ABSTRACT
Ano-rectal disorders are on exponential growth in the population of mankind, with bleeding per anum as one of the main prodromal symptom. Just like the metabolic or lifestyle disorders namely diabetes mellitus, hypertension, ano-rectal disorders also owe their etiology to irregular & improper diet, sedentary lifestyle, prolonged sitting in inaccurate postures, improper bowel habits & also psychosocial factors. In Ayurveda, Sushruta has described it vividly in Arsha nidanam that those people suffering from Mandagni i.e., reduced digestive power which leads to Vata aggravation alone or in combination with other Dosas and manifests itself with symptoms like bleeding per anum, pain, irritation, discharge in the Guda. In modern science, excessive straining, increased abdominal pressure and hard stools are told to be the etiology of symptomatic haemorrhoids as these causes leads to increased venous engorgement of the haemorrhoidal plexus and cause of prolapse of haemorrhoidal tissue. Bleeding, thrombosis and symptomatic haemorrhoidal prolapse may result. Some of the ano-rectal disorders mentioned by Sushruta are Arsha, Parikartika, Bhagandara.
ABSTRACT
Fistula-in-ano is one of the most difficult diseases confronted in ano-rectal patients in Shalyatantra OPD. Sushruta described Bhagandara along with its etiology, clinical presentation and treatment. The description of different types of Bhagandara (fistula-in-ano) are at par with the aetiopathogenesis of Fistula-in-ano of modern medical science. It is a very complicated condition arising out of various causes like pyogenic, tubercular, lymphogranuloma inguinale, inflammatory bowel diseases like Crohn's disease, ulcerative colitis etc. Identification of the aetiopathological factor is necessary for the success of treatment of fistula-in-ano. Histopathological study of tissue from tract of fistula-in-ano is an useful diagnostic tool for assessing the underlying pathology. In this study we use the benefits of histopathological examination from the primary site of the disease to detect the basic etiology. 100 cases diagnosed as fistula-in-ano attending Shalya OPD, Government Ayurvedic College Hospital were randomly selected for a period of one year i.e 2016-2017. After necessary investigations, tissue is collected from the primary site of fistulous tract during primary threading for Kshar Sutra therapy, in OT under local anaesthesia and sent for histopathological examination. The results of the above study were tabulated and lots of cases other than pyogenic cause were detected. The data were analysed with standard statistical methods. Without histopathological examination it is not possible to detect the underlying cause of fistula-in-ano.