Abstract

Dr. Shrikant Patel*, Dr. Deepak Kulshretha, Dr. O.P Dwivedi

ABSTRACT

Bhagandara is one of the recurring diseases occurring in ano-rectal region which is difficult to treat because of its high recurrence rates. In Ayurveda, Bhagandara has been mentioned as one among Ashtamaharoga, it is characterized by the formation of a pidika near the anus that ruptures, leading to a persistent, painful, and often recurrent tract with pus discharge. It attributed to imbalances in Vata and Pitta doshas, leading to tissue disruption, inflammation, and infection. It involves disruption of Rakta and Mamsa and the formation of Aama which contributes to chronic infection. Acharya Sushruta mentioned five types of Bhagandara. He had explained Shastra Karma along with Kshara karma and Bheshaja Chikitsa for treatment. Acharya Sushruta has explained Nidana, Samprapti, Bheda, Lakhshana, Upadrava and Chikitsa in detail. The disease which creates Darana in the area of pelvis, rectum & urinary bladder is called as Bhagandara and when these are not opened it’s called as Bhagandara Pidaka. An abnormal passage between a hollow or tubular organ (Bhaga, Guda, or Basti) and the body surface or between two hollow or tubular organs is called fistula. Fistula in ano, is an abnormal tubular structure connecting the anal canal to the skin around the anus, most commonly caused by an infection from an anal gland or perianal abscess. Symptoms include pain, drainage of pusiu or blood, and skin irritation. Prolong sitting, unhygienic condition, obesity, repeated irritation due to hair may increase the risk of occurrence. Treatment for an anal fistula is surgical, with options like fistulotomy. Kshara destroys the vitiated tissue and make them fall off. It is the most important among Shastra and Anushastra because it does functions like excision, cutting and scrapping, also mitigates all the three Doshas. Acharya Sushruta described that Nadivrana (sinus) should be cut open by Kshara Sutra and, he said the same procedure should be adopted for Bhagandara. Kshara application in the form of Ksharasutra, in anorectal diseases has become more popular due to its easy approach and low rate of recurrence. Ksharasutra induces both mechanical and chemical cutting and healing. Direct reference of Ksharasutra is found in Sushruta for treatment of Nadivrana. Chakradatta has referred to a medicated thread coated with Snuhi and Haridra powder in treatment of Arsha and Bhagandara. But the modified Ksharasutra available now a day is re-established by the Dept. of Shalya Tantra, Banaras Hindu University. The standard Ksharasutra is prepared by 11 coatings of Snuhi Ksheera then 7 coatings of Snuhi Ksheera and Apamarga Kshara and then again 3 coatings of Snuhi Ksheera and Haridra Churna.