11 March 2019 | Interviews
Kshar Sutra is an ayurvedic parasurgical treatment used to help manage Anorectal disorders such as hemorrhoids, fistula-in-ano, anal fissure, and pilonidal sinus. Dr. Parameshwar CM, Chief, Bengaluru Smiles Hospital talks about this procedure.
What is the procedure of Kshar Sutra?
Kshar Sutra is an ayurvedic parasurgical treatment used to help manage Anorectal disorders such as hemorrhoids, fistula-in-ano, anal fissure, and pilonidal sinus. Kshar Sutra is performed by first coating a surgical linen thread of gauge number 30 with Snuhi Latex 11 times, snuhi latex and Apamarga Kshara 7 times, and snuhi latex and turmeric powder 3 times. The patient is anesthetized and a malleable probe with the surgical linen thread (called the Kshar Sutra) in its groove is passed through the external opening of the fistula to its inside and the probe is then carefully taken out with the Kshar Sutra intact. After this, both ends of the Kshar Sutra are tied together and replaced with a new one after a week. Because of this procedure, the tract is eventually cut and healed by the removal of unhealthy tissue. This controls microbial infection and facilitates drainage of pus in the tract aiding in healing.
The therapy for Pilonidal Sinus is done in a similar manner while for hemorrhoids a patient is first sedated after which the pile mass is brought out of the anal orifice using forceps and then the mass is given an incision at the mucocutaneous joint after which the pile mass is pulled and transfixed with Kshara Sutra at its base. Finally, the pile mass in the rectum is replaced with Yastimadhu Taila or ghrita.
What are the benefits of integrating the therapies and how Ksharsutra helps in healing in a better way
Ayurvedic treatments such as the Kshar Sutra are extremely benign and don’t have any side effects. After the Kshar Sutra the results a patient experiences are permanent and benign. This makes Kshar Sutra an effective treatment for those suffering from hemorrhoids, fistula-in-ano, anal fissure, and pilonidal sinus. Those who undergo such treatment recover from the treatment in just 3-5 days after having stayed at the hospital for only 5-6 hours only 30-45 minutes of which are used to perform the surgery.
An advantage of Kshar Sutra is that consultation for the surgery only costs 200 to 300 rupees while treatment costs only between 1,500 to 2,000 rupees, well within the reach of every Indian. Because the treatment is completely natural there are few if any after effects from the surgery which is hugely advantageous for patients.
Kshar Sutra is beneficial to many patients however there are benefits to integrating this surgery with other techniques as well. For instance, this treatment can be supplement by patients who can opt for home remedies such as eating food rich in fiber and consuming more water. Also while this surgery is an effective first line of treatment, if a patient’s condition worsens then advanced techniques such as DG-HAL RAR, MIPH, RFA, and IRC may be used.
What are the factors responsible for increasing colorectal cancer in India?
Over the past few decades, there has been an increase in the number of Indians suffering from colorectal cancer. One of the biggest reasons for this the hectic urban lifestyle so many Indians have adopted. A part and parcel of this lifestyle are that more and more Indians today are eating out and often eating unhealthy food. Foods such as fast foods are high in fat and cause people to become overweight or obese. People who are overweight or obese are far more likely to suffer from colorectal cancer than others.
Other factors that are leading to increasing incidents of colorectal cancer are that people are often not getting exercise. Exercise is essential to remain fit and for the body to continue functioning optimally. Because today much work is performed inside an office people in Indian cities don’t get enough exercise. Another reason why colorectal cancer rates are rising is that people eat irregular meals. This means they eat at different times during the day, every day, putting the body’s rhythm out of synchronicity leading them to eat more at odd times and becoming overweight or obese.
Your views on colorectal cancer market in India? (In terms of vaccines, R&D and treatment)?
My view about colorectal cancer is that it’s important that people adopt a lifestyle that prevents them from getting it. While nearly 50% of those over the age of 50 will suffer from piles, many such people will also suffer from colorectal cancer without knowing it. This is because unfortunately many people are wrongly diagnosed to be suffering from piles when in fact they have colorectal cancer. This is a serious cause of concern because such people may decide to undergo surgery for piles but find that their symptoms don’t improve. It’s important for doctors to correctly diagnose patients and to not simply assume someone who has symptoms similar to piles is suffering from piles and not colorectal cancer.
By eating right and by incorporating healthy foods into their diets including fresh fruits, vegetables, and fiber patients have a better chance of being healthy and not getting piles or colorectal cancer.
What are the major challenges before this market? (In terms of policies, R&D or any other sector)?
Perhaps one of the biggest challenges before this market is the mindset of those who suffer from a colorectal disease. This mindset leads many to not want to seek treatment for colorectal diseases such as piles because of the stigma attached to this disease. Many of those who suffer from colorectal disease also believe that the disease is a punishment from God and that it is contagious. This leads them to not share their problem with others and to suffer the disease in silence when treatment for the disease could greatly improve their lives.
The presence of lakhs of quacks across India is also a challenge in this market because quacks often create more problems for those who come to them for treatment than they solve. The malpractice of quacks leads many to suffer even more after being treated by quacks than they suffered before. Some of those treated by quacks go so far as to commit suicide. Hence the mindset of people should be remoulded and the menace of quacks should be tackled to help this market.