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An Innovative Clinical Study of Anal Stricture and its Management with PCA Therapy

Chaturbhuja Bhuyan, FormerProfessor and HOD, Surgery, Institute For Post Graduate Teaching and Research in Ayurveda, Gujarat Ayurveda University, Jamnagar, Gujarat 361008, India. , Chaturbhuja Bhuyan1 , Tukaram S. Dudhamal2 , Suprit J. Lobo3

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Indian Journal of Ancient Medicine and Yoga 10(4):p 117-124, Oct-Dec 2017. | DOI: DOI: https://dx.doi.org/10.21088/ijamy.0974.6986.10417.1

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Abstract

Background: The anal stricture is a fibrotic narrow way to anal canal, can be also called as anal stenosis, Due to stenosis of the stool passage, there is difficulty and strain defecation leads to painful bowel movements sometimes with bleeding or mucopus in chronicity which is correlated with Sannirudhaguda in Ayurveda. Usually it happens after anorectal surgery in about 90% of Haemorroidectomy and while treating malignant lesions of the pelvis under irradiation with radiation therapy, stenosis may result in 20%. The unsuccessful treatments inspired to find out result oriented method. It is an innovative study. The Ksharasutra under PCA therapy has been proved successful in treatment of Piles, fistula, pilonidal, sinus and KSS method in anal fissure Aim: To evaluate the effect of PCA therapy consisting of Ksharasutra suturing (KSS) and Kshara Malahar (KM) in anal stricture. Materials and Methods: Total 76 patients of anal stricture were selected and randomly divided into group A (24) groupB (20) and groupC( 32).In groupA, the patients were treated with KSS where as in groupB, KM and in groupC , both KSS and KM were carried out. Under spinal anesthesia A& C group patients were treated while the B group from the beginning and groupA, patients and after 7 days by removal of KS were KM applied continuously for one week under local anesthesia, The anal wound was treated for 04 weeks and the result was assessed on the basis of gradation. Results: The assessment of result in the groupC was 98.7% success and in the groupB it was 68.8% while in group –A the result was assessed 84%.The group C treated with the KSS procedure and KM showed the maximum benefit to the patients due to both procedures had continuous action to remove the stricture lesions from the anal area. Totally 89% cases were cured while 6.5% cases of group B marked improvement after 1st week of treatment and 2.6% cases of group A had moderately improved. Conclusion: The group –C patients, treated with KSS and followed with KM procedure were cured early in time as compared to other A group (KSS treatment alone), and B group (KM treatment only)

Keywords: Anal Stricture; Hemarroidectomy; Anastomosis; Sannirudhaguda Colostomy; PCA Therapy KS; KSS; KM. 

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DOI: DOI: https://dx.doi.org/10.21088/ijamy.0974.6986.10417.1

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