Ksharsutra For Fissure | Piles

What is Kshar sutra ?

Kshar sutra is alkaline medicated thread used to treat varoius anorectral diseases. Ksharsutra is being used for treatment since ancient time. SUSHRUTA- the father of surgery explained the role of ksharasutra for the management of anal fistula for first time in 500 B.C. Late Prof. P.J. Deshpande, Prof & HOD of Shalya – Shalakya, Banarus Hindu University revalidated and scientifically established the ksharsutra technique for the treatment of Fistula in ano. Kshararsutra therapy for management of fistula in ano is being practiced in India with high success rate.

Ksharsutra is an alkaline thread; it is made by applying ayurvedic medicines several coating over barbour’s surgical thread 20. These medicines include snuhi ksheera (euphorbia neriifolia’s latex) which is having proteolytic enzymes which produces debridement, Kshara derived from Apamarga (achyranthus aspera) is helpful in debridement of the tract and haridra (turmeric), whoes antiseptic properties help in healing. Ksharasutra formation process is a validated scientifically established process in which proper protocol is followed to get best result. The properties of medicine applied on thread help in excision, scraping, draining, penetrating, debridement and sclerosing as well as healing simultaneously without a surgical excision.


Q. Why ksharsutra treatment is best in anorectal disease like fistula, pilonidal sinus or piles?

Ans: Ksharsutra is the best treatment for fistula in ano it is proved by research conducted by government agency ICMR- Indian Council  of Medical Research – New Delhi at various institute of across India like AIIMS- New Delhi, PGI- Chandigarh. It was found that patient treated with ksharsutra has

  • High success rate i.e. About 96-97% as compared to other surgery where success rate in about 50-60%.
  • Ksharsutra is minimal invasive procedure i.e. There is no cut or incision so no blood loss whereas in other fistula surgery there is extensive dissection (tissue loss) so blood loss is also more.
  • Patient treated with ksharsutra doesn’t require bed rest he can do his day to day activity as compared to other surgery in which patient need bed rest for months.
  • Patient treated with ksharsutra doesn’t require daily dressing whereas patient treated with other surgery require daily dressing for which he has to visit hospital daily and it is also painful.
  • Patient require minimum medication in ksharsutra patient ( rare need of painkiller, no need of antibiotics) whereas patient need lot of medication in the patient treated with other surgery like lot antibiotics in form of injection or tablet to prevent infection, lot of painkiller to subside pain and other medication.
  • To perform ksharsutra procedure no need of general or spinal anesthesia it is done under local anesthesia whereas to perform other surgery in fistula patient need general or spinal anesthesia.
  • Patient doesn’t require hospitalization in ksharsutra patient compared to other surgery.
  • Post procedure ksharsutra patient doesn’t need any kind of blood transfusion because there in no blood loss but other surgery patient requires blood transfusion.
  • Post procedure in ksharsutra patient very minimal scar is there as compared to the patient treated with other surgery.

Ksharsutra is minimal invasive, safe and cost effective treatment in anorectal disease.

Q. What is advance ksharsutra–IFTAK technique?

Ans: Advance ksharsutra -IFTAK is advance technique in which fistula tract is intercepted at intersphincteric groove and tract is divided into two  part. After that ksharsutras placed in two different loops which start cutting and healing at two site simultaneously. At later stage we dont change distal ksharsutra only proximal has to be changed. In this way tract length reduce and so ultimately recovery time also reduce. So advance ksharsutra aim is to reduce treatment duration, and to make patient healthier as early as posssible compared to other fistula treatment.

Q. What are benefits of advance ksharsutra- IFTAK technique?


  • It take lesser time to cure fistula almost half to the traditional ksharsutra.
  • Recurrence rate almost nil.
  • No complications like anal stenosis I.e. narrowing of anal canal.
  • No stool incontinence i.e. loss of stool holding capacity.
  • No need of hospitalization.
  • No need of bedrest, patient can resume his work from next day.
  • Cost effective treatment.
  • Very less requirement of painkiller i.e. one or two tablets a week.
  • No need of antibiotics.