Ano rectal fistula is a chronic inflammatory condition with a tract opening (internal opening) in the Anal canal at one end and another opening at the perianal surface/skin (external opening). It is challenging due to its high recurrence rate. Probable risk factors include recurrent fissure in Ano, prolong sitting, obesity, excessive hairs in perianal region. Based on its symptoms, it can be correlated with Bhagandara in Ayurveda. Acharya Sushruta has included it under Ashtamahagada and as Dushchikitsya vyadhi & have explained five types of Bhagandara & various treatment modalities like bheshaja, shastra, kshara etc. Here we have taken a case of Ano rectal fistula of a male aged around 43 years is examined in Shalya tantra OPD, diagnosed with Bhagandara and treated with Ksharasutra, as it is considered as an ideal parasurgical procedure for the treatment of Bhagandara due to its Ksharana, lekhana and ropana properties.
Dr. Shankar S. Dr. Fareeha Khanum A. K.* (Sun,) studied this question.