COMPARATIVE CLINICAL STUDY OF LAGHU PANCHMOOL KWATHA AVAGAHA SWEDA AND HOT WATER SITZ BATH IN THE POSTOPERATIVE PAIN MANAGEMENT OF ANORECTAL SURGERIES

The anus is the outlet to the gastrointestinal tract, and the rectum is the lower 10 to 15 cm of the large intestine which is that part of the intestinal tract that passes through the muscular canal of the pelvis and anal sphincters. It is the final orifice through which stool passes out of the body. In adults, the anus is 4 to 5 cm long. The lower half of the anal canal has sensitive nerve endings. There are blood vessels under the lining, and in its mid portion there are numerous tiny, anal glands. The valves of Houston are not true valves but are prominent mucosal folds. The dentate or pectinate line divides the squamous epithelium from the mucosal or columnar epithelium. 4-8 anal glands drain into the crypts of Morgagni at the level of the dentate line. Most rectal abscesses and fistulae originate in these glands. The dentate line also delineates where sensory fibers end. Above (proximal to) the dentate line, the rectum is supplied by stretch nerve fibers but not pain nerve fibers. This allows many surgical procedures to be performed without anaesthesia above the dentate line. Conversely, below the dentate line there is extreme sensitivity, and the perianal area is one of the more sensitive areas of the body. The evacuation of bowel contents depends on action by the muscles of both the involuntary internal sphincter and the voluntary external sphincter.