What is Fistula-in-ano?
A fistula-in-ano (or anal fistula) is a small, abnormal tunnel that connects the anal canal (the inside of the anus) to the skin near the anus. It usually develops after an **anal abscess** (a collection of pus) fails to heal completely.
Common Causes
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Blocked Anal Glands
The main cause is infection of the small glands just inside the anus. If these glands get blocked, they can turn into an abscess.
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Abscess History (Anorectal Abscess)
90% of anal fistulas are the result of a previous anal abscess. Once the pus drains, a tract can remain open, forming the fistula.
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Chronic Digestive Issues
Conditions like inflammatory bowel disease (Crohn’s disease) or severe, chronic infection can also lead to fistula formation.
Primary Symptoms
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Pain and Swelling
Constant, throbbing pain in the anal area, especially when sitting or during bowel movements. Swelling is often noticeable near the tract opening.
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Pus/Fluid Discharge
Persistent, foul-smelling, and bloody discharge from the small external opening (the fistula opening) near the anus.
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Recurrent Abscesses
The fistula may temporarily close, only for the infection to build up again, leading to repeated, painful abscess formation.
Types of Anal Fistula (गुदा नालव्रण के प्रकार)
Anal fistulas are classified based on the tract's location relative to the sphincter muscles (Parks Classification). This helps determine the complexity and required treatment approach.
This is the most common type. The tract passes through the internal sphincter muscle and lies in the space between the internal and external sphincter muscles before opening onto the skin.
The tract passes completely through both the internal and external sphincter muscles before draining externally. These are more complex and require careful treatment to preserve continence.
The tract passes above (superior to) the puborectalis muscle, looping above both sphincter muscles. These are quite rare and very complex to treat due to the high risk of incontinence.
The tract originates from the rectum or sigmoid colon, travels outside the sphincter muscles entirely, and opens onto the skin. They are typically not caused by anal gland infection.
*Identifying the correct type is critical for planning procedures like Kshara Sutra therapy to prevent damage to the sphincter muscles.
WHAT IS FISTULA-IN-ANO
A **Fistula-in-ano**, or anal fistula, is an abnormal tunnel that forms between an infected cavity (abscess) within the anal gland and the skin around it. It is a common anorectal condition that typically requires medical intervention to heal.
TYPES OF FISTULA-IN-ANO
Fistulas are categorized based on their position relative to the sphincter muscles, according to the **Parks Classification**:
- Intersphincteric
- Transsphincteric
- Suprasphincteric
- Extrasphincteric
- Submucosal
SIGNS & SYMPTOMS
- Bleeding during bowel movements
- Recurrent anal abscesses
- Pain and swelling around the anus
- Painful bowel movements
- Fever, chills, and fatigue
- Skin irritation due to discharge
- Foul-smelling or bloody discharge from an opening near the anus
CAUSES OF FISTULA-IN-ANO
- Inflammatory bowel diseases, such as Crohn's disease
- Past radiation treatments or trauma to the anal area
- Sexually transmitted infections
- Conditions like diverticulitis and tuberculosis
- Previous perianal surgery or abscesses
FAQ'S
A fistula-in-ano is a small infected tunnel between the anal canal and the skin around the anus. It forms after an untreated or recurring anal abscess. Ayurvedically, it is known as Bhagandara, caused by Vata-Pitta imbalance and poor tissue healing.
No. Fistula does not heal naturally. The tract keeps producing pus or infection. It requires proper medical treatment like Kshar Sutra therapy or Ayurvedic management.
Repeated anal infections, abscesses, chronic constipation, poor hygiene, injury, Crohn’s disease (rare), and weak digestion leading to toxin buildup (Ama) are primary causes.
Pain around the anus, pus or discharge, swelling, redness, itching, recurrent boils, and difficulty sitting. During abscess formation, fever may also occur.
Kshar Sutra is a minimally invasive Ayurvedic procedure where a medicated thread is placed inside the fistula tract. It gradually removes infection, cuts the tract, and promotes healing with a very low recurrence rate.
If untreated, fistula may cause chronic infection, recurrent abscesses, severe pain, and difficulty in daily activities. Early treatment prevents complications.
Avoid spicy, oily, fried foods, red chilli, junk food, bakery items, meat in excess, alcohol, and caffeinated drinks. These increase Pitta, heat, and inflammation.
Yes. Ayurveda offers Kshar Sutra therapy, medicines to reduce infection, diet management, sitz bath, and lifestyle correction. Combined, these provide long-term healing with minimal recurrence.
If you experience recurrent pus discharge, constant pain, boils near anus, swelling, fever, or a non-healing wound — visit Dr. Prince Juneja immediately for proper evaluation.
Home Remedies for Fistula Management
🌡️ दर्द और सूजन का प्रबंधन (Pain & Swelling Management)
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Sitz Bath (गुनगुने पानी का सेक)
गर्म (लेकिन तेज़ गरम नहीं) पानी से भरा एक टब लें और गुदा क्षेत्र को 15-20 मिनट के लिए दिन में 2-3 बार भिगोएँ। यह दर्द, सूजन और ऐंठन को कम करने में मदद करता है।
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Warm Compress (गर्म पट्टी)
दर्द और सूजन वाले क्षेत्र पर कुछ देर के लिए गर्म, नम पट्टी (जैसे तौलिया) रखें। इससे रक्त प्रवाह बढ़ता है और आराम मिलता है।
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Hygiene (सफाई)
मल त्याग (bowel movement) के बाद गुदा क्षेत्र को कोमल साबुन और गुनगुने पानी से धीरे से साफ़ करें और धीरे-धीरे सुखाएँ। कठोर साबुन या रगड़ने से बचें।
🍎 आहार और जीवनशैली में बदलाव (Dietary & Lifestyle Changes)
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High-Fiber Diet (फाइबर युक्त आहार)
कब्ज को रोकने के लिए अपनी डाइट में खूब फल, सब्जियाँ और साबुत अनाज शामिल करें। मुलायम मल त्याग (soft stools) से नालव्रण (fistula) पर दबाव कम होता है।
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Hydration (पानी पीना)
प्रतिदिन 8-10 गिलास पानी पीकर शरीर को हाइड्रेटेड रखें। यह मल को नरम रखने के लिए आवश्यक है।
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Avoid Sitting Long (ज़्यादा देर न बैठें)
एक ही जगह पर लंबे समय तक बैठने से बचें। यदि आवश्यक हो, तो गुदा क्षेत्र पर दबाव कम करने के लिए डोनट के आकार के कुशन का उपयोग करें।
🌱 हर्बल सहायता (Herbal Support)
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Triphala Powder (त्रिफला चूर्ण)
कब्ज को दूर करने और पाचन को स्वस्थ रखने के लिए रात को गर्म पानी के साथ 1 चम्मच त्रिफला चूर्ण लें। यह शरीर को शुद्ध करने में मदद करता है।
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Neem Oil/Turmeric (नीम तेल/हल्दी)
नीम के तेल को प्रभावित क्षेत्र पर लगाने से संक्रमण से लड़ने और घाव भरने में मदद मिल सकती है। हल्दी (Turmeric) एंटी-इंफ्लेमेटरी गुण रखती है।
⚠️ **Disclaimer:** ये केवल सहायक उपाय हैं। नालव्रण को ठीक करने के लिए चिकित्सा मूल्यांकन और उपचार (जैसे क्षार सूत्र) आवश्यक है।
Home Remedies for Fistula (Ayurvedic & Safe)
1. Warm Sitz Bath (Hot Water Tub Bath)
- Add **turmeric** to reduce infection
- Add **neem leaves** for antibacterial effect
- Sit for 10-15 minutes twice daily
- Helps reduce pain, swelling & pus discharge
- Promotes **natural drainage** and healing
2. Triphala Churna at Night
- Prevents **constipation**
- Softens stool for painless motion
- Cleanses intestines gently
- Reduces pressure on fistula tract
- Supports long-term digestive balance
3. Turmeric Milk (Haldi Doodh)
- Acts as a natural **antibiotic**
- Reduces internal inflammation
- Boosts immunity for faster healing
- Drink warm before bedtime
- Add **black pepper** for better absorption
4. Neem (Leaves / Oil / Paste)
- Strong antibacterial, prevents infection
- Use **neem water** wash for hygiene
- Apply neem oil around the area
- Helps reduce itching & irritation
- Detoxifies the body internally
5. Aloe Vera Gel
- Soothes burning and discomfort
- Mild antibacterial action
- Helps tissue regeneration
- Apply externally (not inside)
- Drink **aloe juice** for digestion
6. Isabgol (Psyllium Husk)
- Adds bulk to stool
- Prevents straining
- Keeps bowel movement smooth
- Take with warm water or milk
- Reduces risk of fissures & further tearing
7. Buttermilk with Rock Salt
- Good for digestion & gut health
- Reduces bloating and gas
- Cooling, soothing effect
- Add **roasted cumin** for extra benefit
- Helps maintain healthy gut flora
8. Castor Oil (Erand Tail)
- Natural mild laxative
- Prevents hard stool
- Reduces inflammation
- Helps smooth bowel movement
- Take **1 tsp with warm milk** if needed
9. Sesame Oil / Coconut Oil
- Lubricates the anal area
- Reduces dryness & irritation
- Mild antibacterial action
- Apply lightly after washing
- Promotes comfortable daily toilet routine
10. High-Fiber Ayurvedic Diet
- Add **leafy vegetables**
- Soaked **raisins & figs** for soft stools
- 1–2 tsp ghee daily for lubrication
- Whole grains like dalia, oats, millets
- Avoid **spicy, fried, processed food**
Why Choose Dr. Juneja for Your Health?
Decades of experience in Ayurvedic treatments, focusing on anorectal, digestive, and lifestyle-related health conditions.
Focuses on identifying and correcting the internal imbalances (Agni, Doshas, Ama) that cause chronic symptoms, ensuring lasting relief.
Treatment plans are tailored to your unique body type (Prakriti), incorporating diet, lifestyle, and customized herbal formulations.
Expert application of advanced techniques like **Kshara Sutra** for conditions like Piles and Fistula, offering minimal invasion and high success rates.
Uses pure, natural herbs and methods, avoiding dependence on chemical drugs and minimizing side effects.
Provides comprehensive guidance on nutrition and lifestyle modifications for sustained health and disease prevention, not just temporary fixes.
