Kshar sutra treatment for piles, fissures and fistula

kshar sutra

Last Updated February 22nd, 2023


Kshar sutra treatment is an ancient form of therapy that is based on the Ayurveda technique. This technique emphasizes the use of herbal remedies and lifestyle practices like dietary changes and massage to achieve good health.

Kshar sutra is cost-effective, less invasive, and safe, and for these reasons, has found widespread applications in treating fissures, piles, and fistula.

Medical practitioners classify Kshar sutra as a form of para surgical treatment. This is because the therapy makes use of Anushastra in the management of non-surgical and surgical techniques. Anushastra refers to the instruments that can be used in surgical procedures but are inferior to surgical instruments. The benefits of the Kshar sutra are that it is a reliable, safe, cost-effective, and secure treatment procedure for piles, fistula, and fissures. However, the procedure is characterized by a high rate of recurrence for these ailments, plus the contraindications and side effects are not fully apparent.

Kshar sutra procedure for the treatment of fistula, piles, and fissure

The first step is to identify the patient(s) who will undergo this procedure on the basis of their medical history This step also helps to identify the problems facing patients with anal fistulas, piles, and fissures. In this case, priority is given to patients that have 2nd, 3rd, and 4th-degree piles

kshar sutra

However, in case the patient is pregnant and has 1st-degree piles, or carcinoma such a patient cannot be subjected to the Kshar sutra procedure. The same case applies to patients with tuberculosis and rectal prolapse.

For those patients that fulfill the selection requirements, they must then meet the following pre-treatment criteria:

  • The patient must consent to this procedure by signing the necessary forms and other relevant documents
  • On the eve of the procedure, the patient’s pubic area is thoroughly cleaned and thereafter, shaved. This is followed by the application of an ayurvedic solution on the shaved pubic area and allowed to rest overnight.
  • The patient must not take anything by mouth 6 hours before the surgery
  • Only a light diet is allowed on the eve of the surgery
  • Soap enema is administered the night before surgery to ensure a clean bowel. Soap enema is also administered two hours prior to the surgical procedure
  • This is followed by the medical staff administering 0.5 ml of tetanus toxoid injection
  • It may be necessary to also undertake such various sensitivity tests, including xylocaine test

On the day of the procedure, the medical staff administers general, spinal, or local anesthesia to the patient prior to the surgery. If the goal is to treat anal fistula, the Kshar sutra is prepared using several coatings of various ayurvedic medications. These include Apamarga kshara, Snuhi latex, and Haridra Churna. It is important to ensure the correct PH is achieved.

Treating piles with kshar sutra

The surgeon begins by placing a pack of Yasktimadhu oil inside the rectum. The goal is to soothe or minimize the irritation caused by Ksharsutra.

Once the surgeon has examined how the pile masses are positioned, he will then use forceps to transfix the pile masses.

The surgeon then proceeds to ligate the pile masses posteriorly and anteriorly.  The blood vessels are strangulated using caustic thread. This ensures that the ligated pile mass undergoes ischemic necrosis

Dead tissue is shed one week after the procedure while wound healing is accomplished in 10-15 days

Treating fistula with kshar sutra

This procedure entails passing kshar sutra via the fistulous tract. For this, it is necessary to administer a minor surgical technique. The technique involves a gradual incision of the anal fistula to promote healing

The kshar sutra helps to remove any unhealthy tissue from the anal fistula, thereby promoting natural healing

The technique also facilitates pus drainage or discharge from your anal tract. This is important to avoid any infection. Ultimately, the procedure aids in curing your anal fistula

Proper healing is attained within 3-4 weeks following the surgical procedure

It is important to replace the medication thread each week till complete healing is attained

Treating fissure with kshar sutra

The procedure is conducted under local anesthesia.

kshar sutra 2

During the kshar sutra treatment for anal fissure, the surgeon positions the thread coated with turmeric at a suitable location in your anus. This is important in helping to release the spasm of your anal muscles.

Sometimes, it is important to note that some fissure cases are not suitable for Kshar sutra treatment; only the fissure that proves stubborn to treat should be subjected to kshar sutra procedure. Recovery from the kshar sutra treatment is often accomplished within 2-6 weeks. Your surgeon can offer the relevant guidelines on how to manage your wound post-operation. Certain anti-inflammatory medications and antibiotics are useful in promoting healing and minimizing pain.

Lifestyle and dietary modifications are necessary to promote faster healing and minimize recurrence.

  • A regular sitz bath enables the patient to reduce discomfort by relaxation.
  • Medicated creams and stool softeners may be prescribed post-surgery.
  • Your surgeon will keep you informed on when you can reduce normal file activities.

What are the benefits of kshar sutra procedure for treating anal piles, fissure and fistula?

  • The ayurvedic therapy has been conducted successfully for over 2500 years. It has therefore been perfected, and tested for many years
  • kshar sutra involves a minor surgical procedure
  • It takes a very short time to perform surgery, usually about 30 minutes
  • Post-surgical recovery is faster, meaning that an individual can go back to daily routine or normal work-life within a very short time
  • The kshar sutra procedure entails easy to follow post-surgery instructions. This one does not require the assistance of a medical staff to abide by these instructions

What are some of the side effects associated with the kshar sutra treatment for piles, fissure and fistula?

  • Some patients have reported feeling pain after undergoing the procedure
  • The procedure is still not backed by proper scientific studies
  • The patient is likely to experience complications and pain post-surgery. Some of the surgical complications that the patient might experience include incontinence and stenosis.
  • It is not clear yet the actual rates of recurrence after surgery
  • There is the risk that the patient will experience infections and bleeding after undergoing this procedure

Based on the above reasons, the kshar sutra treatment may not be the best approach to treat piles, fistula, and fissures. We already have more effective procedures, such as laser surgery. This technique can effectively eliminate anorectal disorders quickly. Moreover, the procedure is minimally invasive, implying less bleeding and quicker recovery.

Post-op care and diet management

Post-surgical care and diet management help to maximize the benefits of treatment. This also reduces the risk of recurrences. After undergoing kshar sutra surgery for treating anal fissure, fistula, and piles, it is important that the patient follows the following instructions:

Fistula and fissures
  • Avoid the consumption of highly spicy and oily foods as these might exacerbate constipation
  • Ensure a balanced diet always
  • Increase your daily intake of water to at least 6-8 glasses to improve your bowel movements
  • Increase your consumption of foods rich in fiber such as fruits, vegetables, and whole grains.
  • These supply you with dietary fiber that helps to increase bulk during bowel movement
  • Ensure that you do not stand or sit for longer duration of time
  • Maintain proper toilet hygiene
  • Do not strain while passing stool

Consult with your doctor on the use of laxatives in the event that you have constipation

Healing is quick with regular physical activity.  However, make sure you consult with your doctor as too much physical excretion can be deleterious.

Your ayurveda expert might recommend a sitz bath following the procedure. Patients must take such baths at least three times a day, over the duration of about 3 weeks.

Avoid kshar sutra if you have:

Kshar sutra may not work in case the wound is located away from your anal region. Also, certain conditions do not suit kshar sutra. These include:

  • Crohn’s disease
  • Colorectal cancer
  • Inflammatory Bowel Disease (IBD)

Kshar sutra procedures are safe and effective to treat anal piles, fissures, and fistula. People often consider alternative treatment methods that are minimally invasive and painless due to the side effects associated with kshar sutra treatment. Besides, not everyone is eligible for kshar sutra treatment for piles, fissures, and fistula. Anorectal problems may not in themselves be life-threatening.

However, there is still the likelihood that it might affect your overall wellbeing and quality of life. For this reason, it is important that you get in touch with your doctor if you experience pain, bleeding in the anal region, or any other symptoms associated with piles, fistula, and fissures. Feel free to get in touch with your surgeon to know about the minimally invasive laser technique for the treatment of piles, fissures, and fistula.

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