A comparative clinical study on the effect of Vibhitaki Ksharasutra and Apamarga Ksharasutra in the management of Bhagandara (Fistula-In-Ano)

Abstract

Bhagandara (Fistula in Ano) at modern parlance is a common anorectal condition prevalent in the populations worldwide and its prevalence is second highest after Arsha (hemorrhoids). It is very common surgical condition necessitating safe treatment modality as open surgery may result anal incontinence in most of the time. Fistula- in- Ano is one such disease where ideal care delivery is still a challenge. It may be because of nature of disease, regional anatomy, hygiene, etc. Kshara Sutra is one of the chief modality in the treatment of Bhagandara in Ayurvedic science. Exploration of the new plants for the preparation of the Kshara as a better substitute for previously tried Ksharasutras. The Apamarga Ksharasutra is widely being practiced. When we go through the classics, we get reference regarding Vibhitaki grouped into Kshara dravyas. This Vibhitaki is not widely practiced. Apamarga Kshara is very effective but preparation of this Apamarga Kshara is not at all an easy process. It needs burning of lot of Apamarga plants, then process including boiling etc, and at the end we get very little quantity of final product. In the other hand Vibhitaki, as per reference, is also Kshara, cost effective and abundantly available as it is a huge plant will get adequate quantity of drug, hence this study is planned to evaluate the efficacy of Vibhitaki Kshara Sutra in the management of Fistula- in- Ano which is referred as Bhagandara in Ayurveda.