Fistula can be regarded as
a condition, which results from an abnormal connection (tract / sinus) that
forms between two organs that are lined with epithelial cells. Fistula may be
from anal canal to the external surface of skin near anus (perianal skin), or
between the rectum and vagina or urinary bladder. The main cause is the
unattended abscess which leads to the tract formation from the anal canal.
Ayurveda treatment for fistula in ano:
Fistula in ano can be correlated to Bhagandara, one among the 8 mahagadhas. A sinus
tract (Nadi Vrana) in the region of Guda (anal region), which is caused by
imbalance of all the three doshas and which gets lodges in the anal region due
its Kha Vaigunya (aggravated / obstructed Apana Vayu and increased pitta caused
by long standing, long sitting habits, constipation, issues of digestive
system, food habits which disturbs digestion and increases pitta).
Causes:
· A fistula develops if there is an outburst of the abscess, or an
incomplete treatment of the abscess.
· Other causes are Crohn's disease or ulcerative colitis (disease
that affect the intestines), low immunity, hemorrhoids.
Symptoms:
· Pain in the perianal / ano rectal region
· Discharge — either bloody or purulent
· Itching in the perianal region
· Systemic symptoms (if abscess becomes infected)
· Pain, which is usually constant, throbbing and worse when
sitting down
· Skin irritation around the anus, swelling, redness and
tenderness
· Discharge of pus or blood from the abscess
· Constipation or pain associated with bowel movements
· Fever
Classification based on the predominance of the dosha:
1. Shataponaka -
Vataja type of Bhagandhara which expresses as severe pain and multiple small
openings
2. Ushtragreeva -
Pitta type of Bhagandhara, characterized by red colored pustule which
suppurates quickly giving a foul smelling discharge
3. Parisravi -
Kapha type of Bhagandhara, Which has increased itching, thick discharge and is
a less painful condition.
4. Shambukavruta –
Combination type which has pustules resembling teet of cow, creating spiral
sinuses inside resembling that of seashell.
5. Agantuka –
Caused by trauma or any injury to the anus, if neglected forms sinuses and gets
infected.
Ayurveda treatment in fistula in ano:
Treatment for Bhagandhara
involves one or following of the procedures depending on the type and the path
of tract. Through ayurveda treatments the recovery is faster, less painful and
reoccurance rate is very low.
The treatment modalities
includes panchakarma, kshara Sutra, kshara karma, and agni karma external
therapies, internal medications, Activities, Advice of food and life
style changes
1. Panchakarma – Mrudu
Virechana and Basti
2. Kshara-sutra – In
this procedure the tract is probed and the kshara sutra (alkanine thread) is
passed through it and changed at regular intervals until the healing is
complete.
3. Application of Kshara – Application
of medicine (alkaline in nature) derived from a combination of various
herbs.
4. Agnikarma – thermal
cautery .
5. Internal Medication – A
combination of herbs which works on the following principles is administered
o Balance
the Doshas
o Improve
digestion
o Improve
dietary habits
6. Externally – Medicated
Sitz bath.
Activities:
Specific Asanas,
Pranayama, Meditation, Mudra.
Food and lifestyle changes: specific to the individuals constitution, nature of
work and geographical conditions.