Ksharkarma & Ksharsutra in Proctology
(Indigenous alkali & Alkaline seton)
Kshar Karma (Indigenous Alkali)
Ayurveda depends largely upon the medicinal plants for the therapy. Among the four Vedas – Rig-Veda, Yajurveda, Samaveda, and Atharvaveda – the Atharvaveda is considered to be one from which Ayurveda is derived and several medicinal plants are mentioned that can be used as a drug. Kshara is the herbal extracts of plants. Kshara can be a multiple combination of many herbs or may be from single herb. This alkaline preparation has many therapeutic usages and many surgical procedures. Ksharkarma is useful as the substitute of surgical instruments, because they can be used safely on the patients who are afraid of surgery. It has been proved to be effective in treating many disorders like piles, fissures, fistula in ano, abscess, pilonidal sinus etc. External application of Kshara is indicated in children, weak persons and decrepit. Ksharakarma has been considered as a wealth and a strong weapon in Ayurvedic Pharmacopeia. A.Y.U.S.H., Government of India & W.H.O. has recognised these treatments.
Indigenous Alkali
Definition:
Kshar refers to the alkaline substances derived from plants or minerals that are used in the treatment. Karma means action or therapy, hence Kshar Karma is the therapeutic use of these caustic substances.
Importance of Indigenous alkali (Kshar)
- The Indigenous alkali (Kshar) consider as advanced amongst all surgical (shastra) & Para surgical (anushastra).
- Indigenous alkali is superior than any sharp instrument because it possesses the property of exicision, incision, scrapping & other para surgical properties.
- Indigenous alkali (kshar) & alkali thread (ksharasutra) is an alternative for many surgeries especially in anorectal surgeries.
- The alkali has corrosive property so that can cause debridement of unhealthy tissue is very easy.
- Indigenous alkali (kshar karma) minimizes complication, reduces recurrence of condition & reduces chance of post-surgical infection due to its aikinite.
- It’s a safe minimal invasive procedure.
- It has a property to catabolisation, debridement & liquefication of vitiated tissue.
Mechanism of indigenous alkali (Kshara) on Haemorrhoids:
Indigenous alkali (Kshara) was applied to the internal haemorrhoids. It was observed that the Pile mass became black in 35-40 seconds. Diluted vinegar or Lemon juice (citric acid) was used to neutralize the effect after proper burning of pile mass.
Alkali (Kshara) causes coagulation of Hemorrhoidal plexus (cauterization of pile mass), necrosis of tissue followed by fibrosis of plexus, adhesion of mucosal, submucosal coat helps in prevention of further dilatation of veins and prevents prolapse of regional mucosa of anus. This makes permanent radical obliteration of Haemorrhoid.
Before
Before alkali apply
Alkali apply
Pile mass become black
Result
Other properties of Indigenous alkali (Kshara)
- Indigenous alkalis pacify the vitiated tissue in wound & infection carrying microorganism.
- It has high intense energy, liberates heat.
- Hygroscopic – it absorbs water from wound & dries the wound early.
- Helpful in production of enzymes & hormones.
- It mobilises stagnant slough/pus.
- It promotes diffusion, osmosis & capillary action making condensed material into liquid form.
- Alkalis dilates vessels & dissolve the clot & remove obstructive material from vessel.
Advantages of Ksharkarma in proctology
- Time tested & proven.
- Minimally invasive compared to conventional surgery.
- Predictable outcome & faster recovery.
- Can be performed on an outpatient basis.
- Can be perform under local anesthesia.
- Minimal bleeding.
- No stricture formation.
- Minimal hospitalization.
- Negligible recurrence rate.
- Patient can perform his regular activity earlier.
- Cost effective.
Ksharsutra:
Ksharsutra is an Ayurvedic treatment method used primarily for managing anal fistulas and pilonidal sinuses. This therapy involves the use of a medicated thread (Ksharsutra) which is inserted into the fistula tract. It is considered effective due to its simplicity, safety, and the low chances of recurrence and anal incontinence post-treatment. However, it may come with some discomfort and minor post-procedural complications
Alkali Seton
Advantages of Ksharsutra (Alkaline Setone)
- Minimally Invasive: It is less invasive compared to traditional surgical methods, reducing the risks and recovery time associated with more extensive surgeries.
- Effective for Complex Fistulas: It can be particularly effective for complex anal fistulas, which may not respond well to conventional treatments.
- Lower Recurrence Rate: There is evidence to suggest that Ksharsutra has a lower recurrence rate compared to some surgical interventions.
- Preservation of Anal Function: The procedure aims to avoid damage to the sphincter muscles, which helps preserve normal anal function and reduces the risk of faecal incontinence.
- Reduced Hospital Stay: Typically, Ksharsutra therapy may involve shorter hospital stays and quicker recovery times, allowing patients to return to their daily activities sooner.
- Natural Healing: The medicated thread used in Ksharsutra promotes natural healing processes in the body, enhancing tissue repair.
- Cost-Effective: It can be a more affordable option compared to surgery, making it accessible for many patients.
- Favourable for High-Risk Patients: For individuals who may not be suitable candidates for surgery due to other health conditions, Ksharsutra offers a viable alternative.
- Minimal Scarring: The method generally results in less scarring compared to traditional surgery.
Considerations: Although generally considered safe, Kshar Karma should be performed by qualified Ayurvedic practitioners who can evaluate individual cases and monitor for any adverse effects.
Aftercare: Post-treatment care is crucial for optimal healing and often involves dietary recommendations, lifestyle modifications, and follow-up consultations.
Ksharkarma & Ksharsutra are most effective treatment in proctology in haemorrhoids & fistula in ano respectively. These treatments are already mentioned in ayurvedic textbooks which are time tested & proven.
One should think about these treatments because these techniques are most effective in complex & recurrent fistula as well complex haemorrhoids, so consider as gold standard techniques in proctology, which minimizes the post-operative time along with betterment in mild post procedural pain and minimum scar mark and less hospitalization.
Dr Kamthe piles clinic, Surgical Hospital and research Centre is India’s best hospital where KsharKarma and KsharSutra treatments are done, scientifically . complicated Fistula complex, Fistula, recurrent Fistula and complicated piles are treated in this hospital. Dr Kamthe and his team of doctors age efficient to handle all complicated Proto logical problems, one should think to treat their prophetical problems through Ayurveda treatments, side-effects