Fistula-in-ano: An Ayurvedic Perspective

Bhagandara (Fistula-in-ano): An Ayurvedic Perspective

Definition of Bhagandara (Fistula-in-ano):
(Bhaga= Vagina, Darana= tear, spitting)

ते तु भगगुदबस्ति प्रदेशदारणाश्च ‘भगंदरा’ इत्युच्यन्ते ।
अभिन्ना: पिडका:, भिन्नास्तु भगंदरा: ।। (Su. Ni. 4/3)

This creates a tear in the area of Bhaga (Vagina), Guda (Anal canal & rectum) and Basti (Urinary bladder), so this is called Bhagandara.

Particularly, in the earliar stage when this is not open, called ‘Pidakaa’ (furuncle). Later on it will get burst and forms the Bhagandara (Fistula-in-ano).

Probable Causative Factors:

  • Obesity
  • Heavy diet
  • Indigestion
  • Suppression of natural urges
  • Trauma
  • Unhygienic condition
  • Infection of the anal glands
  • Worm infestation
  • Ingestion of foreign bodies
  • Excessive horse  riding or bicycle riding
  • Abrasion by stone, cloth and ground
  • Constipation
  • Excessive drinking of alcohol
  • Straining
  • Excessive coitus

According to Dosha Involvement:
Ayurvedic classical texts have classified Bhagandara mainly in eight entities according to doshik involvement.

  • शतपोनक भगंदर (Shatponak Bhagandara)- Vāta dosha dominance
  • उष्ट्रग्रीव भगंदर (Ushtragriva Bhagandara)- Pitta dosha dominance
  • परिस्रावी भगंदर (Parisravi Bhagandara)- Kafa dosha dominance
  • शम्बूकावर्त भगंदर (Shambukavarta Bhagandara)- Tridosha dominance
  • उन्मार्गी भगंदर (Unmargi Bhagandara)- Aāgantuja /Traumatic
  • परिक्षेपी भगंदर (Parikshepi Bhagandara)- Vāta  Pitta dosha dominance
  • ऋजु भगंदर (Rhiju Bhagandara)- Vāta Kafa dosha dominance
  • अर्शो भगंदर (Arsho Bhagandara)- Pitta Kafa dosha dominance

According to opening:
Sushruta (School of Ayurvedic Surgery) again classified each type of Bhagandara according to its opening whether presents externally or internally. He used the terms,

  • पराचीन (Parachina) or  बहिर्मुखम् (Bahirmukham) – blind external and,
  • अवाचीन (Avachina) or  अंतर्मुखम् (Antarmukham) – blind internal.

According to modern contrive:
According to modern texts, fistula-in-ano can be divided in two groups broadly, on whether the internal opening is below or above the ano-rectal ring respectively.

  • Low level fistula
  • High level fistula

Low level fistula can be further subdivided into subcutaneous type, submucous type, intersphincteric type, trans-sphincteric type and supra- sphincteric type.

High level fistula can be further subdivided into extrasphencteric or supralevator type, trans-sphencteric type and pelvi-rectal fistula.

Symptoms of Bhagandara (Fistula-in-ano):
The main symptoms are boil around the anus, anal discharge and pain in anal region.

Management (treatment) of Bhagandara (Fistula-in-ano):

  • Local treatment:

Aālepa (Paste of Ayurvedic herbal drugs)- for local application
Upanāha (Warm poultice)- for local application
Pariseka (Pouring of Ayurvedic decoctions)- for local application
Swedana (Hot fomentation)- for local application
Rakta vistravana (Blood letting)
Varti application (Application of wick of cotton cloth mix with Ayurvedic herbal oils)

  • General treatment:

Follow the ‘Ayurvedic life style’ (look forward on the home page of this site)
Apatarpana (Making the body thin by fasting)
Vamana & Virechana (Ayurvedic Panchkarma Therapy/Ayurvedic Detoxification Programme)

  • Para-surgical  procedures:

Kshāra- sutra Therapy (Application of Alkaline Herbal Seton)
Rakta mokshan (Blood letting)
Agni karma (Thermal cauterisation)
Kshāra karma (Application of Ayurvedic herbal caustics)

  • Surgical procedures:

Bhedana karma- Fistulotomy
Chhedan karma- Fistulectomy



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8 Responses to “Fistula-in-ano: An Ayurvedic Perspective”

  1. anita patil says:

    last 2year i have fistula problem and operation complit by in DEC 5 2011 but not solve the problem so please good solution for me .

    • Admin says:

      Dear Anita,
      You have inquired about fistula treatment, but you haven’t show your age, height and weight, so i can not guess about your body structure and constitution, but for resolve the problem you should understand about your problem first. Fistula is a communicating track or pus forming track between two epithelial surfaces, so you should try to clean the pus all the time, so it will go towards healing. For cleaning the track you should take Sitz bath (Tub bath) by Ayurvedic medicine ‘Panchvalkal Kwath’ or wash the local area by the same twice/thrice a day. You should apply the ‘Ksharsutra’ in the track. Ayurvedic ‘Ksharsutra Therapy’ is the best among all the equipment/treatments available for fistula in ano. So I advice you to contact your nearest Ayurvedic Hospital for ‘Ksharsutra treatment which will give you permanent solution. Till then you can use Tab. Triphal guggulu, 2 tablets thrice a day and ‘Pathyadi Kwath’ around half a cup once or twice a day orally. Try to follow the ‘Ayurvedic lifestyle’ including Diet Plan, Daily Routine and Seasonal Regimen for avoid the chance of recurrence. I hope this is enough for your guidance, but you may also contact further if you have any doubt. Take Care.

  2. Parth Sarthi says:

    I am Parth Sarthi, 37 yrs.5’11″ tall, 68 kg, suffering from fistula in ano from 6 month, my fistula track is not mature in fistulogram, doctors have advised for surgery, but i want to know that have any medicine in ayurved for fistula to cure & not recurance, and how much time to take.

    • Admin says:

      Dear Parth,
      As per you said that your Fistula is not mature, so as per my understanding that it is still up to skin and or subcutaneous tissue level, may be it is just like a furuncle which oozing pus sometimes, so you should try to clean the pus all the time, so it will not spread in the deep tissues. For cleaning the track you should take Sitz bath (Tub bath) by Ayurvedic medicine ‘Panchvalkal Kwath’ or wash the local area by the same twice/thrice a day. Ayurvedic Formula ‘Mustadi Churna’(Ref. Charak Samhita Chikitsa 7/67) can heal the immature fistulas completely and permanently without go for future surgeries. Try to follow the ‘Ayurvedic lifestyle’ given on the home page of this website including Diet Plan, Daily Routine and Seasonal Regimen for avoid the chance of recurrence. Take Care.

  3. nagaraju says:

    iam suffring from fistla from 6 months. surgery on29.10.2012 .my age 32 yrs.heigt 5.6 inch.weight much time to take healing of track. track very leanty. doctrine say very leanty poor healing. iam take medicins prporly and diet also.what can I do?medicins prporly using kanchanar gugul abyaristasta jatyaditel triphala panchakara but no advance in healing and I no sugar b.p

    • Admin says:

      Dear Friend,
      I would like to suggest you to take sitz bath of ‘Panchvalkal Kwath’ (Decoction made of Ayurvedic Medicine named ‘Panchvalkal Kwath’) and do dressing by ‘Nimbadi Kalk’(Herbal paste named ‘Nimbadi Kalk’– For more details, how to made this paste freshly and how to apply, please go through the article on this website ‘Healing of Non Healing Ulcer’ in ‘Non Healing Ulcer’ Category). You should take ‘Tab. Navak Guggulu of Punarvasu Pharma, 2 tablets thrice a day with ‘Triphala Kwath’ (Decoction made of ‘Triphala’). I also would like to advice you to take follow up regularly of your concern doctor. Take care.

  4. jeet says:

    I am 35 year old . I an having fisdtula from last 4 years. Just in july 2012 I went for anal fistula plug treatment. Now after more than 1 year my fistula again reoccured. Kindly suggest me ayurvedic treatment. Is Fistula Fatal ?

    • Admin says:

      Dear Friend,
      I like to tell you that fistula in ano is not a fatal condition but on the other hand, if it is not treated properly, it can create many complications. I would like to suggest you to please consult with a good Ayurvedic surgeon and get ‘Kshara sutra treatment’ for getting permanent relief from this chronic ailment. If your fistula is not going deep, that you can also try Siddham Ayurveda’s ‘OPD CHEK Decoction‘ which will give you excellent result. You should also take ‘Sitz Bath’ in a big tub with adding of Ayurvedic ‘Panchvalkal Kwath’ for cleaning and washing of the local part. If you want to know about ‘Kshara sutra treatment’ then please refer our website for it. Along with all this treatment please follow the ‘Ayurvedic Lifestyle’ (including diet plan, daily routine and seasonal regimen) for getting more benefits. Take Care.


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