Article: EFFECT OF TILVAKA KSHARASUTRA IN THE MANAGEMENT OF BHAGANDARA (FISTULA-IN-ANO): A CASE REPORT

Article Category: Case Reports

DOI: 10.7897/2277-4343.110480

Pages: 18-21

Author: Jithin K Nair *, G Chandra Kumar, Sreejith Satheesan

Abstract: Bhagandara is a common disease occurring in the anorectal region. Acharya Sushruta has included bhagandara under Ashta-mahagada. The treatment of this disease is difficult due to its high recurrence rate. Patients have inconvenience in their routine life. Acharya Sushruta has explained about the concept of Ksharasutra in the context of Nadivrana (sinus). Hippocrates has explained about the application of plain silk thread for the treatment of fistula-in-ano. The treatment of fistula-in-ano by Ksharasutra has become a big revolution in the field of surgery. The main aim of this study was to make a Ksharasutra which would be easy to prepare and more effective than Apamarga Ksharasutra while calculating unit cutting time. In present case report, a 59 year old male patient who came to Shalya OPD with chief complaints of pain, pus and blood discharge from pustules in the perianal region along with itching for the past 6 months was advised for Tilvaka Ksharasutra therapy. The patient was treated with Tilvaka Ksharasutra prepared at Pankajakasthuri Ayurveda Medical College. Rethreading was done on weekly basis. The patient recovered well within a period of 7 weeks. Tilvaka Ksharasutra therapy is a procedure with minimal complications and is cost effective. Thus, Tilvaka Ksharasutra is very effective minimal invasive surgical modality for management of bhagandara (fistula-in-ano).

Keyword: Tilvaka, Ksharasutra, Bhagandara, Fistula-in-ano.