of Ksharsutra the healing thread for fistula-in-ano.
Fistula in ano is a disease, which has been included in the
ashta mahagad by acharya sushruta. Even today when
surgery is at its peek, fistula in ano is still a challenge
to the surgeons for its incidence of recurrence & Postoperative
The method devised by ancient acharyas to treat this disease
is the only fool proof method available to cure fistula-in-ano.
Kshara-sutra is a medicated thread which is prepared by applying
the coatings of apamarg kshara, haridra churna etc. with snuhi
ksheer as binding agent. The thread is then sterilized by
U V Radiation. The cumulative effect of the above-mentioned
three drugs exerts a powerful debridement effect on the fistula
tract & induces healing by the fresh & healthy granulation
tissues. The sutra is the mechanism of drug delivery precisely
at the tissues involved.
The patient is routinely investigated with special reference
to any other associated disorder like hypertension diabetes
mellitus, tuberculosis etc. The next step lies In the proper
identification & evaluation of the fistulous tract. This
is achieved by careful probing with malleable probes.
However USG or fistulogram may be required in the cases like
high anal fistula, recurrent fistula, fistula with multiple
openings & branching pattern. Once the tract has been
accurately defined, it has to be ligated with kshara-sutra,
as an OPD procedure. Every seventh day the old sutra is
replaced with a new KS till there is a finale cut through.
It has been observed that the length of the tract reduces
@ 0.5-1 cm per week, but then there are several factors
this cutting rate of the thread e.g. in the patient of post
surgical recurrence, there is abundance of fibrous tissue
which reduces the cutting rate.
Kshara sutra is the novel idea of drug delivery along
the whole length of the fistulous tract by the ayurvedic
During kshar-sutra therapy there is debridement & cutting
of the tissues followed by healing.
The kshara acts as powerful debriding agent & selectively
acts on the unhealthy tissues, pus pockets etc.
This process of debridement & healing starts from deeper
tissues & travels towards periphery in stages.
The postoperative complications like recurrence of the disease,
fecal incontinence, bleeding is not seen with kshara sutra
treatment. Further this therapy is performed as an OPD
No general anesthesia & no hospitalization is required.
Patient maintains his normal routine activities as usual during
indications of Ksharasutra
discharging sinuses with osteomyelitis
methods of application of Kshara
Ayurveda specialist offers beter cure rates for fistula
in ano as compared to modern surgeons.
The incidence of anorectal diseases is increasing day by day
due to fast food culture, Low fibrediet, sedentary life style
etc. Most of these diseases are treated surgically, which
is usually associated with Post operative pain, bleeding,
decrease in sphincter strength & some times recurrence
of the disease. After extensive research using ayurvedic treatment
methodologies with modern equipments & technology certain
treatment modalities have been formulated. These methods are
non surgical or parasurgical hence more convenient & have
better results as compared to modern surgery in certain diseases.
Sushruta surgical center is a pioneer center for treating
ano-rectal Diseases ie. Fistula, piles, fissure etc using
graded Kshar sutra therapy-a concept of Ayurvedic surgery.
The technique has been scientifically developed & clinically
evaluated. Indian Council Of Medical Research, the apex body
of medical research in India has conducted clinical trials
of kshar sutra therapy in the disease FISTULA-IN-ANO, at four
centers including AIIMS.
The results of this clinical trial have been officially released.
It has been proved that ksharsutra is more effective &
more suitable treatment as compared to surgery for treating
fistula in ano.
Surgeons & medical practioners who are aware of this
research are referring the patients of fistula-in-ano to
Dr. S.K. Singh M.S. (Ayurveda) Gold Medalist
(B. H. U.)
Member-National Academy of Ayurveda, Govt. of India
Ex. Senior ano-rectal (ayurveda) specialist MOOLCHAND HOSPITAL,
Ex. Senior kshar sutra specialist-mahirishi ayurvedaarogyadham