Q1. What is fistula in ano ?
Q2. How can one diagnose fistula in ano ?
Q3. What are the general causes that lead to the formation of fistula in ano ?
Q4. Is fistula in ano a painful problem ?
Q5. Which age group & gender is more likely to have fistula in ano ?
Q6. How can one prevent the formation of fistula in ano ?
Q7. How commonly does a fistula in ano recur ?
Q8. What factors are likely to aggravate the symptoms of fistula in ano ?
Q9. What is the role of oral medications in fistula in ano ?
Q10. How long does the recovery take after Surgery / KsharaSutra ?
Q11. Is it hereditary ?
Q12. What are the complications ?
Q13. Chances of recurrence after Surgery / KsharaSutra ?
Q14. Daily routine ?
Q15. Diet ?
Q16. Laboratory investigations required before the procedure ?
Q17. X-ray of a fistula and its role ?
Q18. Where can it be done ?
Q19. Other diseases ?


A1. It is an opening around or near the anus, sometimes at a distance of 2 - 4 inches. It occurs with pus discharge, swelling or pain around that area.

A2. Fistula in ano generally presents as a small boil - like opening around the anus at a distance of few mm. to couple of inches, in any direction. Pus or blood keeps on oozing out of this opening, continuously. In short, a recurrent opening near anus with pus - like discharge should always be suspected as Fistula in ano.

A3. Main cause of Fistula in ano is an injury at external anal area. Injury may be due to scratching, shaving and infected hair roots etc. After injury, infection occurs and an abscess is formed in which pus develops & causes pain. Usually that abscess drains spontaneously making an opening which may be a Fistula in ano.

A4. Yes, Fistula in ano is occasionally a painful problem. Whenever the wound track is full of pus it results in severe pain that will cause discomfort to patient & when the pus drains out the pain also reduces.

A5. Fistula in ano is more likely in males. Between 21 - 40 years of age persons are more prone to this disease, although plenty of females suffering from this problem are encountered. There also seems to be a predisposition in patients having a family history.

A6. Fistula in ano may prevented by avoiding constipation and any injury to the area around the anus.

A7. If Fistula in ano is treated by surgery then reccurence rate is upto 30% but with KsharaSutra is less likely to reccur only 2%.

A8. Hot spicy foods, deep fried foods & constipation are the main aggravating factors in Fistula in ano that may increase pus / pain.

A9. Oral medications have little or no role in the treatment of Fistula in ano.

A10. Recovery of Fistula in ano after Surgery / KsharaSutra depends upon length of the fistulous track. The longer / deeper the track, the higher the rate of recurrence with surgery. The recovery period may be from a couple of weeks to a couple of months. KsharaSutra therapy may take anything from a couple of months to more than a year, but the success rate is above 98%.

A11. No, Fistula in ano is not a hereditary disease, but a familial predisposition is often noticed.

A12. If, left untreated for over 20 years or so, malignancy may develop in a small percentage of patients.

A13. With surgery i.e, Fistulectomy / Fistulotomy its reccurence rate is upto 30%. With KsharaSutra its reccurence rate is less than 2%.

A14. With KsharaSutra treatment, there is no effect on patient's daily routine. He can do his job as usual, but with surgery, the patient has to be hospitalised for some days and after that he has to take bed rest for variable periods.

A15. Green vegetables, fresh fruits, high fibre diet, cooked food with little or no spices / grease, milk etc. and preferably vegetarian diet.

A16. (1) Blood investigations (a) Haemoglobin (b) TLC, DLC (c) Blood sugar - fasting & PP (d) Bleeding time & Clotting time (e) ESR.
(2) X-ray chest (PA view).
(3) ECG / EKG.

A17. Injection of a radio opaque dye through the fistulous opening near the anus, and subsequent immediate X-raying of the area may be used to determine the extent/direction/ramifications of the track. It is, though not a 100% reliable instrument.

A18. I am at present doing the primary threading at Chakravarty Nursing Home, Panchkula, Haryana, India and the subsequent change of threads at my outdoor clinic at sector 46-C, Chandigarh, India. The primary threading can be done in any well equipped operation theatre.

A19. Patients suffering from diseases like diabetes, tuberculosis, haemophilia, ulcerative colitis etc. need to be treated adequately for the above conditions, before they begin the KsharaSutra Therapy.