A randomized, controlled clinical study to evaluate the role of Sarjarasa Apamarga Ksharasutra in the management of Bhagandara w.s.r to fistula-in-ano

Fistula-in-ano is one of the most common ailments pertaining to ano-rectal region, is prevalent all over the world and its occurance is 8.6 cases per 100,000 population.[1] The main cause known for fistula-in-ano is crypto glandular infection of anal crypts. In Ayurveda, according to similar clinical features the disease Bhagandara can be correlated with fistula in ano. Presently Ksharasutra therapy is found most approaching and attractive treatment modality among para-surgical procedures for fistula in ano. Guggulu Apamarga Ksharasutra which is widely used, having good binding nature and anti-inflammatory effect, But the main complaints reported by the patients are pain and discomfort during and after Ksharasutra procedure. So, instead of Guggulu, Sarjarasa was taken which is having binding property, Vedanasthapaka, Vrana Ropana and Vrana Shodhana Guna, for the Ksharasutra preparation.[2] A total of 30 subjects were taken, Trial group treated with Sarjarasa Apamarga Ksharasutra and control group treated with Guggulu Apamarga Ksharasutra. The study shows Sarjarasa Apamarga Ksharasutra had high efficacy in subjective parameters like pain and burning sensation compared to Guggulu Apamarga Ksharasutra. There were no complications like necrosis, stenosis, anal incontinence after application of Sarjarasa Apamarga Ksharasutra.