksharasootra treatment is a very peculiar and highly effective way of managing fistula.

Commonly used medicines

  • Guggulupanchapala choornam
  • Guggulu Tikthaka kashayam
  • Kanchanara Guggulu
  • Kaisore guggulu
  • Chiruvilwadi Kashayam
  • Varanadi kashayam
  • Patoladi Kashayam
  • Dusparsakadi Kashayam
  • Kaisora guggulu
  • Gandharvahastadi kashaya, etc.
  • Sitz bath in medicated water with Triphala choorna

Brands available

  • Aryavaidyasala Kottakkal
  • Vaidyaratnam Oushadasala
  • Kerala Ayurveda
  • SNA
  • Dhootpapaeswar

Home Remedies and diet

  • High fibre diet like wheat germ, brown rice, barley
  • Fruits like papaya, orange, apple
  • Vegetables like carrot, spinach, cauliflower, radish, onion can be used
  • Avoid hot spicy foods
  • Vitamin C rich food
  • Sitz bath in warm water

Yoga

  • Uttanasana
  • Sarvangasana
  • Chakrasana
  • Vajrasana
  • Kakasana
  • Breathing exercises
  • Meditation

Research articles link.

https://www.researchgate.net/publication/314168513_COMPREHENSIVE_REVIEW_ON_BHAGANDAR_FISTULA-IN-ANO

http://ijrap.net/admin/php/uploads/1690_pdf.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518420/

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