A Integrative Ayurveda Management of Krimi Bhagandara – A Case Report:

Prabha Weeranayake; Pashmina Joshi; manisha kapadiya; YR Meghani; TS  Dudhamal

doi:10.51649/healer.113

Prabha Weeranayake MS scholar
Pashmina Joshi MS (Ayu).
manisha kapadiya phD scholar
YR Meghani MS (Ayu).
TS Dudhamal MS (Ayu), PhD

DOI: https://doi.org/10.51649/healer.113

Keywords: Anal fistula, Bhagandra, Krimighna, Ksharasutra, Partial fistulectomy, Parasites.

Abstract

Background: Anal fistula remains a surgical challenge due to high recurrence rates, delayed healing, and postoperative complications. Ayurveda correlates this condition with Bhagandara, wherein Krimi Bhagandara is described as a subtype caused or aggravated by parasitic infestation. While modern literature sparsely documents parasitic involvement in anorectal diseases, ancient Ayurvedic texts emphasize Krimighna Chikitsa (antiparasitic therapy) as an essential component of management.

Case Presentation: A 60-year-old male presented with pain and purulent discharge from the perianal region for 12 days. TRUS revealed a low Intersphincteric fistula. Opting for a surgical approach, Partial fistulectomy with Apamarga Ksharasutra threading as well as the treatment plan included a series of Ayurvedic polyherbal formulations and topical applications for wound care. Parasites infestation was observed in the anal canal during surgery. Results: The wound showed healthy granulation and complete elimination of Krimi by the seventh postoperative day. Sequential Ksharasutra changes demonstrated steady tract reduction, and complete wound healing occurred by the 40th postoperative day, with no recurrence after two months.

Conclusion: This case highlights the efficacy of an integrative approach combining surgical intervention with Ayurvedic Krimighna Chikitsa and wound management principles. Addressing parasitic pathology alongside surgery ensured rapid healing, infection control, and recurrence prevention demonstrating a promising holistic model for managing parasitic fistula-in-ano.