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
Classification:
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
No comments:
Post a Comment