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Kshar Sutra

The Ksharsutra Therapy is the highly effective method available to treat anal fistula. The efficacy of this ksharsutra treatment is better than the most recent techniques advised by modern surgeons for treating this disease.

Fistula in ano is a disease which is manifested as a small nodular swelling around the anal region, with occasional pus or watery discharges.

It has been noticed in some of the patients that swelling & pain has subsided after the pus has discharged out however after a certain interval of time; the swelling and pain may reappear which is again followed by pus discharge and subsequent relief in the symptoms. This cycle goes on.

Indian Council of Medical Research has clinically evaluated this technique. Trials of Ksharsutra therapy has been clinically conducted at four centers including AIIMS New Delhi. The results of these trials have been released officially. Ksharsutra is more effective and convenient treatment for treating anal fistula.

Ksharsutra – A medicated thread is prepared by applying the coatings of apamarg kshara, haridra churna and many other ayurvedic herbs. All these herbs are mixed with snuhi ksheer. Ultraviolet radiation is used for sterilizing the thread. The combined effect of all these herbs exert strong debridement effect and thus induce healing by the fresh and healthy granulation tissues.

As per observations, the length of the tract heals by 0.5 to 1 cm per week. But several factors influence healing rate of fistula tract. The Kshar present in Ksharsutra acts as powerful debriding agent & selectively acts on the unhealthy tissues, pus pockets etc. This process of debridement & healing starts from deeper tissues & travels towards periphery in stages.

Benefits of Ksharsutra Treatment over Surgery:

  • In Ksharsutra treatment, the postoperative complications such as fecal incontinence, recurrence of the disease, bleeding etc. are mostly not seen.
  • Local anaesthesia is required
  • No hospitalization or bed rest is required.
  • Patient maintains his/her normal routine activities as usual during treatment period.

Other indications of Ksharsutra

  • Pilonidal sinuses
  • Tubercular sinuses

kshara Sutra

Ayurvedic practitioner may recommend a therapy called kshara sutra. Kshara sutra uses special medicated thread to tie a hemorrhoid off at the base. This cuts off the blood supply to the vein, allowing the hemorrhoid to shrink over the next 7 to 10 days. It will shrivel and detach on its own. This more invasive approach will be considered only when other treatments are not effective. Your Ayurvedic practitioner will consider your dosha when it comes to treatment. You might need specific herbs to support postoperative healing. It’s also possible you may need to make some permanent changes in diet, exercise, and other factors to avoid future hemorrhoids. While this procedure is considered minimally invasive, it does have risk. Surgical intervention could be dangerous for people who are susceptible to infection, have a bleeding disorder, or are on medications for heart conditions or blood-thinning. Consult a licensed healthcare practitioner for advice.

Kshar lepan

Kshar lepana involves the application of a herbal alkaline paste, such as Apamarg Kshar, Snuhi Kshar, into the affected area resulting in the collapse of the vein walls & shrinking of hemorrhoid pedicles as it causes protein coagulation and necrosis of the tissues which sheds the pile mass.

Method of application of kshara:

  • The Kshar paste is applied to the dilated pile pedicles with the help of a probe & proctoscope.
  • After Kshara Application the pile pedicle is washed with Dhanyamla which neutralizes the chemical reaction and is followed by the local application of Yashtimadhu Ghrita.
  • Kshara application leads to arrest of the bleeding and regression of the pile mass.
  • This method is safe, simple, cheap and ensures a high success rate with fewer complications.

Herbal application or kshara

Kshara is a caustic, alkaline paste used to manage hemorrhoids. The paste is made of an herbal blend and has a cauterizing action. Kshara is applied to the hemorrhoid using a specialized device called a slit proctoscope. The paste then chemically cauterizes the hemorrhoid, which may have been open and bleeding. In Ayurvedic medicine, this Kshara karma method is considered to be the best approach for treating hemorrhoids.


Many treatment modalities have been mentioned in ayurveda. matra basti is one of the important therapy in treatment of fissure. in this treatment various kind of medicated ointments are usedwhich are having proprties like pain relieving, wound cleansing, wound healing.this helps in increasing granulation tissue formation thus pramoting ulcer healing.

Basti treatment has been highly praised in the classical Ayurvedic texts: “Although the Basti has its effect in the colon, through its power it pulls all impurities out from head to toe, just as the sun that stands high in the sky dries up all rivulets.“

Bastis have a cleansing, calming and nourishing effect and are part of a complete Panchakarma programme. Matra-Basti contains individually prescribed oils to target specific situations, while at the same time it nourishes the physiology.

It plays important role in Fissure treatment. Various oils are used in Matrabasti, which are having properties like wound cleansing & wound healing. And in this way Matrabasti is beneficial in Fissure treartment.


Dhoopan means fumigation. This treatment is used for fissure and painful condition of anal area. Ayurveda herbs which are mentioned below are used for dhoopan. Haridra, Daruharidra, Manjishtha, Jatamansi, Yashtimadhu, Prapoundarik, Hiber, Tagar, Nagarmotha, Raktchandan, Jati, Guggulu, Vacha, Aguru, Sarjras, Nimb, Karanj, Ashwatha, Lodhra, Devdar etc.

All these drayas has one or more below mentioned qualities..
According to modern sciences, these drugs are antimicrobial, antibacterial, antipyretic, analgesics, antifungal, anti - exudative, anti – inflammatory, antiviral, antitumour qualities. Some more details of selective dhoopan dravyas:


  • The volatile oil of guggulu is effective as fumigant.
  • Guggulu gum possessed antibacterial activity against gram-positive and gram-negative bacteria.


  • Vacha is mainly responsible for the antimicrobial activities.


  • Neem seed oil is having insecticidal properties.
  • Its effective against staphylococcus aureus .
  • This natural fumigant.

Fragrant substances like chandana

  • Mask obnoxious smells of some other pungent drugs.
  • Chandana provide a soothing effect on the brain.

Dhoopan kal

  • Dhoopan kal is minimum of 10 sittings.
  • Dhoopan kal is for 10 – 15 minutes as per patients convenience.

Sitz bath (Avagaha)

It is a special treatment modality in Ayurveda where the patient is made to sit in medicated decoctions for a specified period of time. This comes under local treatment modalities and is commonly done for diseases like fissure ,piles,fistula..

Treatment Procedure

If the patient is found fit for the procedure, they are advised to void any urges. An initial oleation with the desired oil is done on the abdomen and back region for 5-10 minutes and the patient made to sit in the luke warm medicated decoction selected as per the condition of the patient so that the region from the umbilicus is immersed in the medicated decoction which is taken in a sitz bath tub. The procedure is done for 10- 15 minutes.

After the procedure the patient is asked to lie in supine position for ten minutes and is then allowed to leave.


  • Pile
  • Fissure
  • Fistula


  • Relaxation of the sphincter mechanism and spasm aids in relieving constipation and there by improvement in piles,fissure and fistula.
  • Pelvic and abdominal organs receive reflex effects from spinal cord.
  • It dilates the blood vessel and ensures proper assimilation of the active principles of the medicine.
  • Direct effects according to the water temperature and duration of bath.

Ayurveda Medicines

Ayurveda Medicines for hemorrhoid fissures appear to be safe and effective,
Most minor hemorrhoids earlier stages of fissures can be treated with medication only. No other procedures are needed unless hemorrhoids fissures are more severe. In worse cases, medications may be used in addition to procedures.

Oral medications

It includes stool softner.It will help in piles & fissures.Various stool softners are available in ayurveda.Acccordig to the condition doctor prescribes the appropriate medicine.

Triphala, Nagkeshar,Harda etc these are some of the herbs are beneficial in piles and fissures. Various decoctions ,oils are utilized in piles fissures treatment. Various topical applications are used in piles and fissure treatment,which are having antimicrobial anti bacterial properties.And this helps in faster recovery.

Fissures can be cured permanently by Ayurvedic Treatment in initial phase. It can provide faster recovery, quick relief, and long-term results. Ayurvedic medicines are highly effective in treating acute and chronic fissures. Good improvement can be achieved within 10-15 days if used properly.

Diet (Pathya)

Eating foods that are high in fiber can make stools softer and easier to pass and can help treat and prevent hemorrhoids. Drinking water and other liquids. Whole grains, such as brown rice, oatmeal, bran cereals, whole grain flour, or multi-grain bread are good food for piles

Foods To Avoid In Piles

  • Avoid spicy food
  • Non veg
  • Processed food
  • Fast food
  • Frozen food
  • Spices

Consume plenty of water

Consume 3 to 4 of litres of water daily. Staying hydrated is not just the best way to keep anal fissures & piles at bay, but crucial aspect of good health. If you are drinking enough liquids throughout the day: This will prevent your body from getting constipated and also soften your stools.

Consume plenty of fiber

Since anal fissures are caused due to constipation, eating a diet rich in fiber can be an effective remedy for anal fissures. Increasing your daily consumption of fiber-rich food can soften stools. This makes them easier to pass and reduces the risk of re-injury to the anal tissue. It is prescribed to intake 25 to 35 grams of fiber daily. The list of high-fiber food to keep the stool soft- Legumes- Kidney beans, black beans, almonds, lentils, peas, whole grain flour and oatmeal

Consume a good amount of green leafy vegetables and fruits

For Piles fissure patients intake of green leafy vegetables and fruits are beneficial It is important that you increase the intake of whole fruits rather than juice as these contain more fiber. Eat vegetables and fruits such as Berries, Grapes, Tomatoes, , Watermelon, Cauliflower,onion, carrot, beetroot , Sprouts, Green peas, Cucumbers, Bananas, Papayas, Figs, Dates, Asparagus, Broccoli, Carrots, Cucumbers, Mushroom. Have salads in lunch and dinner.

Consume curd

For piles and fissure patients curd and butter milk is advised Probiotics are good bacteria that help to regulate the digestive tract. Curd contains lots of good bacteria which help in a regular bowel movement and ultimately, helps to relieve pain from piles. But it should be kept in mind that choosing a probiotic is important. Curd helps the digestive system to work well and pass the stool without or with much less discomfort. There are so many benefits of taking curd and butter milk.So should be used by patients of piles and fissures.

Consume milk and ghee

Patients having piles and fissures if consuming milk along with ghee is beneficial .It lubricates large intestine and so stool passes smoothly

Exercise (Yoga)

A sedentary lifestyle will often slow us down and tamper with our natural bowel movements As a result, conditions such as haemorrhoids may crop up. When it comes to exercising to prevent hemorrhoids, fissure the goal is to encourage regular bowel movements, improve circulation, and strengthen muscles in the pelvic area and lower back.

Increased blood flow, in particular, boosts the delivery of beneficial nutrients and oxygen to the affected area. Exercises that are generally considered safe and effective for hemorrhoid and fissure management and prevention include:

  • Walking
  • Water-based exercises like swimming
  • Exercises targeting the sphincter muscles
  • Kegels and similar pelvic floor exercises
  • Yoga and similar controlled-movement exercises to help strengthen abdominal and rectal muscles

Note: If you have an existing hemorrhoid or fissure condition, do not indulge in heavy weight-lifting, squatting, or gym-based exercises, routines that involve holding your breath while you push to exhale may make haemorrhoid fissure pain worse.

Asanas benificial for piles and fissure