Integrated management of Tubercular Fistula-in-ano: A case study.


  • Dr. Krishna Gyawali
  • Dr. Prasanna Narasimha Rao
  • Dr. Gopikrishna BJ
  • Dr. Mahesh Kumar ES


Ayurveda, Fistula-in-ano, Ksharasutra, Tuberculosis, Seton


Introduction: Tubercular fistula-in-ano is one of the extrapulmonary manifestations of Tuberculosis. Around 10-12% cases of Fistula-in-ano have been found to be tubercular in origin. This usually occurs along with pulmonary tuberculosis but can also occur in the absence of pulmonary infection. General management of fistula-in-ano through Ayurveda can be performed along with anti-tubercular chemotherapy in such cases.

Case Report:  A 24 year old male with Tubercular fistula-in-ano has been treated with Partial fistulectomy with Ksharasutra application and Anti-tubercular drugs per orally along with other oral medications and local treatment of the wound. Patient got relief from all his previous signs and symptoms along with complete healing of the fistulous wound without any adverse effects. It took 1 year and 2 months for the same without recurrence till the date.

Discussion: Fistula-in-ano has been well controlled with the Ksharasutra application which acts as a cutting as well as draining seton, where unhealthy granulation is destroyed by liquefaction necrosis of Kshara followed by wound healing. Tubercular infection is well controlled by the anti-tubercular drugs.

Author Biographies

Dr. Krishna Gyawali

Consultant Ayurveda Surgeon, Central Ayurveda Hospital, Naradevi, Nepal. 

Dr. Prasanna Narasimha Rao

SDM College of Ayurveda and Hospital, HASSAN, India. 

Dr. Gopikrishna BJ

SDM College of Ayurveda and Hospital, HASSAN, India.

Dr. Mahesh Kumar ES

SDM College of Ayurveda and Hospital, HASSAN, India. 


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How to Cite

Gyawali K, Rao PN, BJ G, ES MK. Integrated management of Tubercular Fistula-in-ano: A case study. IJATM [Internet]. 2021 Dec. 30 [cited 2024 Feb. 21];3(5):26-9. Available from: