Fistula in Ano
Fistula in Ano is a tunnel that runs from inside the anus -the hole your body uses to get rid of solid waste- to somewhere in the skin around it. It usually follows an infection that didn’t heal the right way.
• frequent anal abscesses
• pain and swelling around the anus
• bloody or foul smelling drainage(pus) from an opening around the anus. The pain may decrease after the fistula drains
• irritation of the skin around the anus from drainage
• pain with bowel movements
• fever, chills and a general feeling of fatigue
Just inside your anus are several glands that make fluid. Sometimes, they get blocked or clogged.When that happens,a bacteria build up can createa swollen pocket of infected tissue and liquid.It is called an Abscess.
If you don’t treat the abscess, it will grow. Eventually, it will make its way to the outside and punch a hole in the skin somewhere near your anussothe gunk inside it can drain. The fistula is the tunnel that connects the gland to that opening.
Most of the time, an abscess causes a fistula. Other much less common conditions that can cause an anal fistula include-
• Crohn’s Disease (An inflammatory disease of the intestine)
• Radiation (Treatment for Cancer)
• Sexually transmitted diseases
• Diverticulitis ( a disease in which small pouches form in the large intestine and become inflamed)
Your doctor can usually diagnose an anal fistula by examining the are around the anus. The doctor will look for an opening (the fistula tract)on the skin. The doctor will then try to determine how deep the tract is and the direction in Which it is going. In many cases, there will be drainage from the external opening. Some fistulas may not be visible on the skin’s surface. In that case, your doctor may need to perform additional tests-
• Ultrasound Or MRI
Some more tests that are to be done to find any other medical reason are –
• Blood tests
• X – rays
There is no medication to fix the condition, so surgery is the only option.
• For a simple fistula that is not too close to your Anus, the doctor will cut open the skin and muscle surrounding the tunnel. This allows the opening to heal from the inside out.
• They may use a plug to close the fistula.
• For a more complicated fistula, the doctor might put a tube – known as seton -into the opening. This helps drain the infected fluid before surgery. It could take 6 weeks or more.
Ayurvedic Perspective –
In Ayurvedic texts fistula in Ano can be correlated with Bhagandara.
Line of treatment-
¤ Ushnodaka avagaha (hot sitz baths) –
A sitz bath is performed using a bathtub or a sitz bath bowl. Herbal formulations or herbs are added to the warm water based on the condition.About 100 ml. of Panchavalkala or Triphla Kwatha is added to the sitz bath for people with fistula in Ano.The bath is usually performed for about 10-20 minutes twice a day. Jatyadi tail is applied to the anal area after every sitz bath.
¤ Kshara Sutra –
Kshara Sutra is utilized in the treatment of fistula in Ano Ayurveda.
Kshara Sutra is a seton thread medicated with organic alkalis, such as Apamargakshara ,Arkashara or Snuhikshara. The alkali is repeatedly coated on the seton thread 15-21 times. Apart from this, natural antibiotic like haridra powder, gugglu etc. an also used to make Ksharasutra.The mechanical action of the threads and the chemical action of the drugs coated, collectively do the work of cutting, curetting, draining and cleaning the fistulous track ,this promoting healing of the track/ wound. This also acts both as the antiseptic and fibrotic agent to induce healing. The process of healing starts from deeper t 1issues and moves towards the periphery. This can be applied and changed periodically till the thread cuts the fistulous tract. Since the sphincter heals by fibrosis, there in no incontinence.
Under local anaesthesia,the Ksharasutra is inserted into the tract and the two ends of the thread are tied forming a loop. The therapeutic action of the thread lasts for seven days. The old thread is then replaced with a new thread following the same procedure. Depending on the length of the tract and the extent of damage, the Ksharasutra may be changed up to 5 times. The changing of the thread is a simple procedure taking about 1-2 minutes and requires no anaesthesia.
¤ Beneficial Herbs-
• Haritaki – It has tridoshaghana properties and wound healing and cleansing properties.
• Argavadha- It has anti- fungal,anti-viral, antimicrobial,anti-parasitic and antidiabetic properties. It has wound healing and anti-inflammatory properties also.
• Triphala – It improves longevity, immunity and promotes health. It cleanses the gastrointestinal tract and improves assimilation and digestion.
• Krishna Tila- It has potent wound healing properties that are helpful in fistula treatment.
¤ Effective Medications –
• Triphla Gugglu
• Saptavishanti Gugglu
• Chitrakadi Vati
• Triphla Churna
• Nirgundi Oil
• Aarogyavardhini vati
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