Dr. Kamathe Piles Hospital

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KSHARSUTRA FOR FISTULA, HAEMORRIODS AND PILONIDAL SINUS

Minimal Invasive Treatment..

Ksharasutra therapy is a minimal invasive treatment procedure and time-tested Ayurvedic technique in the management of Anorectal disorders. It is a safe, sure and cost effective method of treatment for fistula-in-ano, hemorrhoids and other sinus diseases.

Though the therapy has been described in Ayurveda by Sushruta, Charak and Vagbhata 3500 yrs before but the efficacy of this therapy was re-established by the Dept. of Shalya Tantra, Banaras Hindu University and later period revalidated by scientific organizations like CCRAS and ICMR. This technique is being practiced widely in our country and in some other countries.

Preparation of Ksharasutra

This is medicated tread and mostly used for treatment of Fistula, Piles, Sinus, Pilonidal sinus .The Standard Ksharasutra is prepared by 11 coatings of Snuhi latex (Euphorbia nerifolia), 7 coatings of Snuhi latex and Apamarga Kshara (Achyranthes aspera) and last 3 coatings of Snuhi latex and Haridra Churna (Curcuma longum). The pH of Apamarga Ksharasutra is 9.72.

Indications

Fistula-in-ano, hemorrhoids, pilonidal sinus, rectal or anal polyps etc.

Application of Ksharasutra in Fistula-in-ano –

The patient is anaesthetized with local or spinal or general anesthesia, then a malleable probe is passed through the external opening of the fistula to the internal opening in the anal canal and probe is gently taken out through anal opening to outside along with a Ksharasutra in the groove of the probe. Later both ends of the Ksharasutra is tied together. The Ksharasutra is replaced by a new one after an interval of one week. The Ksharasutra gradually cuts and heals the tract. Finally the whole fistulous tract heals after cutting.

Mechanism of action of Ksharasutra in Fistula-in-ano –

  • It helps is cutting, curetting, draining and healing of the fistulous track.
  • It destroys and removes unhealthy tissue and promotes healing of the fistulous track due to caustic action.
  • Controls infection by the microbicidal action
  • Separation of debris and cleaning the wound
  • Facilitate in drainage of pus in fistulous tract and help in healing.
  • Cutting through the tissues and laying the track open.

Application of Ksharasutra in Haemorrhoids –

The patient is anaesthetized with local anesthesia. First pile mass holding with pile holding forceps and bring them out of the anal orifice, then give incision at mucocutaneous junction. Later slight pull exerted over the pile mass and transfixed by Ksharasutra at the base. Ligated pile mass replaced inside the rectum and rectal pack with Yastimadhu taila or ghrita.

Mechanism of action of Ksharasutra in Haemorrhoids –

  • Chemical cauterization and mechanical strangulation of the blood vessel.
  • Local gangrene of the pile mass tissue.
  • Ischemic necrosis and debridement of unhealthy tissue.
  • Sloughing of the mass within 5-7 days.
  • Healing of the resulting wound takes 10-15 days.

Application of Ksharasutra in Pilonidal Sinus –

The patient is anaesthetized with local anesthesia and then a malleable probe with Ksharasutra is passed through the external opening of the pilonidal sinus to the skin. Later both ends of the Ksharasutra is tied together. The Ksharasutra is replaced by a new one after an interval of one week. The Ksharasutra gradually cuts and heals the tract.

Advantages of Ksharasutra Therapy –

  • 3500 years old ayurvedic therapy
  • Day care treatment, Minor OT process.
  • Simple and safe parasurgical procedure.
  • Cost-effective and ambulatory.
  • Time required to perform surgery is maximum of 25-30 min. in almost all cases.
  • Minimal recurrence rate.
  • No any complications
  • Systemic diseases are also undergoing this procedure.
  • No surgical complications like incontinence, stenosis and stricture.
  • No loss of man-days as patient can resume to work-life or daily routine life with simple precautions.
  • Simple post-surgery instructions are to be followed by patients themselves. Therefore, no hassle or requiring help from others.

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