Date: July 22, 2024

Kshar Sutra Therapy: Ancient Ayurvedic Remedy for Piles and Fistula Healing

Kshar Sutra therapy is a cotton thread coated with organic alkalis. It is an effective Ayurveda management of anorectal diseases like piles, fissures in anal and fistula in-anal. The Mechanical action of the thread and the chemical action of the drugs coated collectively do the work. They combinedly exert a powerful debridement effect and induce healing by the fresh and healthy granulation tissues.

Historical Roots of Kshar Sutra in Ayurveda

Kshar Sutra is a unique therapeutic technique in Ayurveda that has deep historical roots. It is primarily used for the management of anorectal disorders like fistula-in-ano, hemorrhoids, and fissures. The technique involves the use of a medicated thread called “Kshar Sutra” for cutting and healing the diseased tissues. Here are some historical aspects of Kshar Sutra in Ayurveda:

1. Ancient Texts: The use of threads for medical purposes dates back to ancient Ayurvedic texts like the Sushruta Samhita, which is considered one of the foundational texts of Ayurvedic surgery. Sushruta, often referred to as the “Father of Surgery,” described various surgical techniques including the use of threads for suturing and treating diseases.
   
2. Sushruta’s Contributions: Sushruta Samhita, believed to have been written around 600 BCE, contains detailed descriptions of surgical procedures, instruments, and treatment methods. It mentions the use of specialized threads for surgical purposes, although the exact technique of Kshar Sutra as we know it today may have evolved over time.
   
3. Evolution of Kshar Sutra Technique: The specific technique of Kshar Sutra, involving the use of a thread coated with medicinal substances like alkaline extracts of plants, evolved over centuries. It combines elements of surgical precision with herbal medicine principles, highlighting the holistic approach of Ayurveda.
   
4. Traditional Knowledge Transmission: The knowledge and skills related to Kshar Sutra were traditionally transmitted through guru-shishya parampara (teacher-student lineage). Practitioners learned the technique through rigorous training and apprenticeship under experienced Vaidyas (Ayurvedic physicians).
   
5. Continuing Practice: Despite advancements in modern medicine, Kshar Sutra continues to be practiced in Ayurvedic centers and hospitals, especially for conditions where conventional treatments may have limitations. Its efficacy and minimal invasiveness make it a preferred choice for certain patients.
   
6. Research and Standardization: In recent decades, there has been an increased focus on scientific research and standardization of Kshar Sutra technique. Efforts have been made to study its clinical outcomes, optimize the medicated thread composition, and ensure safety and efficacy in contemporary healthcare settings.

The historical roots of Kshar Sutra in Ayurveda reflect the rich heritage of traditional Indian medicine and its ongoing relevance in addressing complex medical conditions.

What are disease piles?

Piles are enlarged and irritated tissue masses in the anal region. These masses can vary in size and may either be internal or external. Internal piles are typically positioned from 2 to 4 centimeters (cm) above the anus opening and are the more prevalent type. On the other hand, external piles are located on the outer edge of the anus.

What are the primary factors leading to the development of Piles and Fissures?

Piles (hemorrhoids) and anal fissures are two common conditions that affect the anal region. Anal fissures are frequently caused by the passing of large or difficult stools. Chronic dysphagia and fecal straining can also lead to diarrhea.

What is the process of this traditional method for treating a fistula-in-ano

Once sufficient anesthesia has been administered, the Kshar Sutra is placed into the fistulous tract and then secured by joining both ends. This procedure is repeated weekly. By remaining in direct contact with the tract, the Kshar Sutra acts as a physiological and molecular curette, removing the lining and allowing it to collapse and heal. Compared to other treatments, this method is less invasive and more cost-effective. The risk of complications is minimal, with a very low likelihood of sphincter control loss and consequent anal incontinence.

How is the process carried out?

The patient is placed in a private environment with adequate lighting, positioned on their left side. A generous amount of 2% xylocaine jelly is applied to both the external entrance and the entire infant feeding tube. To create a depression, a partial incision is made 1-2 cm from the end of the infant feeding tube. The side of the tube that will be inserted is then passed through the external opening. The infant feeding tube is then gently pushed and guided through the fistulous tract. Eventually, the inner segment is located and the tube is inserted with the index finger. Once the indented end of the infant feeding tube appears from the internal opening, the ksharsutra is secured at the indentation (towards the internal opening) and pulled across to the other end. Finally, the infant feeding tube is removed and both ends of the ksharsutra are tied together.

Cost and Risk associate

Kshar sutra therapy is considered the most effective treatment for ano fistula. It is a powerful treatment with a low risk of recurrence, only 3.33 percent. This therapy is much simpler and more affordable compared to traditional methods, which often require hospitalization, anesthesia, and continuous post-operative care. These surgical procedures have a much higher risk of recurrence, ranging from 0.7 to 26.5 percent, and can also lead to cognitive impairment and continence issues, with a reported range of 5 to 40 percent.

The cost of the Kshar Sutra treatment is highly reasonable, as the consultation fee ranges from Rs. 500 to Rs. 1000, while the treatment itself costs between Rs. 2,000 and Rs. 3,000.

Other options for treating piles and fissures

The primary method for treating hemorrhoids through surgery is open-surgical hemorrhoidectomy. However, this procedure is often linked with significant issues like pain, bleeding, and wound infection, which may result in an extended hospital stay.

In the surgical treatment of piles or hemorrhoids, a laser beam is utilized to burn and reduce the swollen and inflamed anal tissues. This technique, known as laser surgery, is a painless procedure for treating Piles. The doctor carefully directs a thin beam of light toward the tissues, disrupting their blood supply and causing them to detach.

How can one prevent Haemorrhoids by taking precautions and using home remedies?

1. To maintain good digestion, it is important to have a healthy diet that includes a sufficient amount of fiber from fruits, vegetables, and whole grains. Adequate hydration also helps soften stools. Over-the-counter fiber supplements can also alleviate constipation.
2. It is advisable to avoid straining while using the restroom, as this can increase pressure in the lower rectal vessels.
3. It is important to respond to the body’s need to defecate without delay, as waiting can result in drier stools.
4. Prolonged sitting or standing can put strain on the veins, so it is beneficial to engage in physical activity as it aids in regular bowel movements.
5. Maintaining a healthy body mass index is crucial in preventing hemorrhoids, as obesity is a significant risk factor.

For those seeking information on Hemorrhoids and Fissures, Dania Medicare Solutions offers complimentary consultations that will provide insight into your condition and assist in making informed decisions.

Written By
Shafiq Ahmad Khan
Founder & CEO