Recurrence of Fistula-in-Ano (Bhagandara) After Ksharasoothra Therapy -A Single Centre Prospective Cohort Study

Abstract

Fistula in ano is an abnormal communicating tract between anal canal and perianal skin which is lined by granulation tissue. It is a condition where surgical intervention is required. Recurrence is one of the common complications seen after surgeries. Ksharasoothra therapy is a para surgical procedure, is found more effective in the management of fistula in ano. The subjects who underwent Apamarga Ksharasoothra therapy for fistula in ano from the OPD and IPD of Govt. Ayurveda College, Trivandrum, were observed for one year after complete healing of fistulous tract to find out recurrence of fistula in ano. Methods: This study is a prospective cohort, of patients with fistula-in-ano who underwent Ksharasutra therapy followed by a specific dietary regimen. Fifty patients were followed for one-year post-therapy, and the recurrence rate was calculated. Results Among the 50 observed samples 8, reported signs of recurrence. Among the 8 patients who experienced recurrence, the majority (5 cases, 10%) had recurrence at 6 months after complete healing. Recurrence at 3 months, 9 months, and 12 months was observed in 1 patient each (2% each). A striking and statistically significant association was found between adherence to Pathya (dietary and lifestyle regimen) and recurrence. Conclusion: This design is especially helpful in understanding the importance of Pathya and Apathyas in Bhagandhara which is identified in a study population. The recurrence of the disease was observed in those who did not follow the Pathya, highlighting the significant importance of adhering to these dietary and lifestyle recommendations.