Friday, July 1, 2016

Fistula in ano - Challenges in the treatment

Fistula in ano:
It is a chronic discharging wound in periphery of anal canal. There is recurrent discharge of pus and blood from the wound. Initially it may look like a boil in the anorectal region which is ignored by the patients.

How it looks?
It looks like a boil, a swelling or a small wound. A streak of pus or blood may be noticed on the wound.


1. Pain
2. Bleeding
3. Pus discharge
4. Swelling

On careful digital examination, a cord like structure may be seen running from opening towards the anal canal. It is the fistula track. It starts from internal to external. The internal opening of the fistula in ano can be appreciated by a surgeon on careful digital examination. 

Treatment Options:
1. Medicines - Only temporary relief, no permanent cure.
2. Surgery - Chances of recurrences are fairly normal in surgical procedure. 
3. VAAFT and LIFT - Less pain but chances of recurrences are fair even more than surgery
4. Ksharsutra: It may be painful a little but chances of recurrences are minimal. 

What is ksharsutra?
It is a thread smeared with medicines and it is placed in the fistula track and it causes slow cutting and healing of the track. 

How it is done?

Benefits of Ksharsutra therapy:
It is safe and it can be performed by using local anaesthesia. Patient can go home after having this therapy. He or she can perform normal duties during the therapy.

Dr Praveen Choudhary

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