Namsakar you all are welcome to the Youtube channel of Planet Ayurveda. We are doctors team from Planet Ayurveda. Today we are going to discuss on (Anal fistula) bhagandar which has become a very common problem in both, men and women. Bhagandar means anal fistula. Anything which causes pain becomes a discomfort to anybody. It causes pain in such a place which makes your sitting, standing routines difficult and causes discomfort. So what is anal fistula? It is a tract between anal region and perianal skin which is painful in nature and with that pus discharge and foul smell also occur. Blood discharge is also there. There is a formation of new tract which joins anal region with perineum. So any person facing this issue faces difficulties in daily routine works. It makes sitting difficult and even in standing position also, person feels the pain. Patient with fistula can’t pass the faeces properly as defecation becomes painful and blood also oozes out so it also leads to anemia. It also gives mental distress to the patient. In today’s time every professional person such as banker, student, office going or a doctor, have to sit for their jobs but this issue makes it difficult. In Ayurveda it is told that when all three doshas get vitiated then it leads to the formation of bhagandar (Anal fistula). So doctor will you please explain how Ayurveda has explained bhagandar. As told in Sushrut Samhita, Anal fistula is explained as bhagandar in Ayurveda and its causative factors are the vitiation of vata, pitta and kapha dosha. It is classified further into different types like shatponak is vata predominant. Ushtergreev due to pitta dosha and paristravi due kapha dosha. Next is shambookavrat which happens due to all three doshas, also known as Sannipattaj. Unmargi is caused due to any injury or trauma. So what are the common symptoms seen in it? Main symptom is pain, even when the patients come here in clinic they keep walking and feel pain while sitting. Symptom of itching is very common and it is one of the initial symptoms, with this blood discharge and pus discharge also occur which is called as pyuastrava in Ayurveda. Sometimes pain becomes very severe which makes patient unable to sit as you have told. So what can be its causes? Its main cause is constipation. Loose stools can also occur. Patients of IBS, Ulcerative colitis can be seen with this. Obesity is also a major cause. So prevention from these issues also matters in this situation. If crohn’s disease is not treated properly then it can lead to the formation of anal fistula. In other medical systems, there is no proper treatment for it but in Ayurveda it has proper treatment, ksharsutra is also mentioned for such conditions in Ayurveda but here in Planet Ayurveda we can treat it with medicines only. So there is no requirement of ksharsutra. At Planet Ayurveda we have many products like vara chrna, triphla guggul, nirgundi oil and Curcumin. Vara churna is used in constipation as you told that constipation is the main cause and when patient passes the stool, in constipation it causes strain on the muscles and ruptures the internal muscles resulting in formation of the tract inside. So to give relief from the constipation we have vara churna which contains amla, haritaki and vibhitaki. To relieve constipation and normalize the peristaltic movements, vara churna is prescribed. It has anti-inflammatory action too, in fever and itching it can be used as well. So how we use nirgundi oil in it? It is used for local application and work as an analgesic. It is used for local application in anal region. We also have triphla guggul which contains amla, haritaki, and bibhitaki and it acts as an analgesic, anti-inflammatory and also controls the pus formation. Another medicine is Curcumin which is an extract of haldi (turmeric). We commonly use turmeric in any wound or cut. So Curcumin capsule can be taken one in the morning and one in the evening. Vara churna can be taken one teaspoon in morning and evening. Triphala guggul, 2-2 guggul 2-3 times in the morning or evening. So will you tell what lifestyle changes have to be done in this. First thing to do is that stop all fast foods. Try to drink water in lot of quantity which will help in hydrating the body and will help in passing the stools easily. Patient should take papaya daily and it will give a relief to the patient. With this one can take cabbage juice or can take it by boiling. One can also take citrus fruits like oranges, lemon. Amla is also very beneficial in it as it is 20 times more efficient and rich in vitamin C than other citrus fruits. Patient has to avoid all chilies, spices, unhealthy food and packed foods. Sitz bath is also recommended in it with any analgesic oil, warm oil or can use nirgundi oil. Take it for about 30 minutes, it acts as an analgesic and will help in healing the fistula. As it commonly happens to the person who has long sitting hours so they should use ring shape cushion. Take walk after fixed time and don’t sit for long hours. As in anal fistula pus comes out so don’t clean or rub that area again and again which can further aggravate the symptoms and will cause more irritation. So patient should change the diet and lifestyle. Take break from long sittings, lifestyle changes in diet are necessary, take hydrating things, and take more fibers. So many patients of anal fistula come to Planet Ayurveda, there are many patients of Crohn’s and Ulcerative Colitis who also develop fistula in later stages which worsen their condition. So for such patients we offer Fistula Care Pack with other medications like Curcumin, Boswellia Curcumin. If Pitta is aggravated then pitta balance is given, Dr. Vikram prescribes all these medicines by which within 3-4 months without any operation fistula patient get complete relief. So I recommend all of you to maintain a proper healthy diet and lifestyle and if you have to take treatment then opt for a herbal one because in allopathic treatment they will give steroids which will deteriorate and aggravate the condition and can further lead to formation of ulcers etc. Thank you so much.