Transrectal Ultra Sonography based evidence of Ksharasutra therapy for Fistula-in-ano – A case series

Abstract

Ksharasutra (parasurgical procedure using a thread treated by alkalies) is being practiced in Indian system of medicine since ancient time for management of ano-rectal disorders; particularly for Bhagandara, (fistula in ano), and generally difficult to treat. In this case series, standard Ksharasutra was prepared as per the Ayurvedic Pharmacopeia of India and used to treat the different cases of Bhagandara. In this case series total 6 patients of Bhagandara were treated with Ksharasutra and partial fistulectomy. The average Unit Cutting Time and healing (UCTH) was observed 7.86 days/cm. During treatment Panchawalkala Kwatha (decoction of five medicinal plant's bark), Shatdhautaghrita, Jatyaditaila and Erandabhrishtaharitaki Churna were used as adjuvant drugs. To generate quality evidence Transrectal Ultra Sonography (TRUS) was used in pre as well as post-treatment and showed remarkable tool to assess effect of treatment. Substantial clinical result was observed at the end of treatment and all the patients were free of fistula. No recurrence was observed in any case during the 12 follow up of 12 months. The treatment was reported safe and well tolerated in all the patients.

Treatment of rats anal fistula with glycerin Aloe barbadensis Miller extract

“…Recently, Mena et al 17 published a small series of cases of patients treated with medicinal seton of a compound of five herbal medicines. The authors pointed out that no patient had any adverse effects and all patients had healed fistulas in a one-year follow-up, proved by clinical and ultrasonographic evaluation.…”

Ksharasutra and Ksharakarma in the Management of Common Anorectal Diseases: A Review

“…The Apamarga Ksharasutra is then cut into pieces of 10 inch and each piece of Ksharasutra is packed in air tight container. 1 In Brihat trayee Ksharasutra is described in Sushruta Samhita, Charaka samhita and later in Chakradatta.…”

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Integrated Approach in Diagnosis of Ano-Rectal (Guda) Diseases: A Review

“…[15][16] In rectal tumors, phased array magnetic resonance imaging (MRI) will be regarded as the most appropriate single technique for finding the stage of disease. Endosonography or endoluminal MRI with ultrasonography or spiral computed tomography (CT) in combination gives near about similar results.…”