Abstract

ROLE OF VIRECHANA KARMA IN THE MANAGEMENT OF BHAGANDARA (FISTULA-IN-ANO) - A CONCEPTUAL STUDY

*Dr. Sulfiath K. P.

Abstract

Bhagandara is one of the significant anorectal diseases mentioned in Ayurveda and it is one of the Ashta Mahagada because of its chronicity, recurrency and management. In today's medical practice, the disease is often related to the defect of fistula-in-ano, which is an abnormal channel connecting the anal canal to the perianal skin. According to classical Ayurvedic literature, Bhagandara is a Tridoshaja disorder wherein the Doshas, especially Pitta and Kapha gets vitiated and Pidika gets formed followed by fistulous tracts. Surgical and para-surgical treatments like ksharasutra therapy are well known in the treatment of this, but comparatively less emphasis is laid on its treatment by internal purification therapies. Virechana Karma is one of the main Panchakarma which is indicated for the elimination of vitiated Pitta as well as other Doshas via the Lower gastrointestinal tract. In the present conceptual study, it has been targeted to study the role of Virechana Karma in the management of Bhagandara from various classical Ayurvedic text like Sushruta Samhita, Charaka Samhita, Ashtanga Hridaya, Ashtanga Sangraha and other relevant text. Based on the classical description, it is inferred that Virechana might be helpful in Dosha Shodhana, regulation of Agni, elimination of Ama, Rakta Prasadana and reduction of inflammation process related to Bhagandara. In addition, Virechana can be used as a complementary treatment prior to or in conjunction with surgical or para-surgical procedures improving healing and minimizing recurrence. The theoretical and therapeutic importance of Virechana Karma in the holistic treatment of Bhagandara, and the need for future clinical research to substantiate its effectiveness have been emphasized.

Keywords: Bhagandara, Virechana Karma, Fistula-in-Ano, Panchakarma, Shodhana Therapy.