APAMARGA KSHARASUTRA THERAPY IN FISTULA-IN-ANO (BHAGANDARA): CASE STUDY WITH INTEGRATED REVIEW

Background: Fistula-in-ano (Bhagandara) is a chronic and often recurrent anorectal disorder. Conventional surgery often risks recurrence and incontinence. Ksharasutra therapy—described in classical Ayurveda—employs a medicated seton for controlled cutting and healing. Case presentation: A 36-year-old male with low trans-sphincteric fistula was treated with Apamarga (Achyranthes aspera) Ksharasutra. The tract healed within 3 weeks, with no recurrence at 1 year follow-up. Review integration: This report also summarizes the fundamentals, preparation, indications, peri-operative care, outcomes, advantages, and limitations of Apamarga Ksharasutra therapy, integrating classical principles with modern evidence. Conclusion: Apamarga Ksharasutra offers a safe, sphincter-preserving, evidence-supported option for selected cases of fistula-in-ano.