A Clinical Study to Evaluate The Healing Effect of Karanjadi Ghritha Topically in Ksharadagdha Vrana of Low Anal Fistula

Abstract Introduction: Fistula-in-ano is an inflammatory track lined by unhealthy granulation tissue that connects the perianal skin to the anal canal, anorectum, or rectum. Commonly treated through fistulectomy or fistulotomy, it is correlated with Bhagandhara in Ayurveda. Acharya Susrutha recommends excision followed by ksharakarma or agnikarma, with karanjadighritha, described in Susrutha Samhitha Vidradhichikitsadhyaya, specifically indicated for managing ksharadagdhavrana. Methods: This pre-and-post interventional study included 25 participants aged 20–70 years diagnosed with low anal fistulas. Karanjadighritha was applied topically as a varti (wick) over the ksharadagdhavrana daily for 42 days. Outcomes, including pain, burning sensation, granulation tissue formation, and tract length, were assessed at seven time points: Days 0, 7, 14, 21, 28, 35, and 42. Results: Significant improvements were observed across all parameters, with p < 0.001. Pain and burning sensation decreased substantially, healthy granulation tissue developed by Day 7, and the tract length showed progressive reduction throughout the study. Discussion and Conclusion: The results suggest that topical application of karanjadighritha is highly effective in managing ksharadagdhavrana in low anal fistulas, promoting rapid wound healing and symptom resolution. This study highlights its potential as a safe and effective therapeutic intervention in Bhagandhara. Keywords: Low anal fistula, Bhagandhara, Ksharadagdhavrana, Karanjadighritha, Wound Healing