Anal fistula has a frustrating habit of coming back. A patient gets it exercised, heals for a few months, and then the same discharge and pain show up again, sometimes worse than before, because the surgery cuts through sphincter muscle that hasn’t fully recovered. Ayurveda’s answer to this cycle is Kshar Sutra, a medicated thread that works completely differently from a scalpel.

According to I-AIM Healthcare Centre, Ayurveda Hospital in Bangalore, “Fistulectomy removes the tract in one go, but it also risks cutting through muscle the body needs for continence, which is part of why recurrence is so common. Kshar Sutra drains and heals the tract gradually instead of excising it outright; that is the difference between removing tissue and actually closing the track from within.”

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 Why Repeat Fistula Surgery Keeps Happening?

Fistulas can return when a branch of the tract gets missed, infection isn’t fully cleared, or healing doesn’t go as planned. Conditions like Crohn’s disease or diabetes raise the risk further by slowing recovery.

I-AIM’s surgical Ayurveda program treats fistula-in-ano, called Bhagandara in classical texts, with Kshar Sutra specifically because it sidesteps the excision-versus-continence tradeoff altogether. For more on how Ayurveda approaches digestive health, see our earlier post on Grahani Chikitsa for IBS.

How Does the Kshar Sutra Actually Work?

• The thread isn’t ordinary. It’s repeatedly coated with medicated pastes, commonly Snuhi latex and Haridra (turmeric), building up antimicrobial and healing properties before it’s placed in the tract.
• Once tied in, it drains up continuously, cuts through the tract gradually so healthy tissue heals in behind it, and its coating encourages new tissue to close the track from within. It’s changed weekly, tightened a bit each time, until the tract is fully addressed.
• For more on Ayurveda’s digestive approach, see our earlier post on Grahani Chikitsa for IBS.

Why Choose I-AIM Healthcare Centre

I-AIM is a NABH-accredited hospital in North Bengaluru and its parasurgical team has been treating fistula-in-ano with Kshar Sutra for years, working from a proper fistula mapping and classification before any thread is placed. The procedure is typically done without general anesthesia or an extended hospital stay, which matters a lot for patients who’ve already been through one surgery and are wary of another.

FAQs

Is the Kshar Sutra painful?
Not really, most patients just feel mild discomfort when the thread gets changed. No general anesthesia needed either.

How many thread changes will I need?
Depends on how long and complex the tract is. Usually its weekly changes stretched over a few weeks, sometimes closer to two months for tougher cases.

Will I need to be hospitalized?
Usually not. Most of the process is managed on an outpatient basis, unlike conventional fistula surgery.

Can Kshar Sutra treat complex or recurrent fistulas?
Yes, it’s often specifically chosen for complex or previously recurrent cases where standard surgery already failed once.

References

1. Clinical Evaluation of Kshara Sutra Therapy in the Management of Bhagandara (Fistula-in-Ano): A Prospective Study — Ancient Science of Life, PMC
2. Efficacy and Safety of Kshara Sutra Therapy for the Management of Anal Fistula: A Meta-Analysis — Indian Journal of Health Sciences and Biomedical Research

Desclaimer:
This article is for informational purposes only and does not constitute medical advice. Please consult a qualified Ayurvedic physician before starting any treatment.