Wednesday, February 22, 2017

Facts about Pilonidal Sinus

  1. Pilonidal sinus presents as a nodular swelling in lower spinal region with occasional discharge which might stain undergarments. Mild pain can also be there. Sometimes hairs can also be seen protruding out of this nodular swelling.
  2. Pilonidal sinus is usually seen in adults of college or school going age with hairy skin.
  3. Pilonidal consists of two words Pilus means hair + Nidus means nest i.e. hair nested in a cavity. It tells about the role of hairs in Pilonidal Sinus. The problem is more common in people with hairy skin.
  4. Though exact pathology of Pilonidal Sinus is not certain. It is believed that sharp ends of hairs prick in the skin and infection can invade from these holes and result in Pilonidal Sinus.
  5. Medicinal treatment is not successful in Pilonidal sinus. Oral medication Allopathic/ Homeopathic/ Ayurvedic whatever it may be; can give only temporary relief but do not eradicate the problem.
  6. As per surgeons surgical procedures like Z- plasty etc. are the only treatment for Pilonidal sinus. But in as high as 15 % cases Pilonidal Sinus recur even after surgery.
  7. Post operative pain, hospitalization/ bed rest and chances of recurrence are the factors which suggest that Surgery is not the appropriate choice for Pilonidal Sinus treatment.
  8. Ksharsutra treatment is recommended for pilonidal sinus in Ayurveda. No hospitalization or Bed rest is required in Ksharsutra treatment for Pilonidal Sinus.
  9. Predictably there is 0% recurrence after Ksharsutra treatment for Pilonidal Sinus.
  10. Pilonidal Sinus cannot be treated by any home remedy so instead of searching for Home Remedy for Pilonidal Sinus; plan for treatment i.e. Ksharsutra treatment for Pilonidal Sinus as soon as possible.
To know more about Ksharsutra Treatment for Pilonidal Sinus check:

Top 10 Treatments for Fistula

1. Lay-open of fistula-in-ano: In this procedure; an operation is carried to cut the fistula open. After that it is regularly packed on daily basis to ensure proper healing of wound. It lefts behind a scar tissue and depending upon location of Fistula in relation to sphincter muscles there might be some risk of stool incontinence and if it is not healed properly; there are chances of recurrence.

2. Cutting seton: This treatment involves inserting a tube in fistula tract and tying it outside the body. Seton is tightened on regular basis to ensure cutting the fistula tract. So it is the tightened seton which causes cutting of tract. This procedure might involve too much pain and in some cases there might be incontinence especially of flatus.

3. Fistulectomy: It is surgical procedure where whole Fistula tract is excised (cut out). In certain cases; there might be more than 1 surgery. Recurrence of fistula and stool incontinence are the possible post treatment complications.

4. Colostomy: In this procedure; an opening is made by drawing part of colon through an opening to anterior wall of abdomen. A Stoma appliance is fixed to this opening to make an alternate way for stool to leave the body. This procedure is done to avoid contact of fecal matter with Fistula assuming that it will lessen the chances of infection and fistula will heal easily. Along with recurrence of fistula and incontinence there are certain other complications in this procedure like formation of hernia near Stoma opening, Stomal blockage; another fistula formation near Stomal opening etc.

5. Fibrin glue injection: In this procedure; bio degradable glue is injected in the fistula tract which is supposed to close the fistula and let it heal naturally. Recurrence rate in Fibrin glue injection is as high as 30-35%;

6. Fistula plug: This treatment involves plugging the fistula tract from inside with a plug made up of intestinal tissue. Complication in this treatment involves treatment failure, plug extrusion, abscess at the site of plug etc.

7. Endorectal advancement flap: In this procedure; internal opening of Fistula is identified and a mucosal flap is cut around the opening and opening is closed with this flap. After that external opening is cleaned and sutured. The main complications in this treatment are failure of treatment and recurrence of fistula.

8. LIFT Technique: Ligation of Intersphincteric Fistula tract procedure; involves closure of internal opening of Fistula tract and removal of infected tissue. Recurrence of Fistula is the main complication in LIFT procedure.

9. VAAFT: Video Assisted Anal Fistula Treatment; with fistuloscope fistula tract is visualized and location of internal opening is confirmed. After that internal opening is closed using stapler or flap made from a layer of skin and internal layer of intestine. Disadvantages of VAAFT include reopening of internal opening leading to failure of treatment and recurrence of fistula.

10. Ksharsutra Treatment: It has been proved to be highly effective treatment for Anal fistula. A Clinical trial was conducted by Indian Council of Medical Research (ICMR) in 1991 at various medical institute including All India Institute of Medical Sciences (AIIMS) New Delhi and PGI Chandigarh etc. to see the effectiveness of Ksharsutra Treatment. It was concluded that Ksharsutra treatment is more effective and more convenient as compared to surgery in the patient of Anal Fistula. With the latest concept of Graded Ksharsutra (Sushruta Anorectal Institute; New Delhi) the chances of recurrence after Ksharsutra treatment are predictably zero.

Ksharsutra is a medicated thread which is prepared by coating of certain herbal latex with herbomineral powders. The thread is alkaline in nature and it has highly selective debridement property. The fistulous tract is properly defined using MRI fistulogram or clinical probing and then with the help of certain instruments; the thread is placed in the fistulous tract. The medicine is gradually released in the tract from the thread and do the necessary debridement of fistulous tract. The thread is changed at weekly interval till there is a final cut through and the tract has healed. So here it is the medicine which debrides the fistula and ensure healing. Thread is just working as a vehicle for drug delivery in Fistula Tract. The anal fistula patient in whom fistula has recurred after Fistulectomy/ Colostomy/ Glue/ MAFT/ VAFT; these patients have been successfully treated by Graded Ksharsutra. The treatment is equally effective in the case of complex high anal fistula (Supra levator/ trans sphincterric/ horse shoe shaped multiple tracts).

For more details about Ksharsutra treatment for

Tuesday, January 17, 2017

10 must know facts about Anal Fissure

  1. Anal fissure is a cut in anal wall.
  2. Passage of hard stool is the main reason for Anal Fissure as hard stool causes frictional injury to the anal wall.
  3. Extreme pain while passing stool is the main symptom of Anal Fissure. Pain is so intense that patients tries to avoid defecation. 
  4. Usually there are episodes of recurrence of anal fissure.
  5. Recurrence of Anal fissure results in formation of Senital tag – a skin growth from lower edge of fissure cut. Most of the times; Senital tag is mistaken as piles by patients.
  6. Modern medicine recommends partial sphincterectomy or anal dilatation as treatment for Anal Fissure. Recurrence and stool incontinence are the post operative complications in both of these treatments.
  7. Anal fissure can be treated successfully by Ayurvedic Kshar Karma therapy treatment without surgery; without any complication and without recurrence.
  8. In Kshar Karma; certain Ayurvedic medicines are applied in rectum which leads to healing of fissure. 
  9. Senital Tag can be removed by Kshrasutra ligation which is an OPD procedure and patient can go home after an hour rest. 
  10. Patient suffering from Anal Fissure should take adequate amount of fluid; take plenty of fibrous foods like green leafy vegetables, fruits, salad etc. and avoid spicy food and fast food. 
For more info about Anal Fissure Treatment in Ayurveda please visit:

Sunday, January 15, 2017

10 must know facts about piles

  1. Constipation is the leading cause for piles. To avoid constipation you should take plenty of fluid (water/ butter milk); adequate amount of fibers(Salad/ green leafy vegetables)  and exercise regularly
  2. Straining while defecation is another cause for piles so put too much strain while defecation. Go for defecation only when you are having proper urge for defecation. Do not sit too long for defection.
  3. Piles can be treated without surgery. Ayurvedic treatment for piles ensures treatment for piles without surgery.
  4. Painless bleeding is characteristic sign of internal piles. This stage is termed as first degree internal piles
  5. If piles is not treated at first stage; piles masses start protruding out from anal opening. In starting these get reduced by themselves; if untreated, manual reduction becomes necessary – second stage of piles.
  6. Pile masses should be kept inside rectum. If these remain outside; these might get infected and result in complicated conditions like anal fistula and others.
  7. If piles remain untreated at second stage; pile masses remain permanently outside – third stage of piles.
  8. In first stage of piles; kshar karma is performed which results in arrest of bleeding and regression of pile mass size.
  9. In second & third stage; pile mass is ligated by ksharsutra which is an OPD procedure.  After Ksharsutra ligation; pile mass sheds off by itself in a week or ten days.
  10. No hospitalization or bed rest is required and patient can go home after an hour rest.

For more details about Piles Treatment in Ayurveda; please check:

Wednesday, January 11, 2017

Ten must know facts for a Fistula patient before starting any treatment

Every Fistula Patients must know these facts before starting Fistula Treatment:
  1. Fistula can not be treated by oral intake of medicines
    homeopathic/ ayurvedic or allopathic.
  2. There are periods when patient feel that he is fine. When pus gets discharged there will be no pain or swelling but after some time; there will be pus formation followed by swelling and pain.  
  3. Anti biotics can give only short term benefit. 
  4. Most recent Surgery treatment for Fistula VAAFT has recurrence rate of about 15 % in Anal Fistula.
  5. Ksharsutra treatment is the best treatment for Anal Fistula.
  6. Indian Council for Medical Research has conducted clinical trials to compare effectiveness of Ksharsutra treatment and surgery in Anal fistula patients in AIIMS New Delhi; PGI Chandigarh and other premier institutes in 1990.
  7. Ksharsutra Treatment was found more effective and convenient as compared to surgery in Anal Fistula.
  8. Predictably there is 0% recurrence after Ksharsutra Treatment for fistula.
  9. Anal area is very sensitive and delicate area so you be extra careful while opting for treatment for Fistula. Take Fistula Treatment from well qualified Ksharsutra expert and never hand over your health to quacks/ bengali doctor/ Madrasi doctor. 
  10. As Fistula has an infective Pathology; there is no role of home remedies so a fistula patient should not waste time searching home remedies for Fistula and should plan for Ksharsutra Treatment for treatment of Anal Fistula. 
For more info about Ksharsutra Treatment for Fistula: 


                  Monday, December 26, 2016

                  Piles - Say No to Surgery

                  Piles or Hemorrhoids has become a common problem now a days. It may be due to our changed lifestyles like reduced physical activity, irregular food intake and consumption of fast food etc. These factors lead to disturbance in digestive system leading to constipation. Due to which the person has to put extra strain while passing stool leading to pulling of blood in veins and subsequent engorgement in the form of pile masses. Thus we see the Piles are nothing but engorged blood vessels in the anal canal.

                  Piles are commonly known as बवासीर in the society and is considered as social stigma. Due to lack of knowledge and social inhibition; people do not discuss this problem openly and are subsequently misguided by quacks like benagli treatment, madrasi treatment, Chandsi treatment etc. etc.

                  Anal region being a very sensitive part; the pt. usually avoids any type of surgical intervention in this area and they are looking for some alternative to surgery. We at Sushruta Anorectal Institute, are constantly trying to manage Piles in all its stages preferably without surgery or with minimal surgical intervention.

                  Depending upon the presentation the hemorrhoids (Piles) are grossly divided in two categories 1. External Piles 2. Internal Piles.

                  External Piles:

                  As the name indicates; these are the pile masses which are present outside the anal orifice. They do not bleed but when large in size; may put some obstruction to the passage of stools. Some times patient complains of itching in these masses. When inflamed they become painful and swollen. They are removed by minimal surgical procedure with ligation of Ksharsutra at the root. This is an OPD procedure and patient can go home after 1 hour rest.

                  Internal Piles:

                  There are three stages of Internal pile. In first stage; patient complains of painless bleeding. At this stage; doctor finds presence of internal pile masses on proctoscopy.  In the second stage, the pile masses start protruding out while passing stool. Initially they get reduced by itself but in advanced stage; patients need to reduce these manually. In the third stage; the internal pile mass comes out not only at the time of passing stool but also while walking and sitting.


                  The first stage internal piles are treated by Kshar Karma and oral medication. Second stage piles are treated successfully by combining Kshar Karma and sclerotherapy. If the pile masses are big enough then they are ligated by Ksharsutra. In the third stage also Ksharsutra ligation is done at the base of Pile mass which drops out in 5-7 days. This way the internal hemorrhoids can be successfully treated without surgery without hospitalization in all its stages.

                  Dos and don'ts 

                  The patient suffering from piles should:

                  1. Increase consumption of fibrous food
                  2. Increase intake of fluid/ butter milk
                  3. Exercise regularly
                  4. Always try to reduce the pile masses by applying pressure with fingers so that they remain inside the rectum
                  5. Should not Spend more than 10 minutes for passing stool
                  6. Should not Strain too much while passing stool
                  7. Should not Consume fast food, spicy and oily food

                  At Sushruta Anorectal Institute ore than 12,000 patients has been treated successfully without surgery. For more information visit: 

                  Friday, December 23, 2016

                  Pilonidal Sinus - Say No to Surgery

                  Pilonidal Sinus is a disease commonly seen in the people with hairy skin. Disease presents as a small nodular swelling in the lower spinal region with off and on blood mixed pus and watery discharges. This sinus is formed because of underlying hairs which are impacted beneath the skin and act as a source of infection. Once the pus is formed; it creates a passage to come out on the skin; thus a sinus is formed.This disease is usually not curable by oral medication like anti biotics etc., Ayurvedic as well as homeopathic oral medication is also of not much help. 
                  Now a days; pilonidal sinus patients are treated with surgery/ Z plasty. With these surgical procedure; chances of recurrence are as high as 15 %.
                  How ever in Ayurveda; Pilonidal Sinus can be very effectively and very conveniently treated by Graded Ksharsutra. In this procedure; first the sinus tract is defined with respect to its depth, direction  and branching pattern with careful probing and sinogram. Once the sinus tract has been precisely defined; medicated Ksharsutra is placed in the tract with the help of certain instruments.  Now from this medicated thread; medicine is gradually released in the tract. This medicine (Kshara) induces a potent debridement effect on the sinus tract as a result all the unhealthy fibrogranulomatous tissue, pus pockets and accumulated hairs etc. are cleared from the tract. The medicinal coating on the thread gets dissolved hence the thread has to be replaced by a new thread with in a week or two. 
                  The sinus tract heals at the rate of 0.5 to 1 cm per sitting. Thus a small sinus tract which is around 4-5 cm long may take around 8-10 sittings  to heal properly. The chances of recurrence of Sinus tract after Ksharsutra treatment are predictably ZERO. 
                  The treatment is far better than surgery as- 
                  1. No hospitalization or bed rest required
                  2. Patient can continue his normal routine activities
                  3. Chances of recurrence are predictably ZERO
                  4. No shaving of hairs or laser treatment for hair removal required
                  At Sushruta Anorectal Institute Rohini; New Delhi; under supervision of Dr SK Singh we have treated more than 3,000 patients suffering from Pilonidal Sinus. Many of these patients were operated first at some hospital. Since there was recurrence of Sinus; so these patients were finally treated by Graded Ksharsutra Therapy.