title: Management of Ano-Rectal disorders by Kṣārasūtra: A clinical report.
abstract: BACKGROUND
  Ano-rectal complaints are usually benign in origin. Most of the patients suffering with these disorders do not seek medical advice at an early stage due to embarrassment. It results in advancement of the disease and significant disturbance in the quality of life. Among the available treatment modalities of ano-rectal disorders (ARDs), Kṣārasūtra (medicated thread) appears to be the best in terms of relief and nonrecurrence.
  
  
  OBJECTIVE
  The aim of this study is to provide evidence-based data about the practical application of Kṣārasūtra (medicated thread) in the management of ARDs.
  
  
  METHODS
  An ano-rectal operation theatre was established in September 2012, in association with the Government Ayurvedic Speciality Clinic at District Hospital, Rajahmundry, Andhra Pradesh, to facilitate the AYUSH services in Allopathic Hospitals. Present report includes the details of ARDs treated by Kṣārasūtra (Medicated thread) method during 2012-2013. A total of 127 ano-rectal cases were operated, which included 44 cases of hemorrhoids, 40 cases of fistula-in-ano, 39 cases of fissure-in-ano and three cases of peri-anal abscess. All the cases were analyzed as per the observations, subjective and objective parameters, and follow-up was carried out for a period of 6 months.
  
  
  RESULTS
  In the 127 ARDs treated, 45 patients suffering from hemorrhoids, 36 patients got complete relief, marked relief observed in 4 patients, moderate relief observed in 5 patients. In fistula-in-ano, out of 40 patients 29 patients got complete relief, marked relief was seen in 7 patients out of them 4 patients were referred to anti-tubercular treatment center, 4 patients left against medical advice. In fissure-in-ano-out of 39 patients, 32 patients got complete relief, 5 patients got marked relief, moderate relief observed in 2 patients. These results authenticate the effectiveness of Kṣārasūtra, no adverse effects or recurrence observed in any case.
  
  
  CONCLUSIONS
  ARDs are efficiently treated by Kṣārasūtra technique with prompt symptomatic resolution and prevention of recurrence and complications.
authors: Department of AYUSH, District Hospital, Rajahmundry, East Godavari District, Andhra Pradesh, India.
authors: Vijaya Kumari
authors: VK
authors: Kurapati
authors: Department of Dravyaguna, Institute of Post Graduate Teaching and Research in Ayurved, Gujarat Ayurved University, Jamnagar, Gujarat, India.
authors: K
authors: K
authors: Nishteswar
keywords: Ano-rectal diseases; Kṣārasūtra; fissure-in-ano; fistula-in-ano; hemorrhoids; peri-anal abscess