A randomized open-labelled comparative clinical study to evaluate the efficacy of snuhi ksharasutra, mulaka ksharasutra, and apamarga ksharasutra in the management of bhagandara w.s.r to fistula-in-ano

Fistula-in-Ano is a chronic infective condition of the anorectal region, most commonly resulting from cryptoglandular infection of the anal glands. It is characterized by an abnormal communication between two epithelial surfaces, forming a fistulous tract lined with unhealthy granulation tissue. In Ayurveda, Fistula-in-Ano can be correlated with Bhagandara, which is described extensively in the Ayurvedic classics and considered a Krichchhrasadhya Vyadhi (difficult-to-treat disease). Bhagandara is one of the most common disorders affecting the anorectal region, and its recurrent nature makes management particularly challenging. Ksharasutra therapy is a well-established Ayurvedic para-surgical procedure for the management of Bhagandara. In the present study, 45 patients of either sex diagnosed with Bhagandara were selected from the OPD and IPD of the Department of Shalya Tantra, Taranath Government Ayurvedic Medical College and Hospital, Ballari. The patients were divided into three groups: Group A was treated with Snuhi Ksharasutra, Group B with Moolaka Ksharasutra, and Group C with Apamarga Ksharasutra. The treatment groups demonstrated significant results, suggesting the potential effectiveness of these Ksharasutra in the management of Bhagandara.