‘Kshara’ refers to the alkaline product obtained from medicinal plants. ‘Sutra’ means thread. Thus, Kshara Sutra is a ligation method in which a medicated thread dipped in an alkaline medium is used for treating anorectal problems. The ingredients for both the medium and the medicated thread are derived entirely from medicinal plants.

Kshara Sutra needs to be carried out for the treatment of anorectal disorders.

The development of the anal fistula follows the same procedure. the infected tissues in the passage of the anus burst out and spread in the perianal region. Kshara Sutra is also an established remedy for piles or hemorrhoids.

Additional factors which may lead to the situation that will demand Kshara Sutra are unhealthy dietary habits and lack of exercise in daily routine.

Some of the common symptoms which patients in need of Kshara Sutra display are:

• ● Swelling in the anal region
• ● Itching in the anal region
• ● Foul-smelling discharge from the perianal area
• ● Bleeding while passing out stool
• ● Pain during bowel movements
• ● Chronic constipation.

If the patient recurrently experiences the same symptoms, a proctologist needs to be consulted immediately. A proctologist specializes in treating disorders of the large intestine (comprising the colon, anus, and rectum).

The doctor will enquire about bowel movements, nature of stool, dietary habits, hygiene practices and analyze the situation accurately. A physical examination helps in detecting the actual disease.

Kshara Sutra is the first-line treatment. If the doctor feels Kshara Sutra will not be enough to cure the ailment, it will be combined with modern medical techniques, such as the DGHAL-RAR.

Kshara Sutra gets done in three stages:

• ● In the pre-operative stage, hair surrounding the anal area is removed. An antiseptic lotion is applied a day before the surgery. You are required to empty your bowels before going for surgery.
• ● On the day of surgery, anesthesia is given to the patient. The medicated thread is then inserted through the anus and tied to the affected area. It helps in cutting the hemorrhoids and healing the fistula and sinus tract. The procedure gets repeated weekly. The thread is replaced with a new one every time. The process continues till the pus gets drained out of the piles and the open tract of the anal fistula is closed.
• ● Once the surgery completes, the patient is kept on a liquid diet. The medicated thread should be treated with warm water daily to accelerate the process of healing. Meanwhile, the Ayurvedic medicines prescribed by the doctor should also be consumed regularly.

Kshara Sutra is a very effective and permanent treatment for those who are suffering from anorectal disorders. Kshara Sutra provides satisfactory results in the case of fistula as well.

Advantages of the therapy are:

• ● It is a cost-effective procedure
• ● It adopts a minimal invasion approach.
• ● The time for which the patient is admitted to the hospital is less.
• ● The recovery is quick and the chances of recurrence are also reduced.
• ● The medication required after the surgery is performed is less as compared to modern corrective techniques.

There is no risk in this method except pain after the surgery. The complications are minimum. Chances of loss of sphincter control and anal incontinence after the surgery get eliminated.

The patient undergoing this treatment feels much happier and is more satisfied compared to other types of surgeries. Even the anesthesia does not have any side effects on the patient.

Kshara Sutra ensures a speedy recovery. The patients usually stay in the hospital for about 3-5 days depending upon the severity of the disease. The surgery takes around half an hour or forty-five minutes. The patients need to visit the hospital weekly post-surgery for getting the medicated thread renewed.

The chief cause behind piles, anal fissures, pilonidal sinus, and other anorectal disorders are sedentary lifestyle and unhealthy dietary habits. If you have undergone surgery, improve your eating practices. You should exercise daily and stay physically active. Also, avoid straining during defecation.

Kshara Sutra is an established Ayurvedic technique for the treatment of anal fistula. A medicated thread dipped in alkaline solution derived from ashes of medicinal plants is used for the treatment.

The surgery is performed after the patient is under anesthesia. Thus, the chances of pain during surgery get eliminated. However, once the procedure gets completed, the patient can experience mild uneasiness.

Tying the thread at both ends ensures that the blood supply to vessels causing anorectal disorders reduces gradually. This eliminates the possibility of recurrence and guarantees speedy recovery.