MANAGEMENT OF BILATERAL TRANS-SPHINCTERIC FISTULA IN ANO WITH APAMARGA KSHARA SOOTRA - A CASE REPORT

Abstract

Fistula in ano is an abnormal communication between anal canal or rectum and the perianal skin which mostly follows previous ano-rectal abscess. Chief complaints include intermittent discharge, history of pre-vious pain, swelling and recurrent abscess that ruptured spontaneously or was drained surgically. Various surgical and para-surgical methods are available now a days to treat this disease. In the vast literature of Ayurveda same symptoms are described as Bhagandara. At first it appears as Pidika around Guda and when it bursts out, it is called as Bhagandara1. Acharya Sushruta has counted this disease in Ashta Ma-hagada suggesting its difficulty to treat2. There are many options available to treat fistula in ano ranging from seton application, fistulotomy, fistulectomy, fibrin glues, LIFT technique, advancement flaps etc. Acharyas has used Agni karma, Kshara karma, Shastra karma and Aushadha karma in Bhagndara. But in this case Kshara Sootra application was done to treat Bhagandara. Application of Kshara Sootra not only lessen rate of recurrence to a significant level but also free from almost all major post-operative complica-tion.