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. 

Thursday, December 15, 2016

Anal Fissure - Say No to Surgery

Anal Fissure usually presents as a small tear in the anal region. This may happen because of injury by passing hard stool or by repeated bowel motion. How ever in some cases irregular bowel habits and dryness of the skin may also lead to abrasions in anal skin.

Anal fissure are notorious as they are associated with excruciating pain while passing stool. Pain may persist for few minutes to few hours and then gradually subsides, only to recur again at the time of defecation. At times some bleeding may also be noticed. Because of pain the anal muscle sphincter goes in to spasm and this further leads to narrowing of anal orifice. As the passage gets narrowed; there are chances of increased frictional injury by the passing stool which may further enhance the pain. The magnitude of pain at times; is so much and so increased that the patient is reluctant to pass stool and also avoid eating.

In such condition, if the patient visits doctor; the patient is diagnosed as a case of acute anal fissure and the doctor usually advise immediate surgery. As the patient is in distress they usually follow the advise and get operated. However it has been noticed that this condition may recur again.
In Ayurveda; this painful conditions (Acute Anal Fissure) can be conveniently and effectively treated by Kshar Karma without any Surgery. In this procedure; some medicines are applied in rectum which leads to healing of the underlying wound (Fissure). At Sushruta Anorectal Institute; New Delhi, the Kshar Karma sittings are repeated at weekly interval and in between; the patient can apply the medicine at home. Usually the acute anal fissure heals in 3-5 visits. No hospitalization or bed rest required in this treatment and patient can continue his routine activities as usual. The facility of Graded Kshar Karma is available only at Sushruta Anorectal Institute; New Delhi.
If the condition persists for long duration; a small skin fold comes out from the edge of Fissure which is termed as Sentinal Tag. This Sentinal Tag can be removed by ligating Kshar Sutra at its root which is again an OPD procedure.
Dos and donts for a Fissure patients
Patient suffering from Anal Fissure should avoid:
  • Spicy food
  • Fast food
  • Maida (refined wheat flour) products
Patient suffering from Anal Fissure should prefer:
  • High fluid intake
  • Fiber rich food articles like leafy vegetables, fruits and salads
  • Do sitz bath in warm water in morning and evening
  • Apply Sushruta Ointment p/r in morning and evening
  • Insert 5 ml of Sushruta oil p/r before going to bed
For more information about Anal Fissure treatment check:

Thursday, December 8, 2016

Treatment for Piles (Hemorrhoids) without surgery

Piles are engorged rectal veins with venous blood. Depending on level of engorgement piles are classified in different stages. In first stage painless bleeding is the only presenting sign. There is no visible mass protrusion.

If piles is not treated at this level; pile masses start bulging out of rectum during defecation. After defecation; pile mass reduces by its own.This is call as second stage of piles. At these stages correction of dietary habits, some exercise and kshar karma will benefit.

Further increase in pile mass size makes manual reduction of pile mass necessary i.e. Pile mass does not go inside by itself. This is third stage of internal piles. After manual reduction; pile mass remains inside the rectum.

If piles is not treated at this level also; then Pile mass remains permanently outside the rectum. Manual reduction will also not work and protruding pile mass creates problem in day to day activities like moving or walking.

In third and fourth degree of piles; Ksharsutra ligation of pile mass is necessary. This ligated Ksharsutra blocks the blood supply of pile mass and with the effect of medicine coated on Kshrasutra within 10-15 days piles mass fall down by its own. Ksharsutra ligation of Pile mass is done as a OPD procedure. There is no necessity of hospitalization or bed rest in this treatment.

So Ayurveda assures treatment for piles at all stages of piles. No recurrence is observed in this treatment.

Dos and don'ts for Piles problem

  1. Avoid constipation; for this
  2. Take plenty of fluids; 
  3. Take adequate fiber rich food items; 
  4. If needed you can take some laxative occasionally (under supervision of ayurvedic physician)
  5. Do not go for defecation if you are not feeling urge for defecation
  6. Do not strain too much while defecation
  7. Do not sit for long during defecation.. Maximum of 5 minutes for defecation.
  8. Maintain active daily routine.
For more details about Piles treatment in Ayurveda please visit:

Tuesday, December 6, 2016

Treatment for Fistula without surgery by Ksharsutra Treatment

Anal fistula presents as a nodular swelling in peri anal region. Occasional pus discharge is noticed followed by relief in pain and discomfort. As a treatment option; anti-biotics are tried in starting.
With out any doubt; Anti biotics benefit in this problem as these treat the underlying infection.

But anti biotics are not the treatment for Anal fistula. Anti biotics only treat the infection. Fistula tract is the most favorable site for developing infection. This is the reason that a fistula patients notices recurrent pus discharge. You treat infection.... for some time things will be fine..... again infection develops...... resulting in pus formation and associated discomfort....... take anti botics....... treat infection....... after some time again infection develops....... in this a vicious cycle starts and pt. finds himself helpless.. 

As we have understood that simple treating infection s not the solution for fistula we need to destroy the fistula tract so modern medicine recommends surgery as the only treatment for fistula. But there are many complications associated with surgery for fistula. Stool incontinence i.e. inability to hold stool/ recurrence of fistula are most disturbing among these. Even recent surgical interventions like VAAFT or MAFT are also having these complications. Considering these points Surgery can not be recommended as a full proof treatment for Anal fistula. 

In these circumstances Ksharsutra Treatment is a ray of hope Anal fistula patients as Ksharsutra treatment assures treatment for Anal fistula. Predictably there is 0% recurrence in Ksharsutra treatment for Anal fistula. 

In 1990 Indian Council for Medical Research (I.C.M.R.) conducted clinical trials to compare effectiveness of surgery and ksharsutra treatment in Anal Fistula at AIIMS Delhi, PGI Chandigarh and some other premier institutes of medical science. These trials confirmed that Ksharsutra Treatment is more effective and convenient than all other treatments in Anal Fistula.

                                 Surgery                                                     Ksharsutra
*Chances of recurrence of Fistula in about 15 %       *There is no recurrence of Fistula after         cases after Surgery/ VAAFT                                            Ksharsutra Treatment
*Complications like stool incontinence are observed *There is no such complication after Ksharsutra after surgery for Fistula                                                 treatment for fistula
*Hospitalization required                                            * No hospitalization is required
*Bed rest is required for a considerable time              *No need for bed rest; Pt. can join his working Period                                                                             on very same day of Ksharsutra treatment
*Dressing of wound required for a long time period  *There is no wound formation in Ksharsutra                                                                                            treatment so no need for dressings

At Sushruta Anorectal Institute; we are treating Anal Fistula patients with about 100% success rate. Complicated Anal fistula cases like high anal fistula, multiple fistula, inter sphincteric fistula are also treated successfully with 0% recurrence till date. 

Please visit for more details about Ksharsutra treatmnet for fistula.