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Bleeding and Pain in rectum hemorrhoids

Pain in rectum, which surgery  is best for hemorrhoids.

Pain persist. How to get relief?

hemorrhoids is the most common problem now a days due to uncontrolled and bad eating habits people have constipations which is the main cause for developing the hemorrhoids.

The main problem comes when it bleeds from rectum and sometime it may bleed so vigorously that the patient may become anemic due to loss of enormous blood loss.


what are surgery for hemorrhoids :–

  • for hemorrhoids many types of the surgery available in the current modern methods and in ayurveda .
  • Internal hemorrhoids
  • Surgical removal of hemorrhoids (hemorrhoidectomy)

what is the difference between the modern and Ayurveda (kshar-sutra ) surgery

Modern (hemorrhoidectomy)

Ayurveda Kshar-Sutra Ligation

  • in modern most common process is to remove the complete hemorrhoids at once.
  • in kshar-sutra the hemorroisa is ligated with the kshar-sutra medicated thread , and the hemorroids will cut out within 2-3 day
  • in modern their are a need of blood as in the process the blood loss is possible.
  • in kshar-sutra no need of extra blood because their is no or mini blood loss as compaired to modern way.
  • patient may have to rest for 2-5 day hospitalized.
  • no need for hospitalised patient may go to home within 2-4 hr after the surgery.
  • patient may have to stope food and motion for 2-4 days
  • no need to stop motion or food, patient can live normal life and diet.
  • pain may persist for many days after the surgery
  • no pain or a slight pain after the surgery for 1-2 day and after that no pain at all .
  • about 50% cases may have problem of recurrence
  • 99.96% accuracy without any recurrence


these are the main differences as in modern process and in kshar-sutra ayurveda surgery.

I hope it will help you to choose the right process for your hemorrhoids .

if you wants kshar-sutra then get an appointment at our clinic or just contact us.


PILES/ HEMORRHOIDS : Kshara-sutra treatment


  • Secondary causes
  • Primary causes
  • ¬†Anatomical factors
  • ¬†Dietary habits
  • ¬†Pregnancy
  • ¬†Faulty habits of defecation
  • ¬†Diarrhea and dysentery
  • ¬†Abdominal tumors
  • ¬†Constipation
  • ¬†Carcinoma of rectum
  • ¬†Portal obstruction
  • ¬†Heriditary


  • A. In relation to site of origin
    • 1. Internal hemorrhoids
    • 2. External hemorrhoids
    • 3. Interno-external hemorrhoids
  • B.¬†In relation to pathophysiologically
      • 1. Mucosal
      • 2. Vascular
  • C.¬†In relation to pathological anatomy
      • 1. Primary hemorrhoids
      • 2. Secondary hemorrhoids
  • D. In relation to facilitate the line of management
    • 1. 1st degree hemorrhoids
    • 2. 2nd degree hemorrhoids
    • 3. 3rd degree hemorrhoids
    • 4. 4th degree hemorrhoids

internal piles

  • In case of internal piles due to hare stools, rectal veins are stretched and ruptured and bleeding occurs through them. After passing stool 10 ml – 30 ml blood flows out through anus. After few days, some fleshy part descends down which is reddish in colour and it goes in automatically.

External piles

  • External piles have different symptoms. In this bleeding is not seen but fleshy out growth is seen in the periphery of the anus which is of skin colour or black. After sitting for long time or having non veg diet, this growth swells and pains and itching occurs. The person cannot walk properly. These piles can be one or more in number.

Merits Of Kshar-sutra : 

  • * No recurrence.
  • * No incontinence.
  • * No post-operative complications.
  • * No daily dressings.
  • * Low treatment cost.
  • * No prolong hospitalization.
  • * Patient can walk freely after an hour of treatment.

Fistula in ano common Questions and Answers

Fistula in Ano Question? and their Answers ::

What is an anal fistula?

  • A fistula in ano is a tunnel like- pipe like track, developed in the perennial region, usually having one or more external openings around the anus leading to an internal opening in the mucosa of the anal canal or the rectum.
  • Anal fistula is termed “Bhagandara” in Ayurveda. In Ayurveda fistulas, like other diseases have been classified according to the vitiation of one per more of the three doshas i.e. the vata, the Pitta & the kapha. They have been classified also according to the shape & site of the track of the fistula. Special treatment for such different kinds of fistulas is mention in detail. It is worth noting that the complex & most challenging horse shoe fistula ( complex Ischio-rectal fistula) has been dealt with in detail in Sushruta a classical Ayurveda text) even as early as 300 ad.
  • The Ksharsutra treatment was probably first advised per this type of fistula named Parikshepi Bhagandara by Sushurta. This Ksharsootra treatment, with a little modification has proved its worth even in modern times.
  • Anal fistula, a rare condition, is a chronically inflamed, abnormal tunnel between the anal canal and the outer skin of the anus. It often drains watery pus, which can irritate the outer tissues and cause itching and discomfort.

Fistula In Ano an AyurvedicTreatment1

How does it occur?

  • An anal fistula usually results from an infection that forms in the tissue lining the anal canal. The infection may be caused by spread of bacteria that normally exist in the rectum. Occasionally, it may occur as a result of :
    A healed sore in the rectal area
    Ulcerative colitis, a disease associated with ongoing breakdown of tissues that causes a sore in the lining of the colon
    Diverticulitis, inflammation of harmless growths in the wall of the intestines
    Crohn’s disease, a chronic inflammation of the intestines
    Cancer of the large intestine.

What are the symptoms?

  • Symptoms of anal fistula may include :
    A patient of fistula in ano often suffers from a recurrent, small or large boil/boils/abscess surrounding the anus, accompanied with pain, discomfort & pus/blood discharge.
    The symptoms subside when the boil / abscess burst spontaneously causing some more discharge for a couple of days.
    The boil / abscess “heals up” temporarily but almost always reappears after some times.
  • Itching, discharge of watery pus, irritation of tissue around the anus, discomfort & pain these are the main symptoms of the fistula in ano

How is it diagnosed?

  • To diagnose an anal fistula, the doctor will review your symptoms, give you a physical exam, and may use the following procedures:
    Anoscopy / Proctoscopy , a procedure in which the doctor inserts an instrument called an anoscope into the rectum to inspect the anus and lower part of the rectum
    Probing examination: a procedure in which the surgeon insert an instrument called anal probe it to the external fistulous opening to internal fistulous opening.
    Sigmoidoscopy , a procedure in which a doctor uses a flexible or rigid scope to inspect the lower part of the intestine for inflammation and/or disease
    A biopsy to evaluate for inflammation or cancer
    Lower gastrointestinal (gi) series, a procedure that uses a special fluid to show the intestines better on x-ray
    A lower gi series requires a clean, clear gi tract. The doctor will prescribe a special diet, including plenty of water, for the day before the procedure. In addition, you may be given an enema the morning of the procedure.

Causes of anal fistula?

  • In a few cases there is a previous history of ano-rectal abscess.
    Some times a fissure in ano/ anal fissure gets infects & the infection travels down to form a track or a fistula.
  • However in most cases there are no definite causes found.
  • Possible contributing factors
    Tearing of the lining of the anal canal.
    Infection from an anal gland
    Chron’s, ulcerative colitis, tuberculosis
  • Guide lines to approach an expert for investigating a possibility of anal fistula.
  • Recurrent boils developing at the same site. (around the anus)
    Burning sensation or pain in perennial region
    Pus discharge /blood discharge in perianal or from the anus.

Modes of treatments of anal fistula?

  • Anal fistulas are almost never found to heal spontaneously. The inner wall of the fistula develops fibers tissue & payogenic membrane not allowing spontaneous healings.
    The most commonly followed mode of treatment is laying open the entire track of the fistula and removing the fibrous tissue & payogenic membrane. This sometimes, in complex fistulas is done in two or more sittings. In certain cases a silk setone is passed through parts of the track. (see detail )
    The Ksharsutra / Ksharsootra ( Medicated Setone ) Ligation.
    Laser Surgery ( Fistulectomy / fistulectomy by laser beam )
    Laying open the fistula and applying a skin graft.
    Laying open, excision of the fistulous track and suturing the wounds.
    Coring out the fistulous track. ( link with core technique for fistula )
    Sealing with fibrin glue.
    Fistula Plug Management.
    VAFT Technique for anal fistula.
    Reconstruction with flap surgery for anal fistula.
  • Ayurveda has a unique way of treating fistula in ano. Simple as well as complex fistulas, high anal fistulas, fistulas with multiple track, recurrent fistulas, chron’s fistula, tubercular fistula, all respond well to the Ksharsutra ligation procedure.

What is Ksharsutra / Ksharsootra?

  • The Ksharsootra /Ksharsutra is a type of thread / medicated setone prepared by coating and recoating the thread 15 to 21 times with different drugs of plant origin. The mechanical action of the treads and the chemical action of the drugs coated on the thread, to gather do the work of cutting, curetting, draining, and cleaning the fistulous track, thus promoting healing of the track/ wound.
  • A number of drugs like,
    Apamarg kshar (see picture)
    Kadali kshar (see picture)
    Arka kshar (see picture)
    Nimb kshar (see picture)
    Snuhi ksheer (see picture)
    Udumber ksheer (see picture)
    Papaiya ksheer (see picture)
  • And natural antibiotic like haridra powder, guggulu, etc are used in the preparation of different kind of Ksharsutra. It takes a number of days to prepare this Ksharsutra since the previous coat has to dry before the next is applied.
  • Different kinds of Ksharsootra are prepared using different drugs. These Ksharsutra are passed through the track (usually under short anesthesia) and the two ends of the thread are tied forming a loop.
  • The drugs coated on the thread are continually released through out the length of the track there by cutting, curetting, draining cleansing and healing the track simultaneously in the track after about eight days the thread loosens because it has cut through some of the tissues and also is now almost bare ( with no drugs on it). A new thread is now replaced in the track by a special method.
  • The changing of the thread is a simple opd procedure taking about 1 to 2 minutes and requires no anesthesia.
  • the thread gradually cuts through the tissue. The tissues above the thread heal up. Hence when at last the loop of thread comes out, the track is healed.
  • Ksharsootra (medicated setone) therapy is practiced in India since times immemorial. Modified and revived by the late Dr. P. J. Deshpande. The Ksharsootra therapy is a unique treatment of Ayurveda gaining popularity globally.
  • Special types of medicated setone are used in this procedure Found to be effective in any ano rectal conditions, it has many advantages in the treatment of Anal fistulae.

Benefits of the ksharsutra ligation procedure over other methods in anal fistula?

  • The Ksharsootra ligation method is an age old, time tested procedure originally performed by Sushruta (the father of surgery) around 300 ad. The fact that it is still in practice to day is a proof in it self of its efficacy.
  • The Ksharsutra procedure is performed under short acting anesthesia / local anesthesia and some times even without anesthesia.
  • The procedure usually dose not require hospitalization for more than 4 to 5 hours.
  • The patient requires minimal bed rest & can resume his / her daily routine within 12 to 24 hours.
    It gives freedom from pain full dressings.
  • There is no loss of glutial mussels and hence the anatomy of the peri anal region is not distorted. The procedure lives just a pencil scar at the site.
  • The recurrence rate which is usually found to be quite high after other methods is less than 2% after Ksharsutra ligation procedure. This is because the medicines on the thread gradually and continually curate the payogenic membrane and fibrous tissue in the track and thus leave no pus pockets un drained.
  • Chances of partial or complete incontinence of flatus or / and faces (loss of control of passing stool / flatus) are always present in many types of fistula, (especially in fistulae involving the sphincter muscles after the conventional procedure. ( Fistulectomy Fistulotomy ). There are no chances of developing incontinence in Ksharsutra ligation method.

How can i take care of myself ?

  • Using stool softeners Adding fiber to your diet
  • Drinking plenty of water, up to 8 eight-ounce glasses a day
  • Taking warm baths
  • Using clean, moist pads to wipe the area around the anus, to remove irritating particles and fluid from the fistula
  • Using special skin creams to soothe irritated tissue.
  • How can i help prevent an anal fistula?
  • Follow these guidelines to help prevent an anal fistula. They help to keep the lower gastrointestinal tract healthy.
  • Eat food high in fiber.
  • Drink plenty of water each day (up to eight 8-ounce glasses).
  • Have regular physical exams to look for underlying diseases of the rectum.
  • Be aware of the signs and symptoms of bowel disease, and seek medical attention if any appear.

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Home remedies for Hemorrhoids or piles Causes and Ayurvedic Treatment

Home remedies for Hemorrhoids or piles

  • Hemorrhoids or piles are swelling and inflammation of veins in the rectum and anus.
  • Hemorrhoids are masses of tissue within the anal canal that contain blood vessels and surrounding tissue of support provided by the muscles and elastic fibers. Hemorrhoids can be internal or external.
  • Long Constipation, pregnancy, tumors in the pelvis and chronic diarrhea and dysentery are some of the known causes of hemorrhoids.
  • In Ayurveda, hemorrhoids are called as Arsha Shoola, which literally means “like needles pricking pain.
  • This is indeed how the pain of hemorrhoids is felt. It is¬† caused due to the disturbance of any of the three doshas.
  • It is classified as a digestive disorder, accumulation of waste materials in the rectal area may lead to batteries.
  • Chances that the batteries are augmented by other factors, such as sitting on hard seats, chronic constipation and pregnancy.
  • Hemorrhoids caused by any of the three doshas,have different symptoms according to body type.
  • 1. Vata type of Hemorrhoids : These piles are hard and darker in color, almost black. The pain is acute. Constipation is present.
  • 2. Pitta type of Hemorrhoids : These piles are soft and reddish. The bleeding is present. Other symptoms are excessive thirst, fever and diarrhea.
  • 3. Kapha type of Hemorrhoids : These piles are slimy to the touch. They are big and soft and whitish. The person has digestive problems.
Home remedies for Hemorrhoids or piles 2

Home remedies for Hemorrhoids or piles Causes and Ayurvedic Treatment

Symptoms of Hemorrhoids :

  • hemorrhoid may protrude through the anus outside the body, not becoming irritated and painful.Symptoms of external hemorrhoids may include painful swelling
  • In addition, excessive straining, rubbing or cleaning around the anus may cause irritation with bleeding and itching, which may produce a vicious cycle of
  • or a hard lump around the anus that results when a blood clot forms in blood.
  • symptoms.
  • The most common symptoms of radiation from internal hemorrhoids is bright red blood in the stool, on toilet paper or in the toilet bowl. However, an internal

Causes of Hemorrhoids :

  • Carrot (Daucus carota) :Carrots are effective in reducing bleeding hemorrhoids. They can be eaten raw or cooked form.
  • Garlic (Allium sativum) : Garlic can stop the growth of bleeding piles. When maintained in contact with the battery, that is, rectum, then there is relief of the battery hemorrhage. Ideally, should be inserted high into the rectum to stay there overnight.
  • Herbs useful in the treatment of hemorrhoids :
  • Sitting for a long period of time may start the process of hemorrhoids. Hemorrhoids are also most likely caused by diet and straining on the toilet. Other factors that contribute to hemorrhoids include aging, heredity, bouts of diarrhea, using laxatives. For women, pregnancy is often a factor as the fetus puts pressure on the hemorrhoidal veins.
Home remedies for Hemorrhoids or piles 4

Home remedies for Hemorrhoids or piles Causes and Ayurvedic Treatment

Treatment for Hemorrhoids:

  • Any food that is difficult to digest should not be consumed. These include fatty and spicy foods, red meats and rich desserts. Instead green leafy vegetables should be consumed in large quantities, as they have the necessary fibers required for proper digestion.
  • Ayurvedic Treatment for Hemorrhoids have two concerns – one is to reduce the constipation that is associated.When constipation is under control, then the methods is used to reduce the pain of hemorrhoids. Application of sandalwood or sesame oil in the batteries can help in external cases. In order to reduce constipation other dietary items such as butter, buttermilk and green leafy vegetables is supposed to take by the patient. Traditional Ayurveda offers effective treatment for hemorrhoids.
  • Dietary¬† plan for hemorrhoids :
  • Since hemorrhoids are usually caused due to low digestive fire, you must have a proper diet to prevent or treat disease. The following dietary guidelines must be followed: –
  • The food which tastes bitter and astringent are better in the case of hemorrhoids. Foods with these tastes should form the bulk of the diet.
  • Vegetables such as spinach, radishes, yams, carrots and okra are beneficial.

Home remedies for Hemorrhoids:

  • Chebulic Myroblan: The fruit should be roasted to a brown oil custard, and then powdered and stored. Half a teaspoon of this powder at bedtime will bring normal bowel movements in the morning and the astringent property of the fruit cure piles masses.
  • Dried figs: Three or four dry figs should be soaked overnight in water after being cleaned thoroughly with warm water. Should be taken first thing in the morning along with the water in which are immersed. In a similar manner. This treatment should be also taken at night and must be continued for 3-4 weeks.
  • Ginger: Half a teaspoon of fresh ginger juice, mixed with one teaspoon each of fresh lemon juice and fresh mint juice and a teaspoon of honey, constitutes an effective medicine for piles.
  • How to prevent hemorrhoids:
    Changing your diet to include more bran or fiber and drink more water, changing bowel habits and exercise and not sit around for long.
  • Jambul Fruit: The fruit should be taken with salt every morning for two or three months during the season.
  • Onion: About 30gm finely rubbed with water and sugar added 60 gm. It should be taken twice daily by the patient.
  • Radish: 100gm grated radish mixed with a teaspoon of honey can be taken twice daily in treating this condition.
  • Rice: A thick gruel of rice mixed with a glass of milk and a ripe banana should be administered twice daily.
  • Seeds handle: The dry powder mango seed should be given in doses of approximately 1 ¬Ĺ to 2 grams with or without honey, twice a day.
  • Sesame seeds: It may be taken as a seed decoction 20gm boiling in 500 ml of water until it is reduced by 1/3 or sweets. Ground to paste with water, can be given with butter for bleeding piles.
  • Turnip: the juice from turnip leaves must be extract and about 150 ml is administered to the patient. However, you need to have a proper diet of raw fruits and vegetables while taking this juice.
    Bitter gourd: Three teaspoon juice of bitter gourd leaves mixed with a glass of buttermilk should be taken every morning.
  • Wheat grass: Wheat grass juice used as an enema helps detoxify the walls of the batteries.

Treatment —

Hemorrhoid Laser Surgery Advantages and Disadvantages

Laser surgery: When is it the right choice? Advantages and Disadvantages

  • Lasers are strong enough to cut through diamonds, yet they can be gentle enough to sculpt the delicate surface of your eye.
  • In the medical world, these scalpels of light are helpful in many procedures. But as high-tech as these magic wands are, they can’t zap away every problem. They may be the right tool for some surgeries but not the best choice for others.
  • In addition, as with any operation, the success of laser surgery depends largely on the surgeon’s skill and determining whether the procedure is appropriate for you.
  • The word laser stands for light amplification by stimulated emission of radiation. Laser beams are strong beams of light produced by electrically stimulating a particular material. A solid, a liquid or a gas is used.
  • Lasers generally are named for the substances that produce them. Widely used lasers include the carbon dioxide laser and the argon laser.
  • The combination of the intensity of the light and the ability to focus it on a small area gives lasers their useful role in medicine. Lasers can be used to :
    Cut or destroy tissue that’s abnormal or diseased
    Shrink or destroy tumors or lesions
    Burn off or vaporize tissue
    Sculpt tissue
    Seal blood vessels
  • “Basically what lasers do is vaporize tissue. A scalpel cuts tissue. Lasers also cut tissue, but cut it by destroying (vaporizing) the cells,” says Dr. Webb.
  • Not all lasers burn through tissue. Some lasers, like those used on the eye, gently sculpt tissue without producing significant heat.

Distinct Advantages

  • Lasers have not replaced scalpels. But they do help doctors perform some procedures more effectively than with traditional methods. Lasers cause minimal bleeding, allowing surgeons to have a clear view of the area of surgery. Because of their precision, lasers allow doctors to work on small and hard-to-reach parts of the body. Doctors can also vary how deeply the laser penetrates tissue by adjusting the light’s intensity.
  • In addition, laser surgery may pose less risk of infection and cause minimal scarring. In some cases, laser surgery is faster than traditional surgery, shortening recovery time. Some laser surgeries are performed under a local anesthetic in a doctor’s office. Others require general anesthesia and a hospital stay.
  • Skilled surgeons use laser light with pinpoint accuracy. The unwanted hemorrhoid is simply vaporized or excised. The infinitely small laser beam allows for unequaled precision and accuracy, and usually rapid, unimpaired healing.
  • The result is less discomfort, less medication, and faster healing. A hospital stay is generally not required. The laser is inherently therapeutic, sealing off nerves and tiny blood vessels with an invisible light. By sealing superficial nerve endings patients have a minimum of postoperative discomfort. With the closing of tiny blood vessels, your proctologist is able to operate in a controlled and bloodless environment.
  • Procedures can often be completed more quickly and with less difficulty for both patient and physician. Laser can be use alone or in combination with other modalities. For more detailed information on combining modalities in surgery, view opilesur video on the performance of both a Laser & Harmonic Scalpel Hemorrhoidectomy.

Distinct Disadvantages

  • laser may cut unwanted tissue and if it may divert to any healthy tissue it may cause savior damage to the health tissue and may cause uncontrolled bleeding .
  • The Laser process is very costly as compared to other processes .
  • It may cause fibrosis to the tissue after cutting which may cause fissure in future which is a secondary complications of such processes .

Kshar Sutra Center MsArogyam @ Noida, NCR, Delhi, Faridabad, Gurgaon, Ghaziabad

Kshar Sutra Center MsArogyam @:: NCR, Delhi, Faridabad, Gurgaon, Noida , Ghaziabad

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Kshar Sutra for fistula

Fistula Treatment By KsharSutra

Kshar sutra operation @ Vinayak Hospital multispeciality trauma centre Ghaziabad Opposit Raj Nagar Extention


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