Abstract

EVALUATION OF NIMBA KSHARASUTRA IN THE MANAGEMENT OF BHAGANDARA (FISTULA-IN-ANO): A CLINICAL CASE STUDY

Dr. Satish Mishra*, Prof. Dr. Ranjan Kumar Kasta, Dr. Tapan Kumar Nayak and Dr. Sandhyarani Behera

ABSTRACT

Bhagandara, commonly known as fistula-in-ano, is a chronic and often challenging condition involving an abnormal tract between the anal canal and the skin surrounding the anus. Historically described by ancient scholars like Sushruta and Charaka, it has remained a significant health issue due to its recurrent nature and complications arising from surgical interventions. Conventional treatments, such as surgery and fistulotomy, often result in prolonged healing, scarring, and the risk of fecal incontinence. Moreover, these treatments can be complicated by associated conditions like tuberculosis, venereal diseases, and diabetes mellitus, which exacerbate the condition. Ksharasutra therapy, an Ayurvedic para-surgical intervention, has emerged as a promising alternative for the management of Bhagandara. It involves the use of a thread coated with Kshara (an alkaline herbal preparation) that chemically cauterizes the fistulous tract. Despite itseffectiveness, conventional Ksharasutra therapy can be time-consuming, particularly for high anal or complex fistulas, and may cause discomfort during prolonged treatment. This study aims to explore the efficacy of Nimba Ksharasutra as a modified treatment approach, offering potentially reduced pain and a faster healing time compared to traditional formulations. The preparation of Nimba Ksharasutra, combined with other Ayurvedic medicines, was applied to a 36-year-old male patient diagnosed with low anal fistula. After six sittings, the fistula tract was successfully healed without recurrence. In conclusion, while Ksharasutra therapy, particularly the Nimba variant, offers a viable treatment for anal fistula, further research is necessary to refine its application, reduce treatment duration, and improve patient comfort.

Keywords: Fistula-in-ano, Ksharsutra therapy, Nimba Ksharsutra, Complex fistula, Ayurvedic treatment, Apamarga Ksharsutra.