Abstract
Therapeutically the word Kshalana(irrigation) means the irrigation of the affected site using a suitable solution for the purpose of purification[1]. It is mentioned in the classical textbooks of ayurveda as Poorvakarma, Pradhana karma, and Paschath karma. Kshalana is beneficial in controlling foul-smelling and slimy exudating conditions like ulcers, vaginal infections, etc. A fistula in an ano is an abnormal tract or cavity lined with unhealthy granulation tissue that connects a primary opening inside the anal canal to a secondary opening in the perianal skin[2]. Its prevalence is the second highest after haemorrhoids among anorectal diseases. In Ayurveda, fistula in ano is correlated with the vyadhi Bhagandara (fistula in ano). Modern medical managements have its own limitations, even with various surgical modalities. Due to the presence of irritant discharges and non-dependent drainage, fistula in ano seldom shows healing intention[3]. Although Ayurvedic classics explain various treatment modalities for the management of fistula in ano, Ksharasuthra therapy owes the glorious part of management. But improper pus drainage, pus stagnation, and microbial invasion hinder the action of Ksharasuthra. Kshalana is a simple and cost-effective therapeutic technique. The present review focuses on the understanding of Kshalana karma along with its mode of action and application in fistula in ano.
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