Ayurvedic Treatment for Fistula

In Ayurveda, a fistula near the anus is described as bhagandara, a condition classed among the serious, difficult-to-treat disorders (mahagada). It is not fully equivalent to modern anal fistula, but the two overlap closely. This page is an interpretive and traditional view, not a replacement for a surgeon's assessment.

The traditional approach

• Kshar sutra. A medicated thread, coated with caustic herbal preparations, is passed through the tract and changed at intervals so that the tract is gradually cut open and heals from the base. It is performed by trained practitioners.
• Supportive care in the classics includes diet and routine advice to avoid constipation, and warm sitz baths for comfort.

What the evidence says

Some studies, mainly from India, report that kshar sutra can achieve healing with a low risk of incontinence in selected simple and some complex fistulas. The studies vary in quality and the evidence is limited compared with standard surgery. Results depend heavily on the skill of the practitioner and on the type of tract.

Cautions

• Only a qualified, registered practitioner with surgical training should do kshar sutra. Do not allow unlicensed or street procedures.
• Get a proper diagnosis first. The tract type, Crohn's disease or tuberculosis changes what is safe.
• No oil, powder, paste or herbal preparation should be put into the tract at home.
• for an abscess or a fistula because someone promises a natural cure.