A surgical thread is coated about 21 times with three herbal ingredients: Snuhi (Euphorbia) latex, which binds the coating; Apamarga kshar (an alkaline herbal ash), which gently cuts and cleans the track; and turmeric (haridra), which controls infection and supports healing.
| Step | What happens |
|---|---|
| 1. Examination | Track length, direction and internal opening are assessed; MRI fistulogram if the fistula is complex or recurrent. |
| 2. Thread placement | Under local anaesthesia, the medicated thread is passed through the track with a fine probe and tied outside. |
| 3. Weekly change | Every 7 days the old thread is replaced with a fresh one — a few minutes in the clinic. |
| 4. Cutting and healing | The thread cuts about 0.5–1 cm of track a week while healing occurs behind it, protecting the sphincter muscle. |
| 5. Complete healing | After the thread cuts through, the small wound heals in 2–4 weeks. |
| Condition | How Kshar Sutra / Ksharkarma is used | Typical recovery |
|---|---|---|
| Piles (grade 2–4) | Thread tied at the base of the pile (ligation) or kshar applied (ksharkarma); the pile shrinks and falls off | Pile falls in 7–10 days; back to work in 1–2 days |
| Chronic fissure / sentinel tag | Kshar applied to the tag and chronic fissure bed, with medicines to relax spasm | Pain eases within days |
| Pilonidal sinus | Thread or kshar used to clear the hair-filled tract from inside | Few weeks, depending on tract length |
| Kshar Sutra | Laser | Open surgery | |
|---|---|---|---|
| Anaesthesia | Local | Spinal / general | Spinal / general |
| Admission | Day-care | Often 1 day | 1–3 days |
| Back to work | 1–2 days | Several days | 1–3 weeks |
| Recurrence (fistula) | Low in clinical trials | Higher, variable | Moderate |
| Overall cost | Lowest | Highest | High |
In a multicentric randomised trial by the Indian Council of Medical Research (1991), Kshar Sutra showed lower fistula recurrence than conventional surgery (about 4% vs 11%). Read the detailed laser fistula success rate comparison.
Dr. Pronab Haldar (B.A.M.S., MD, PhD — Ayurveda) has performed Kshar Sutra in Indore for more than 18 years. Clinic: Capital Tower, Sapna Sangeeta Road, near Agrasen Square. Call +91 63720 62915 or WhatsApp +91 96912 41120.
An Ayurvedic para-surgical technique using a medicated thread to treat fistula, piles and similar conditions.
एक आयुर्वेदिक विधि जिसमें औषधीय धागे से भगंदर और बवासीर का इलाज होता है।
It is designed to keep discomfort low; most patients manage with simple medication and continue routine.
इसमें दर्द कम रहता है; मरीज़ सामान्य दवा से आराम पा लेते हैं।
It depends on the condition and severity; Dr. Haldar explains your timeline during consultation.
यह रोग और गंभीरता पर निर्भर करता है; डॉक्टर सलाह में बताते हैं।
