Fistula-in-ano is one of the most common benign colorectal diseases and is defined as the abnormal hollow tract or cavity that is lined with granulation tissue and connects a primary opening inside the anal canal to the secondary opening. This means that it develops between the end of the bowel and the skin near the anus. The secondary tracts may be multiple and may extend from the primary opening.

It can be caused due to the infection near the anus which results in the collection of pus in the nearby tissues. When this pus drains then it leaves a small channel behind it.

Anal fistulas can cause discomfort and skin irritation, and will not usually get better on their own.

Ayurvedic point of view:

Anal fistula is defined as the disease or condition which causes severe referred pain to Bhag (perineum), and Guda (anal area) hence it is called ‘’Bhagandar’’. According to Ayurveda texts, the manifestation begins with the abscess around the perianal region, but if it remains untreated then converts into a discharging tract known as Bhagandar.

According to the Acharya Sushruta, Mithya Aahar-vihar (unsalutary lifestyle and improper food habits) is the main cause of this disease.

When the Vata dosha gets aggravated in the body and gets localized in the anal canal. Further, it accumulates in the muscles and blood which gives rise to Pitika (boil), and if is not treated on time then it leads to the formation of Bhagandar.

Classification:

Anal abscesses are classified upon the basis of their location with relation to its structures that comprise of surrounding the anus and rectum: ischioanal perianal, supra levator and intersphincteric. The perianal area is the most frequent and the supra levator is the least.

What are the causes of fistula in ano?

Most of the anal fistulas are developed after an anal abscess. It develops in most people if the abscess does not heal properly after the pus has drained away.

Less common causes of anal fistulas include:

  • Crohn’s disease- It a long-term condition in which there is an inflammation in the digestive system.
  • Diverticulitis – Infection that sticks out of the side of the large intestine (colon)
  • Hidradenitis suppurativa – It is a long-term skin condition that causes abscesses.
  • Infection with tuberculosis (TB) or HIV

What are the symptoms of anal fistula?

Symptoms of an anal fistula include:

  1. Skin irritation around the anal area
  2. A constant and throbbing pain that may be worsened when you sit down or move around
  3. Foul smelly discharge from near the anus passing pus or blood with it
  4. Redness and swelling around the anus
  5. Fever
  6. The end part of the fistula might be visible as a hole in the skin near the anus

Other symptoms include rectal bleeding or urinary symptoms, such as trouble in initiating a urinary stream or painful urination. Patients with fistulas commonly have a history of a previously drained anal abscess.

What are the panchakarma procedures for fistula?

In Ayurveda texts, a special procedure that has been done to cure fistula is kshara sutra. Chandigarh Ayurved Centre offers this procedure under the guidance of expert doctors.

This procedure is done under local anesthesia with medicated thread and organic alkalis such as Arkakshara (Calotropis gigantea) and Apamargakshara (Achyranthes aspera). These are coated on the seton thread for 15 to 20 times. Natural antibiotics are also used in the formation of ksharasutra. This medicated thread is useful in draining, cutting, curetting and cleaning of the wound.

Chandigarh Ayurved Centre provides the best Ayurvedic treatment for Fistula which work on the main cause of the disease. A wonderful kit has been made which is named as “Fistula Care Kit”. This kit contains 5 products—Detox premium powder, Pranda gutika, Triphala Syrup, Arshofit capsules, and Jatyadi ghrit lepam. These formulations mainly balance the three doshas in the body.

FISTULA-CARE-KIT

1. Detox premium powder:

This herbal formulation is prepared from the gandhak rasayan, jahar mohra pishti, akkik pishti, giloy satv,parwal pishti, etc. These herbal ingredients help to relieve pain, redness, discomfort, and swelling. Being an antioxidant, it also eliminates the toxins (ama) from the body.

Dosage: Take 1 sachet twice daily with normal water.

2. Pranda Gutika:

Prandagutika is an Ayurvedic formulation which balances the Vata as well as pitta dosha. These doshas are the main cause of anal fistula. It comprises of pippali, twak, maricha, chavya, etc. which helps to reduce the problems related to anal fistula like redness, swelling, skin irritation, etc.

Dosage: Take 2 tablets twice daily with normal water.

3. Triphala Syrup:

Triphala syrup comprises of three main herbs such as- haritaki, bibhitaki, and Amalaki. These herbs are the best detoxifiers that eliminate the toxins and support the immune system. Triphala has been used in Ayurveda for many ages for treating constipation. Each of these herbs has a positive impact on the three doshas.

Dosage: Take 2 teaspoonful thrice daily.

4. Arsho fit capsules:

As the name suggests, this herbal formulation treats various ailments like piles, anal fistula, and fissures. It comprises of sodhit gairik, sonth, raswanti, naag keshar, etc which are the best pitta as well as kapha pacifiers. By regular use of these capsules, it treats abdominal discomfort, rectal bleeding, redness, etc.

Dosage: Take 2 capsules twice daily with normal water.

5. Jatyadi ghrita lepam:

Jatyadi ghrita lepam is the herbal formulation that is used as an external application to treat swelling. It is prepared from Nimba patra, tuttha, jati Patra, patola, etc. and these ingredients possess antimicrobial activity and are very effective in fistula and piles. Being an anti-inflammatory, it reduces the inflammation by working on the root cause of disease.

Method of application: Apply this lepam on the affected part.

Healthy diet and lifestyle:

  1. Do exercise regularly for at least 30 minutes to keep the digestive system moving and in good shape.
  2. The anal area should be properly dry.
  3. Clean the affected area gently after each bowel movement.
  4. Use soft and dye-free toilet paper or wipes.
  5. Eat rich fiber diet daily which keeps the stools soft and improves the healing of the fistula. It includes vegetables, fruits, nuts, and whole grains.
  6. Include barley, oatmeal, brown rice, wheat bran, cereals, beans, broccoli, spinach, peas, cauliflower, apples, orange, banana, papaya, etc. to your daily diet.
  7. Avoid spicy and oily foods that may aggravate swelling, pain, burning sensation, etc.
  8. Eat light and small meals so that they can be easily digestible. It relaxes the intestine and maintains the proper metabolism of the body.
  9. There a lot of yoga poses or asanas that the patient should perform regularly to ease the symptoms of fistula – Sarvangasana, Vajrasana, Kakasana, Uttanasana, Sirasana, Vajrasana, Uttanpadasana, etc.