The Fistula in ano is an inflammatory track lined by granulation tissue with an internal opening to the anal canal or rectum and an external opening to the skin outside the anus.

The disease usually occurs due to persistent infection of the anal glands. The infection leads to the formation of anorectal abscesses. If the abscesses are neglected or not healed properly, resulting in rupture to the inside as well as outside leading to the formation of a fistula.

The disease occurs more in males than females.

Causes of Anal Fistula

Usually, the fistula in ano occurs due to the formation of an anorectal abscess, which ruptures resulting in the fistula. The other causes are:

1. Tuberculosis.
2. Ulcerative colitis.
3. Crohn’s disease.
4. Colloid carcinoma of the rectum.
5. Schistosomiasis.
6. Lymphogranuloma venereum.
7. Trauma.

Classification of fistula in ano

The fistula can be classified into the low-level fistula and high-level fistula depending upon whether the internal opening is below or above the dentate line respectively.

The low-level fistula opens into the anal canal below the anorectal ring. These can be again classified into subcutaneous, submucous, intersphincteric, transsphincteric, and suprasphincteric types.

The high-level fistula opens into the anal canal at or above the anorectal ring. These can be again classified into extrasphincteric, transsphincteric, and pelvi-rectal types.

Symptoms of Anal fistula 

• Previous history of anorectal abscess and recurrent infection of the anal glands.
• Seropurulent discharge that sometimes contains feces (rare) or blood keeping the region always wet.
• Itching of the anal skin.
• Pain around the anal region.
• Swelling around the anal region.
• Skin excoriation.
• External openings can be single or multiple.
• Fever and tenderness in the area.
• Internal opening felt like a “buttonhole” on a digital examination.

Ayurvedic view of Fistula in ano

Ayurveda refers anal fistula by the name bhagandhara. The swelling formed in the rectum, perineum, and bladder region that are not suppurated is known as bhagandara pidaka and when it ruptures and forms a tract, it is known as bhagandhara.

Due to unhealthy dietary habits, local irritating factors like defective sitting, vehicle riding, injury to the anal region, other systemic diseases, low digestive fire, etc Vata dosha (apana vayu) is vitiated. Apana vayu is located in the large intestine and moves into the waist, bladder, and genitals. It performs functions like ejaculation, urination, menstruation, defecation, and childbirth.

The vitiated apana vayu vitiates other doshas like pitta and Kapha, gets localized in the anal region, and leads to the vitiation of shonita (blood) and mamsa (muscles). Thus the abscess is formed and when it ruptures bhagandhara is formed.

Classification of Fistula according to Dosha involvement in Ayurveda.

1. Vataja bhagandhara/ Sataponaka – Vataja type causes various types of pain such as pricking type, stabbing type, and tearing type in the anal region. It contains multiple small openings with frothy and watery discharge.
2. Pittaja bhagandhara / Ushtagreeva – Presents with a small, raised red pustule that ruptures leading to a burning sensation, and fetid and hot discharge.
3. Kaphaja bhagandhara / Parisravi – Presents with a whitish abscess that is firm and associated with itching. The rupture of the abscess results in a hard and indurated track with slimy and continuous discharge associated with pruritus ani.
4. Sannipataja bhagandhara / Sambookavartha – The vitiation of three doshas results in the formation of an abscess that is big and firm (like a great toe). The rupture results in wounds with discharge that have different colours and severe pain.
5. Agantuja bhagandhara – When foreign bodies like fish bone, bone pieces, etc pass through the rectum and anal canal, sometimes it can cause injury or get impacted on the anal canal. This leads to infection of the affected tissue causing an abscess, which leads to a foul smell and pus discharge when ruptured.

Line of treatment of Fistula in ano

In Ayurveda, an anal fistula is managed after confirming whether the abscess is ruptured or not. If the abscess is not ruptured, the management of the wound (Vrana) according to Ayurveda can be implemented.

If the abscess rupture and a fistula is formed, it is then managed by External therapies like:

1. Sitz bath (avagaha sweda).
2. Cleaning the wound with Triphala choornam.
3. Dressing with jatyadi ghritam or tailam.

Do’s and don’ts of Fistula in Ano

Do’s

• Intake of food items rich in fibre.
• Drink plenty of fluids.
• Regularly practice sitz bath.
• Sit on a soft surface.
• Clean the anal region after each defecation.
• Regular and timely intake of food.
• Take warm baths.
• Early to sleep.
• Use stool softeners if necessary.

Don’ts

• Drinking alcohol, caffeine, and saturated beverages.
• Avoid spicy food items and heavy meals.
• Don’t sit on a hard surface and avoid prolonged sitting.
• Avoid straining while going to the toilet.
• Don’t lift heavy objects.

CONCLUSION

Fistula in Ano is caused by certain medical conditions, lifestyle factors, genetic factors or even mechanical factors like long sitting desk jobs.

Our ayurvedic professionals are well trained to treat Anal Fistula. The ayurvedic procedure involved in treating the condition is carried out with utmost care and perfection with our best Ayurvedic doctor in Melbourne.

Your search for the finest treatment in Ayurveda medicine, Melbourne ends here. We’ll guide you effectively with the Do’s and Don’ts when it comes to handling Fistula in Ano. Apart from this, we provide the best Ayurvedic massage therapy as well.

To know more about ayurvedic treatment options for fistula in anus and treatment cost, book an appointment now.