An Updated Review on Bhagandara With Special Reference to Fistula-in-Ano

Bhagandara is identified by Acharya Sushruta as one of the Ashtamahagada (eight grave disorders) due to its chronic nature and difficulty in management. Classical Ayurvedic literature provides an extensive description of this condition, including its causative factors, pathogenesis, clinical features, classification, as well as preventive and therapeutic approaches. The term Bhagandara is derived from the words “Bhaga” (perineal/genital region) and “Darana” (tearing or rupture), indicating a pathological tract involving the ano-rectal and adjoining areas. It commonly affects the region surrounding the anus and may extend toward the perineum and genital structures. The disease typically develops following the formation of a Pidika (boil or abscess), which subsequently ruptures and leads to the formation of a sinus tract with external openings near the Guda Pradesh, often associated with persistent pain and discharge. This review article aims to provide a comprehensive overview of Bhagandara, including its etiology, classification, clinical manifestations, and management from both Ayurvedic and modern medical perspectives.