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Fistula-in-ano is one of the most common anorectal diseases, associated with considerable discomfort and morbidity to the patient. Surgery is usually necessary to treat an Anal Fistula as they usually do not heal by itself. Kshara Sutra is a minimally invasive Ayurvedic para-surgical technique, effective for the treatment of Anorectal disorders like Hemorrhoids, Fistula-in-ano, Anal fissure and Pilonidal sinus.


An Anal Fistula is a small tunnel that connects an abscess, an infected cavity in the anus, to an opening in the skin around the anus.

Anus is the external opening through which faeces are expelled from the body. Numerous tiny glands that produce mucus are located right inside the anus. These glands can occasionally become clogged and infected, which can result in an abscess. About half of these abscesses may develop into a fistula.

Signs & Symptoms of FISTULA-IN-ANO

  • 01 Pain and swelling around the anus.
  • 02 Frequent anal abscesses.
  • 03 Pain with bowel movements.
  • 04 Bleeding
  • 05 Foul-smelling, bloody discharge (pus) from an opening around the anus, pain subside once the Fistula has drained.
  • 06 Irritation of the skin around the anus from discharge.
  • 07 Fever, chills and a general feeling of fatigue.

Causes of Anal Fistula

* Inflammatory bowel disease, mainly perianal Crohn’s Disease.
* Previous radiation therapy to the anal region (treatment for cancer).
* History of trauma to the anal region.
* Sexually transmitted diseases.
* Diverticulitis (a disease in which small pouches form in the large intestine and become inflamed).
* Patients with pulmonary tuberculosis have got 1-2% chance of developing multiple Fistula in Ano.
* Colloid carcinoma of the rectum can present as multiple Fistula in Ano.
* Previous surgery in the perianal region.

Types of Anal Fistula

Depending on their relationship with the internal and external sphincter muscles, Fistulas are classified into five types:

1. Intersphincteric Fistula
2. Transsphincteric Fistula
3. Suprasphincteric Fistula
4. Extrasphincteric Fistula
5. Submucosal Fistula

Diet for Anal Fistula

  • Cereals, Lentils, Green Vegetables, Fruits, Nuts
  • Drink plenty of fluids.
  • Eat high-fiber foods

When to See a Doctor for Anal Fistula

  • Frequent anal abscesses along with pain and swelling around the anus.
  • Foul-smelling, persistent purulent discharge from an opening around the anus.
  • Previous history of anal gland infection, with recurrent abscess.

How to diagnose?

A rectal examination can help your doctor to make a diagnosis. A proctoscope and a probe may be required for further evaluation. An MRI, Colonoscopy or Fistulogram may be required at times.



There are several different procedures. The best option will depend on the position of the Fistula and whether it’s a single channel or branches off in different directions.

What will do in Ayurveda for this kind of disease?

Kshara sutra treatment in Ayurveda is very effective, and easy, requires a lesser hospital stay, lesser pain and has a very low rate of complications. During the Kshara sutra procedure, the thread is passed through the entire tract and both ends are tied. The thread will change once in a week so that by 6 weeks tract heals completely.

How to avoid?

  • More fibrous food
  • Drink Plenty of water
  • Avoid constipation
  • Don’t go toilet without urge
  • Don’t do stress while defecation

Frequently Asked Questions

How to cure anal Fistula, what is anal Fistula?

An Anal Fistula also known as Fistula-in-ano is a tunnel that develops between the inside of the anus and the outside skin around the anus. Surgery is usually needed to treat an anal fistula. Sometimes nonsurgical treatments may be an option.

How to treat anal Fistula at home?

If an Anal Fistula is acute, the chances of finding relief are easier with simple home remedies. A healthy diet and lifestyle habits become a part of daily remedies to bring down the impact of the fistula.

  • Healthy bowel habits.
  • Using stool softeners or laxatives.
  • Drink plenty of fluids.
  • Sitz bath.

How Anal Fistula surgery is done?

In the course of surgery (Fistulotomy) Fistula’s internal opening cuts, scrapes and flushes out the infected tissue, and then flatten the tunnel and stitches it in place. In a more complicated Fistula, if the entire tunnel cannot be found or a large portion of the sphincter muscle needs to be severed, Fistulotomy may be performed in two stages.

what should not eat in Anal Fistula?

  • High-fat dairy products.
  • Spicy, Fast, Fried foods.
  • Alcohol, Caffeinated beverages.

How Ayurveda treatments in Sanjeevanam helps in Fistula-in-ano?

Sanjeevanam Ayurveda Hospital is one of the best hospitals in Kerala, which provides specialized, authentic Ayurvedic treatment for Fistula-in-ano.

Kshara Sootra therapy (Medicated seton) is an important para-surgical procedure in Fistula-in-ano. During Kshara sootra procedure, a thread is passed through the entire tract and two ends of the Ksharasutra was then tied together with a moderate tightness outside the anal canal. Ksharasutra was changed and a fresh one was tied in an interval of one week until the tract cuts completely. It acts as a chemical cautery which burns out the fibrous track thereby promoting fresh healthy granulation tissue development and wound healing without recurrence.


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