MANAGEMENT OF BHAGANDAR [FISTULA IN ANO]BY USING KSHEERSUTRA- A CASE REPORT

BAMS PG SCHOLAR

ABSTRACT Bhagandara, Identified by Acharya Sushruta as one of the eight major ailment(Asthamahagada),is considered particularly difficult to treat.Ayurvedic literature provides a comprehensive explanation of this condition,which is derived from the terms bhag(perinealregion) and darana(tearing or bursting).Bhagandara commonly affects the ano-rectal region, extending from the anus to the genitalia, and is marked by the formation of a pidika (boil or abscess), which eventually leads to painful discharge and the development of tracts around the guda (Anus). Clinically known as fistula in- ano, this condition is a surgical challenge due to its high rate of recurrence, often necessitating fistulectomy. In traditional Indian medicine, the application of Ksheerasutra -a medicated thread therapy—has been advocated for treating ano-rectal diseases, particularly Bhagandara. Prepared according to the standards of the Ayurvedic Pharmacopeia of India(API) ,Ksheerasutra is made using Udumbara Ksheera and Haridra powder (Curcuma longa Linn.). In a clinical case involving a 29-year-old male patient with a posterior anal fistula located at the 4 o'clock position, initial management involved probing and threading with Ksheerasutra. The thread was replaced weeklyusing the rail-road technique,and the length of Ksheerasutra was recorded to determine the Unit Cutting Time (UCT). The wound was managed with daily dressings using betadine solution, and healing was supported with Vranaropak taila (wound-healing medicated oil). The site healed completely, forming a healthy scar with no complications. Thus, Ksheerasutra therapy emerges as a highly effective, minimally invasive surgical intervention for treating Bhagandara,offering sphincter preservation and reduced recurrence.

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