Role of Udumbara Sutra in the Management of Fistula in Ano a Rare Case Study
Role of Udumbara Sutra in the Management of Fistula in Ano a Rare Case Study
The anal fistula is a notorious disease due to its recurrence rate. Bhagandara is varyingly
 defined as a tear, ulcer or boil at Bhaga (Perianal region) within 2 finger circumference of
 it, causing painful abscess when opened is called Bhagandara. The Sanskrit word 'Bhagandara'
 has got two components-Bhaga and Darana. Bhaga means perianal region and Darana means to
 tear. The ancient Surgeon Sushruta has advocated various types of operations in Sushruta
 Samhita. He has advocated Kshara Sutra treatment due to probability of recurrence after
 surgery. Sushruta describes many kind of kshara like Palasa, Kadali. The most remarkable is
 Udumbara( Ficus Glomerata) among them. The present treatment modality Udumbara Kshara Sutra
 has been found effective due to its action of proper drainage of pus from the fistula that
 leads to a proper healing and as adjuvant therapy by avoid recurrence in Fistula in ano.

 Hypothesis; Present treatment modality Udumber Sutra will found to be useful in tne
 management of Fistula in ano.
A 5 year male child, come with complaints of painful discharging boil at left side of
 perianal region and pain with surgical history of incision and drainage for gluteal abscess
 done before six month. On local examination Patient had discharging sinus at 8 o' clock
 position on right side of Perianal region. Before planning the treatment other aetiologies
 were ruled out.

 Under short general anaesthesia diagnosis was confirmed by probing as Fistula in ano.
 Internal opening of Fistula was confirmed by injecting Methylene Blue dye through external
 opening. The track was directed upward in the anal canal without any tributary. Length of the
 tract was 3cm, suggestive of low anal fistula.

 Then Udumbara Sutra was tied covering the entire underlying track for cutting and healing
 under all aseptic precaution. The patient was discharged on the next day of procedure. The
 Udumbara Sutra was changed skilfully by weekly. To promote healing and to reduce pain and
 inflammation oral antibiotics, anti-inflammatory medicine were also prescribed.

 The total period of Udumbara Sutra treatment was 1,1/2 month. The track cut through and
 simultaneously healed. The patient was observed for a period of 6 month to check for
 recurrence.

 The Sutra or Medicated seton was a standard medicated thread smeared with latex of Udumbara
 (Ficus Glomerata), which has quality of cutting and healing.
Inclusion Criteria:

 -  Patient without any major illness. Fistula in ano without tributaries ano without
 complication.

 Exclusion Criteria:

 -  Multiple fistula and associated ano rectal conditions.