Ksharasutra Ligation In Intersphincteric Fistula: A Detailed Case Study

Abstract

Ksharasutra therapy is a well-established Ayurvedic parasurgical technique for the management of Intersphincteric fistula, offering controlled chemical cauterization, debridement, and simultaneous healing. This case study presents the successful management of a 36-year-old male diagnosed with a low anal fistula (intersphincteric type) who underwent Ksharasutra ligation. The patient presented with pain, seropurulent discharge, and recurrent swelling near the anal verge. After probing and confirming the tract, a standard Apamarga Ksharasutra was ligated under local anesthesia. Weekly changes were performed for four weeks. Significant reduction in discharge was noted by the second week, progressive tract cutting and healing by the third week, and complete healing by the fifth week without complications. No recurrence was observed during three months of follow-up. This case demonstrates that Ksharasutra ligation is safe, minimally invasive, cost-effective, and offers high healing rates with low recurrence compared to conventional surgery.