Fistula in Ano is a passage created between anal/rectal canal and outer skin (Mostly perianal skin).

In Fistula there is an opening on the skin other than that of Anal opening.


It is mainly caused due to an abscess in the lower part of rectum or anal canal. Abscess is generally formed due to infection of blocked and inflamed anal glands. The Abscess when not healed spreads deep inside the mucus membranes and later creates an opening on the external part of the skin. Constipation, hot and spicy meals, excessive intake of carbonated drinks, sedentary lifestyle, alcohol and smoking are aggravating factors of the disease.


Symptoms may depend on the site and severity of fistula:-
  • Pain in and around the opening.
  • Discharge from the opening which may be Pus, watery or bloody or stool mixed.
  • Itching.
  • Tenderness.
  • If the infection is very severe it may lead to fever.

The symptoms may occur on and off.


In Ayurveda, this disease has been mentioned as “Bhagandara”.
A very detailed and scientific discussion on Fistula-in-Ano has been given by Acharya Sushruta in his textbook Sushruta Samhita.

According to Acharyas, the papules formed in rectal region, pubic region and urinary bladder region when burst out in the skin is called as “Bhagandara”.


Unheatlhy Diet and lifestyle are the two main causes as described by Acharyas.


The causative factors mentioned earlier lead to aggravation of all three Doshas in the rectal region. This results in formation of Pidika (Papules) in the internal wall of rectum or anal region (Blind external) which when not treated leads to spreading of Doshas towards the skin creating a tract with external opening in skin known as “Bhagandara”.


Clinical features depend on the Types of Bhagandara.

According to the shape and type of tract created, Bhagandara has been classified into five types:-

1. Shatponaka (Multiple fistula) – This type mainly occurs due to vitiated Vata Dosha. The main clinical feature includes multiple openings of fistula with tingling sensation in the openings. Discharge of frothy or serous fluid from the openings.

2. Ushtragriva (arc shaped) – This type mainly occurs due to vitiated Pitta Dosha . The fistula tract is like a shape of camel with immense burning sensation in the opening. The discharge excreted from the opening is hot and of foul odour.

3. Parisravi – This type mainly occurs due to vitiated Kapha Dosa. The main clinical feature is itching and sticky discharge from the opening.

4. Shambukavarta – This type mainly occurs due to vitiation of all three Doshas. The internal opening is as large as size of toe. The external opening is extremely painful and excretes multiple types of discharges.

5. Unmargi – This type mainly occurs due to internal injuries in the rectal region. This leads to collection of pus and blood in the internal opening which slowly spreads toward the skin creating an external opening.


The main line of treatment for blind external fistula includes balancing of all three Doshas and improving the Agni (metabolism).

The line of treatment for complete fistula includes local application of medicated oils and fomentation. Surgical incision (Incision and drainage) and Kshar sutra therapy forms main part of treatment of fistula-in-ano.


  • Hot sitz bath.
  • Surgical incision or thermal cauterization.
  • Single herbs – Nyagrodha, Haridra, Manjistha, Chopchini, Lodhra, Amaltas, Dhatki, Sariva.
  • Medicines – Trifala churna, Chopchinyadi churna, Kaishor guggulu, Manjishthadi churna, Trifala churna, Vidangadi churna, Lodhradi churna.
  • Local application – Jatyadi oil.
  • Ksharsutra ligation – A process in which a medicated thread is inserted in the tract and bind through both openings is very effective and the most revolutionised treatment of fistula-in-ano. It has got world wide acceptance for high rate relief in fistula and rare recurrence rate.


If suffering from Fistula then you should take proper medical advice with your doctor. Few Home remedies that can help along with medical treatment are as follows:

1. Take a small tub of luke warm water and mix 1 tablespoon medicated alum powder on this. Sit regularly in this tub thrice daily for 5 min. Hot sitz bath with alum powder helps in removing infection and cleaning the drainage.

2. If suffering from pus discharge from the opening, then take 4 -5 neem leaves and boil them in 4 glasses of water till 1 glass of water remains. Wash the fistula region with this decoction.

3. 1 glass of milk with 1 teaspoon of curcumin powder at night helps in curing internal infection and will also improve the immunity of body.

4. If suffering from constipation then take 5gm of triphala powder at night with luke warm water or Aragwadha (Cassia fistula) Kwath 15-20 ml at night with luke warm water. Don’t take harsh purgatives.

5. If suffering from bloody or watery discharge take 10-20 gm of tender bark of peepal and banyan tree and boil it in 4 glasses of water till 1 glass of water remains. Wash the external opening of fistula with this. You can also do hot sitz bath with this decoction thrice daily for 5 min.

6. Take fiber diet and packed, preserved or frozen foods. Drink lots of water and do mild warm up exercises for 20-30 min daily.

7. Avoid alcohol as it hinders the healing process in body.


The purpose of Ayurvidya is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider regarding your medical condition or treatment and before undertaking any new health care regimen.