Development and Standardization of Guggulu-Based Ksharasutra: An Ayurvedic Approach to Fistula-in-Ano Management
Hemant Toshikhane, Harish Daga and Kamal Patel
Department of Shalya Tantra, Parul Institute of Ayurved, Parul University, Limda, Waghodiya, Vadodara, Gujarat - 391760 (India) *Corresponding Author: *Dr. Kamal Patel Contact No: +91 9408094493 Email ID: kamalpatel11101998@gmail.com
ABSTRACT
Ksharasutra is a specialized Ayurvedic para-surgical medicated thread extensively used in the management of anorectal disorders, particularly fistula-in-ano (Bhagandara). Conventional Apamarga Ksharasutra is highly effective but may cause burning sensation because of its strong alkaline nature. Guggulu-based Ksharasutra has been developed as an alternative by incorporating Triphala Shodhita Guggulu, Apamarga Kshara, and Haridra Churna to enhance antiinflammatory, antimicrobial, and wound-healing properties while maintaining therapeutic efficacy. The preparation involves coating Barbour linen thread No. 20 with 21 sequential layers comprising 11 coatings of Shodhita Guggulu, 7 coatings of Guggulu with Apamarga Kshara, and 3 final coatings of Guggulu with Haridra Churna, followed by controlled drying in an ultraviolet-equipped Ksharasutra cabinet and sterile packaging. This standardized method ensures uniform coating, sterility, and quality of the medicated thread. The combined pharmacological actions of Guggulu, Apamarga Kshara, and Haridra facilitate controlled chemical debridement, reduce inflammation, prevent microbial contamination, and promote faster wound healing. Thus, Guggulu-based Ksharasutra represents a promising and standardized Ayurvedic alternative for the effective management of Fistula-in-ano with the potential to improve patient comfort and clinical outcomes.