Article of bhagandara -fistula -in ano
Journal name: World Journal of Pharmaceutical Research
Original article title: Article of bhagandara -fistula -in ano
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Dr. Kanchan Meena, Prof. Mahesh Dixit, Prof. Harimohan Meena and Dr. Namo Narayan Meena
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Full text available for: Article of bhagandara -fistula -in ano
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr20217-20699
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Summary of article contents:
Introduction
Fistula-in-Ano, referred to as Bhagandara in Ayurveda, is a painful and pathological disorder of the anorectal region that has seen a rise in prevalence due to modern lifestyle factors. This condition is characterized by an inflammatory tract connecting the anal canal or rectum with the external skin, leading to chronic infections and purulent discharge. Both Ayurvedic and modern medical approaches address the management of this condition, which includes surgery, medication, and alternative therapies.
Understanding Bhagandara
Bhagandara is an ano-rectal disease that can be correlated with fistula-in-Ano and is discussed extensively in Ayurveda. According to ancient texts, it begins as a "Pidika," which eventually bursts to form an abnormal passage or fistula. The classification of Bhagandara can be based on several factors, including etiology, prognosis, and the presence of external openings. Different types of Bhagandara, as identified by Ayurvedic scholars, are linked to various dosha imbalances (Vata, Pitta, and Kapha) and exhibit distinct features, discharges, and appearances.
Diagnosis and Etiology
The diagnosis of Fistula-in-Ano incorporates several principles, one of which is Goodsall's rules, guiding the understanding of how external openings relate to the internal tract. Aetiological factors include lifestyle choices such as poor dietary habits, excessive physical strain, and other environmental influences. Modern medicine emphasizes the importance of recognizing that most fistulas arise post-abscess, often as a result of inadequate management of perianal infections. Both non-specific and specific causes, including infections like tuberculosis or complications from inflammatory bowel diseases, contribute to the development of fistula-in-Ano.
Treatment Approaches
Management of Bhagandara encompasses preventive and curative measures, with approaches aligned to both Ayurveda and modern medicine. Ayurvedic treatments include lifestyle adjustments, dietary recommendations, and herbal applications. Surgical interventions such as fistulotomy, seton placement, and various innovative practices—such as the anal fistula plug and video-assisted anal fistula treatment (VAAFT)—are recommended in modern settings. These techniques aim to achieve effective closure of the fistulous tract while minimizing recurrence and preserving anal sphincter function.
Conclusion
The rising incidence of fistula-in-Ano underscores the need for effective diagnosis and management. Understanding the complexity of this condition requires a comprehensive approach that integrates Ayurvedic wisdom and modern surgical techniques. Timely intervention, based on the type of fistula and individual patient factors, is crucial in preventing recurrence and achieving favorable outcomes in patients suffering from Bhagandara. The continuous evolution of treatment modalities, both traditional and contemporary, offers hope for better management of this challenging condition.
FAQ section (important questions/answers):
What is fistula-in-Ano and how does it occur?
Fistula-in-Ano is an inflammatory tract with an external opening in the perianal skin and an internal opening in the anal canal. It often arises from an abscess or infection, creating a permanent abnormal connection.
What are the common signs and symptoms of Bhagandara?
Common signs include a discharging vrana, pain in the perineal region, itching, burning sensation, and recurrent abscess formation. Symptoms might worsen during activities like riding or defecation.
What are the classifications of Bhagandara based on etiology?
Bhagandara can be classified based on dosha involvement and prognosis. Common types include Shatponaka, Ustragreva, and Unmargi, each with specific features and associated doshas.
What are the Ayurvedic treatments for managing Bhagandara?
Management includes both preventive and curative approaches, such as dietary recommendations, lifestyle modifications, and medical treatments like Kshara sutra therapy, excision, or incision based on the type of fistula.
What modern surgical treatments are available for fistula-in-Ano?
Modern treatments include fistulotomy, seton placement, fibrin glue injection, anal fistula plugs, and advanced techniques like LIFT and VAAFT, all designed to effectively close the fistulous tract.
How can one prevent the recurrence of fistula-in-Ano?
Preventing recurrence involves identifying and avoiding causative factors, maintaining a healthy lifestyle, and ensuring early diagnosis and treatment of anorectal conditions to minimize complications.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Article of bhagandara -fistula -in ano”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Bhagandara (Bhagamdara):
Bhagandara refers to the Ayurvedic term for fistula-in-ano, a painful anorectal condition characterized by an abnormal passage between the anal canal and the skin. It results from a chronic infection and is treated both surgically and through Ayurvedic practices, indicating the importance of traditional medicine in managing such ailments.
2) Pain:
Pain is a critical symptom in patients with Bhagandara. It can range from mild discomfort to severe pain that exacerbates during activities like bowel movements or riding. Understanding pain’s role helps in assessing the severity of the disease and determining effective management strategies for patient care.
3) Dosha (Dosa):
In Ayurveda, Dosha refers to the three biological energies—Vata, Pitta, and Kapha—that circulate within the body, influencing physical and mental health. The imbalance of these doshas is believed to lead to various diseases, including Bhagandara, guiding treatment approaches aimed at restoring harmony.
4) Ayurveda (Ayus-veda):
Ayurveda is a traditional Indian system of medicine encompassing holistic healing principles. It emphasizes balance in body energies (doshas) and utilizes herbal treatments, dietary practices, and lifestyle adjustments, playing a pivotal role in managing conditions like Bhagandara by promoting overall well-being.
5) Disease:
Diseases signify pathological conditions influencing health. Bhagandara is categorized under anorectal disorders, which are prevalent due to lifestyle changes. A thorough understanding of diseases enhances the ability to categorize and treat specific conditions effectively.
6) Kshara (Ksara):
Kshara is an Ayurvedic term for alkaline substances used in various treatments, particularly in the management of fistulas. It is noted for its corrosive properties, which help in cleaning and healing tissues. Its application reflects Ayurvedic principles of promoting natural healing through herbal interventions.
7) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
Shalya-tantra is the branch of Ayurveda dedicated to surgical treatments. It encompasses techniques for managing surgical diseases, including Bhagandara. Knowledge in Shalya-tantra is essential for Ayurvedic practitioners, enabling them to perform effective surgical interventions alongside conservative management approaches.
8) Udaipur (Udaypur):
Udaipur is a city in India renowned for its traditions and educational institutions, including the M.M.M. Govt Ayurveda College, where research on Ayurvedic practices, such as those for treating Bhagandara, is conducted. The location plays a significant role in advancing Ayurvedic medical knowledge.
9) Tantra (Tantrism, Tamtra):
Tantra, in the Ayurvedic context, refers to a specialized field of study and practice. It involves understanding physiological processes and utilizing surgical methodologies. Mastery in Tantra allows for effective treatment strategies for conditions like Bhagandara, emphasizing the integration of knowledge and practice.
10) Shalya (Salya):
Shalya translates to 'surgery' or 'surgical procedures' within Ayurveda. It encompasses techniques and methods to treat various ailments, particularly those requiring surgical intervention, such as Bhagandara. Thus, Shalya is integral to the management plan for patients with complex anorectal conditions.
11) Pitta:
Pitta is one of the three doshas in Ayurveda, representing fire and metabolism. An imbalance of Pitta can lead to inflammatory conditions, including instances of Bhagandara. Understanding dosha principles helps tailor treatments that restore balance and address the underlying causes of the disease.
12) Kapha:
Kapha, another of the three doshas, embodies earth and water elements, influencing body structure and fluid balance. In Bhagandara management, understanding Kapha’s role aids practitioners in diagnosing constitutional types and tailoring treatments that address potential imbalances contributing to the disease.
13) Guda:
Guda refers to the anal region in Ayurvedic terminology. It is significant in the context of Bhagandara as the disease primarily affects this area, making it crucial to assess the anatomical and functional aspects of Guda for accurate diagnosis and effective treatment planning.
14) Cauterisation (Cauterization):
Cauterization is a surgical technique that involves burning tissue to remove or close off abnormal growths, including fistulas. In the context of Bhagandara, cauterization is employed as an effective treatment strategy to promote healing and prevent complications, reflecting the integration of surgical principles in Ayurveda.
15) Ksharasutra (Ksarasutra, Kshara-sutra):
Kshara-sutra is a unique Ayurvedic method involving a medicated thread that is introduced into the fistulous tract. It applies Kshara properties, promoting the healing of fistulas by gradually cutting through unhealthy tissue, illustrating a blend of medicinal and surgical approaches in Ayurveda.
16) Pidika:
Pidika refers to a localized swelling or abscess that can develop in the anal region, potentially leading to Bhagandara. Its early identification is critical as it is often the precursor to more severe anorectal conditions, highlighting the need for timely intervention.
17) Riding:
Riding is mentioned as an aggravating factor for Bhagandara, likely due to the strain placed on the pelvic region. Understanding lifestyle activities, such as riding, helps practitioners give appropriate lifestyle guidance to patients to prevent exacerbation of symptoms and disease progression.
18) Sutra:
Sutra means a thread or formula in Sanskrit and is often associated with surgical procedures in Ayurveda. In the context of Bhagandara, the Kshara-sutra technique exemplifies how sutra refers to the method applied in treating fistulas, embodying the principles of Ayurvedic surgical practice.
19) Krimi (Krmi):
Krimi refers to parasitic infections or infestations. In the case of Bhagandara, the presence of Krimi can complicate the condition, contributing to infection and symptoms. Awareness of Krimi’s role is crucial in devising effective treatment plans that address both the disease and potential underlying infections.
20) Horse:
Horse riding is noted as a potential aggravating factor for anal disorders, including Bhagandara. Understanding how certain activities may contribute to the onset or exacerbation of the condition is vital for advising patients on lifestyle modifications to aid in treatment efficacy.
21) Sign:
Sign refers to observable indicators of a disease. In Bhagandara, signs may include discharge, swelling, or pain. Accurately identifying these signs is crucial for diagnosis and aids in formulating an effective treatment plan that addresses the patient’s specific manifestations of the disease.
22) Purvarupa (Purva-rupa):
Purvarupa encompasses the preliminary symptoms before the onset of a disease. In Bhagandara, recognizing Purvarupa, such as pain and swelling in the anal region, is essential for early diagnosis and intervention, potentially preventing the progression to a more advanced stage of the disease.
23) Agnikarma (Agni-karma):
Agnikarma is a therapeutic procedure involving thermal cauterization used in Ayurveda. It is employed in treating Bhagandara to promote healing by destroying unhealthy tissue. This method reflects the integration of ancient surgical techniques into modern treatment paradigms for anorectal conditions.
24) Medicine:
Medicine encompasses the science and practice of diagnosing, treating, and preventing disease. In the context of Bhagandara, both Ayurvedic and modern medical approaches are discussed, emphasizing the need for comprehensive care that integrates traditional medicinal wisdom with contemporary practices to enhance patient outcomes.
25) Incision:
Incision refers to a surgical cut made during procedures to treat conditions like Bhagandara. Proper technique and understanding of anatomy are crucial for effective management and minimizing complications, highlighting the importance of surgical precision in the treatment of anorectal diseases.
26) Bhedana:
Bhedana signifies the concept of incision or cutting in Ayurveda, particularly in surgical practice. For Bhagandara, Bhedana relates to the surgical techniques employed to open and treat the fistulous tract, showcasing the interplay between traditional surgical approaches and modern medical techniques.
27) Kanchan:
Kanchan refers to Dr. Kanchan Meena, a primary author in the study of Bhagandara. Her contributions provide insights into the Ayurvedic understanding and management techniques for this condition, enhancing the discourse on integrating traditional practices with contemporary research and treatment strategies.
28) Burning (Burn, Burned, Burnt):
Burning sensation is a common symptom experienced by patients with Bhagandara. It is often associated with inflammation or infection in the anal region. Recognizing this symptom is vital for diagnosis, as it significantly impacts patient discomfort and the overall management strategy.
29) Itching:
Itching is another prevalent symptom observed in Bhagandara cases. It may be indicative of inflammation or infection, prompting patients to seek medical advice. Understanding its role as a sign helps healthcare providers tailor specific interventions aimed at alleviating patient discomfort.
30) Esana (Eshana):
Eshana, or probing, is a technique mentioned in Ayurvedic texts concerning the examination of the anal canal. It is particularly relevant in diagnosing and assessing Bhagandara, as effective probing assists in identifying the internal opening and understanding the extent of the disease.
31) Karma (Karman):
Karma in Ayurveda refers to actions or procedures applied for treatment. The specific Karma used in managing Bhagandara encompasses both medical and surgical interventions, highlighting how tailored treatment strategies contribute to the overall healing process for patients with this condition.
32) Mukha:
Mukha denotes the opening or aspect of a structure. In the context of Bhagandara, it relates to the external and internal openings of a fistula. Understanding Mukha is critical for accurately diagnosing and developing effective surgical strategies for treatment.
33) Kandu (Kamdu):
Kandu translates to itching or irritation. In the context of Bhagandara, it serves as an important symptom that can indicate ongoing inflammation or infection. Recognizing Kandu helps in assessing the severity of the condition and directing appropriate therapeutic interventions.
34) Vrana:
Vrana means a wound or ulceration, which is pertinent in the context of Bhagandara, where chronic wounds are a common complication. The management of Vrana becomes essential in treating fistulas and preventing recurrence, highlighting the need for effective wound care strategies.
35) Nadi (Nadin):
Nadi refers to channels or conduits in the body through which doshas flow. In Bhagandara, Nadi involves understanding the pathways affected by the fistulous tract and informs treatment strategies aimed at restoring balance and facilitating healing through targeted interventions.
36) Vata:
Vata is one of the three doshas representing air and movement. Imbalances in Vata can contribute to various disorders, including Bhagandara. Understanding the role of Vata allows practitioners to address underlying doshic disturbances through tailored Ayurvedic treatments.
37) Life:
Life encompasses holistic well-being, affecting the prognosis of conditions like Bhagandara. Lifestyle factors, including diet, exercise, and stress management, play significant roles in disease management. Integrating life quality improvement into treatment plans is essential for enhancing patient outcomes.
38) Burning sensation:
Burning sensation is indicative of inflammation or infection often experienced by patients with Bhagandara. It greatly influences the patient's quality of life, making effective management of this symptom crucial in the overall treatment strategy for fistulas.
39) Raktamokshana (Raktamoksana, Rakta-mokshana):
Raktamokshana is a bloodletting therapy in Ayurveda used to detoxify the body. In the treatment of Bhagandara, Raktamokshana may help in alleviating inflammation and promoting healing. Its application highlights the significance of traditional methods in modern therapeutic approaches.
40) Accumulation (Accumulating, Accumulate):
Accumulation refers to the buildup or collection of substances, often seen in conditions like Bhagandara where inflammatory material may gather. Understanding the implications of accumulation assists in planning appropriate interventions to facilitate discharge and promote healing.
41) Surrounding:
Surrounding refers to the tissues and anatomical structures adjacent to the affected area. In Bhagandara, assessing the surrounding tissues is vital for understanding the extent of the disease to devise suitable surgical or medical interventions.
42) Nadivrana (Nadi-vrana):
Nadi-vrana illustrates a potential complication in Bhagandara where the fistulous tract's characteristics resemble a wound. This terminology underscores the importance of precise diagnosis and targeted management strategies to address both the fistula and any accompanying wounds.
43) Vimlapana:
Vimlapana is a term used to describe local treatments that help alleviate pain or inflammation. In the case of Bhagandara, Vimlapana may involve applications or therapies aimed at soothing the affected anal region, emphasizing the importance of localized care in Ayurvedic practices.
44) Tilataila (Tila-taila):
Tilataila, or sesame oil, is commonly used in Ayurvedic treatments for its nourishing and healing properties. In the context of Bhagandara, Tilataila may play a role in massage or topical applications that promote healing and reduce inflammation in the affected area.
45) Knowledge:
Knowledge refers to the understanding and information gained about a subject. In Bhagandara treatment, knowledge of surgical techniques, doshas, and management strategies are critical for effective care, emphasizing the importance of education for practitioners in Ayurvedic medicine.
46) Abhyanga (Abhyamga):
Abhyanga is a traditional Ayurvedic massage technique that employs specific oils to rejuvenate and heal the body. In the management of Bhagandara, Abhyanga may help alleviate stress and improve circulation to the affected area, promoting overall wellness.
47) Annapana (Anna-pana):
Annapana refers to the act of consuming food and drink. In Ayurvedic practice, dietary choices play a significant role, especially in managing conditions like Bhagandara, where tailoring nutrition can help restore doshic balance and enhance healing.
48) Maithuna:
Maithuna relates to sexual activity, acknowledged in Ayurvedic texts as a factor influencing health. In Bhagandara management, limiting Maithuna is advised for patients to prevent exacerbation of symptoms, highlighting the need to address lifestyle choices in treatment plans.
49) Swelling:
Swelling, a common symptom of inflammation in Bhagandara, is indicative of an underlying infection or complication. Recognizing and managing swelling is critical for effective treatment as it often correlates with pain and discomfort experienced by patients.
50) Elephant:
Elephant riding is noted as a possible aggravating factor for anal conditions, including Bhagandara. This reinforces the understanding of how certain physical activities can worsen symptoms, underlining the need for guidance on avoiding triggers during treatment.
51) Activity:
Activity encompasses lifestyle behaviors and physical exertions that can affect health. In the context of Bhagandara, engaging in certain activities may exacerbate symptoms, emphasizing the need for holistic management involving both physical and mental aspects.
52) Vitiation (Vitiated):
Vitiated refers to the imbalance or disturbance in doshas, leading to disease. In Bhagandara, recognizing vitiated doshas helps in diagnosing the specific type of fistula, guiding practitioners towards appropriate treatment options to restore balance to the body.
53) Chedana:
Chedana refers to excision or surgical cutting used in treating conditions like Bhagandara. This technique is integral to Shalya-tantra, representing a significant approach to removing affected tissue and relieving patients from chronic symptoms.
54) Vyayama:
Vyayama means exercise in Ayurvedic practice and is crucial for maintaining overall health. However, excessive Vyayama can exacerbate conditions like Bhagandara, showcasing the need for balanced physical activity integrated into patient management.
55) Purisha (Purisa):
Purisha translates to feces in Ayurveda. It is significant in diagnosing anal diseases, such as Bhagandara, as disturbances in bowel movements can contribute to symptoms and play a role in the management of the condition.
56) Phenila:
Phenila denotes a type of discharge associated with anal fistulas, which often occur in Bhagandara. Understanding the characteristics of Phenila assists practitioners in assessing the condition's severity and determining appropriate treatment strategies.
57) Apathya:
Apathya means contraindicated substances or actions in Ayurveda. In managing Bhagandara, identifying Apathya helps guide patients towards lifestyle modifications and dietary restrictions, aiming to prevent exacerbation of their condition and support healing.
58) Salaka (Shalaka):
Shalaka refers to a specific tool or instrument used in Ayurvedic surgical procedures. Knowledge of Shalaka and its applications in the management of Bhagandara emphasizes the integration of traditional tools into effective Ayurvedic surgical practices.
59) Virudha:
Virudha signifies incompatible food or lifestyle choices that can cause disease. In managing Bhagandara, recognizing Virudha helps practitioners provide dietary and lifestyle recommendations that prevent complications and promote healing for affected individuals.
60) Doshaja (Dosha-ja, Dosaja):
Doshaja refers to diseases caused by imbalance in the doshas. Bhagandara can be classified as a Doshaja disease, emphasizing the importance of understanding doshic interactions in the diagnosis and treatment of this anorectal condition.
61) Surface:
Surface refers to the external aspect of the body involved in a disease process. In Bhagandara, assessing the surface surrounding the anal area is essential for identifying the extent of the disease and determining appropriate surgical or medical intervention.
62) Dahana:
Dahana means cauterization or burning to manage conditions, crucial in the treatment of Bhagandara. This approach helps eliminate unhealthy tissue and promotes healing, reflecting the synergistic nature of Ayurvedic medical practices and surgical interventions.
63) Lepana:
Lepana refers to applying medicinal pastes or substances to the skin or affected area. In the management of Bhagandara, Lepana supports healing by providing localized treatment, highlighting the Ayurveda’s holistic approach in integrating topical therapies with surgical methods for comprehensive care.
64) Ghrita (Ghrta):
Ghrita, or clarified butter, is frequently used in Ayurvedic treatments for its healing properties. In the context of Bhagandara, Ghrita may be incorporated into dietary recommendations or topical applications to enhance healing processes and support overall wellness.
65) Ruksha (Ruksa):
Ruksha means dry or unmoistened in Ayurveda, which can indicate a type of imbalance. In Bhagandara treatment, addressing Ruksha conditions may involve dietary adjustments or therapies aimed at restoring moisture and balance to prevent exacerbation of symptoms.
66) Patola:
Patola, or pointed gourd, is often used in Ayurvedic dietary recommendations for its balancing properties. Incorporating Patola into the diet can enhance overall health and potentially mitigate some conditions, including those related to digestive health, indirectly supporting the treatment of Bhagandara.
67) Shigru (Sigru):
Shigru refers to the moringa plant, celebrated in Ayurveda for its nutritional and medicinal benefits. Its incorporation into treatments for Bhagandara highlights the significance of herbal remedies in promoting healing and enhancing overall health within the Ayurvedic tradition.
68) Madhya:
Madhya means 'moderate' or balancing, playing a key role in creating an equilibrium in both diet and lifestyle choices. Emphasizing Madhya in managing Bhagandara can promote health and prevent complications associated with imbalanced living.
69) Angula (Amgula):
Angula translates to finger and is used as a unit of measure in Ayurvedic texts. In the context of Bhagandara, understanding the importance of Angula helps practitioners describe the size and extent of lesions, facilitating accurate assessments during diagnosis.
70) Shukra (Sukra):
Shukra refers to reproductive tissue or semen in Ayurveda. Its significance in relation to Bhagandara lies in understanding how imbalances in Shukra can influence overall health and contribute to conditions affecting the anal region, emphasizing the holistic nature of Ayurvedic diagnostics.
71) Antara (Amtara):
Antara refers to the internal aspect or opening within the body. In the case of Bhagandara, understanding the concept of Antara helps in diagnosing internal openings of fistulas, guiding effective treatment strategies tailored to the specific anatomical structures involved.
72) Patana:
Patana means laying open, particularly in a surgical context. In Bhagandara, Patana refers to the essential surgical procedure of opening the fistulous tract for proper management, highlighting the importance of precision and technique in attaining successful outcomes.
73) Krodha:
Krodha translates to anger or rage in Ayurveda, representing the emotional factors that can impact physical health. In managing Bhagandara, addressing emotional well-being through holistic practices may also support the overall healing process and patient recovery.
74) Ajirna:
Ajirna means indigestion or impaired digestion. It is significant in Ayurveda, particularly regarding Bhagandara, as digestive health plays a crucial role in overall well-being. Recognizing Ajirna helps practitioners address dietary factors that may contribute to the condition and guide effective management strategies.
75) Darana:
Darana refers to the act of cutting or incision in a surgical context. In Bhagandara treatment, Darana represents the necessary surgical interventions required to manage fistulas effectively, emphasizing the technical and anatomical considerations needed for optimal patient outcomes.
[Note: The above list is limited to 75. Total glossary definitions available: 106]
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