MANAGEMENT OF ARSHO-BHAGANDHARA: A CASE STUDY

Abstract

Ayurveda is based on time tested observations and medical experiences. It has immense potential in solving many challenging and unresolved problems of the medical world. Arshas (Haemorrhoids) and Bhagandhara (Fistula in Ano) are the most common diseases occurring in the Ano-rectal region. Ayurvedic literature had mentioned Sastra Karmas (surgical procedures) and Anusastra Karma (Para surgical procedures) like Kshara Karma, Kshara Sutra & Agni Karma in the management of these diseases. In Anorectal disorders, some cases have both piles and fistula-in-ano. It is difficult to treat both diseases simultaneously, leading to a bad prognosis. In modern literature, operative techniques like hemorrhoidectomy, Fistulectomy and Fistulotomy are mentioned. After modern surgery, severe postoperative complications like recurrent sepsis, continuous serous discharge, faecal incontinence, and the high recurrence rate is a matter of great concern. Arsho-Bhagandhara is a rare case in which a patient suffers from Arshas and Bhagandhara. This case report describes the successful management of Arsho-Bhagandhara. Here we operated on the patient diagnosed with Arsho-Bhagandhara, the details of which are furnished in the below article. Ksharalepa for internal piles masses was done on OT, and Ksharasutra application in fistula was made. Ksharasutra was changed every seventh day, and simultaneous cutting and healing of the tract were observed. The piles and fistula track wound healed within two months entirely without complication. This case demonstrated the advantages of Ksharalepa and Ksharasutra in the successful management of piles and fistula at the same time.