Mode of Action of Kshar Sutra
(1) The cut through of fistulous tract is effected by the pressure exerted on anorectal tissue by the moderately tight Kshar Sutra tied in the fistulous tract.
(2) The presence of Kshar Sutra in the fistulous tract does not allow the cavity to close down from either ends and there is a continuous drainage of pus along the Kshar Sutra itself.
(3) The Kshar Sutra slowly and gradually cuts through the fistulous tract from apex to the periphery. There is an ideal simultaneous cutting and healing of the tract and no pocket of pus is allowed to stay back.
(4) The Kshara (Caustics) applied on the thread are anti-inflammatory, antislough agents and in addition, have property of chemical curetting. The Kshar Sutra remains in direct contact of the tract and therefore, it chemically curettes out the tract and sloughs out the epithelial lining, thereby allowing the fistulous tract to collapse and heal.
(5) The Kshar Sutra, due to its antibacterial property, does not allow bacteria to multiply in its presence.
(6) The pH of Kshar Sutra was towards the alkaline side and therefore it did not allow rectal pathogens to invade the cavity.
Advise after kshar sutra therapy
(1) To be ambulated (stay active like walking) during the period of treatment.
(2) To take normal food daily and avoid irritant spicy food.
(3) To take fibre containing diet & vegetables with plenty of water.
(4) To avoid such types of foods which cause constipation.
(5) To keep the bowel clear regularly by taking suitable and mild laxatives.
(6) To avoid prolonged sitting as well as standing during the treatment.
(7) To avoid long distance travelling and driving.
(8) To keep the anal region clean and do proper dressing.
Benefits of the Ksharsutra Therapy
(1) It is an Out Patient Treatment.
(2) Performed mostly under Local anesthesia.
(3) Only 30- 45 minutes is required for the procedure.
(4) Hospital stay is usually minimum (5-6 hrs).
(5) Minimal bed rest is required after the procedure.
(6) Patient can resume his / her daily routine within 3 to 5 days.
(7) The recurrence rate is very less after Ksharsutra ligation procedure.
(8) Most important benefit of Kshar Sutra Therapy over Modern Surgeries is that the muscles that supports the Anus and helps in controlling the bowel movements are not dissected and hence the possibility of Anal Incontinence (loss of power to hold stools) is not there.