What is Kshar Sutra And Herbs that are Used in Kshar Sutra Procedure?

Kshar Sutra

Are you suffering from an anorectal disorder? If yes, then various conventional medicines are available to treat the disorder. 

But most of them have specific side effects and will not provide permanent relief. Ayurveda treats anorectal disorders through natural herbs and has almost no side effects.

For instance, Kshar sutra is an Ayurvedic treatment that helps treat anorectal disorders like piles, hemorrhoids, anal fistula, and pilonidal sinus. The treatment is safe and cost-effective and is practiced in India and many parts of the World.

The article discusses about Kshar sutra treatment in detail. So, keep reading this article to know more about this Ayurvedic treatment.

What Are The Common Anorectal Disorders?

Anorectal problems can be of numerous types, which are listed below.

1. Pilonidal Sinus

It is a condition in which a small hole or tunnel will develop on the top of the buttock. The hole will be filled with fluid or pus, and gradually cyst can develop inside it. The cyst will be filled with dust, dirt, and debris. Sometimes cysts become infected, and blood will come out from the hole or tunnel-like structure on the top of the buttocks.

Pilonidal sinus usually occurs in men. Young adults who sit in one place for a long time typically have pilonidal sinuses.

You will notice first a dimple-like appearance on your skin. But lately, it may get infected and develop cysts or abscesses. You will have pain while sitting and standing. If the condition is serious, then the doctor advises you for surgery.

2. Anal Fissure

An anal fissure is a small tear in the muscle lining of the anus. The anus is where your digestive tracts and stool exit from your body.

The most common causes of anal fissures are constipation or strain while passing bowel. Sometimes the condition becomes serious that blood comes out from the anus. You may also experience muscle spasms near the anus, which is quite painful. An anal fissure is common in young adults.

Most anal fissures can be treated by soaking the anus in warm water or consuming fiber-enriched food. But if the condition becomes severe, then the doctor recommends surgery.

3. Anal Fistula

The anal fistula is a tunnel-like structure that starts from the anus and goes toward the skin inside the anus.

There are numerous glands inside the anus which create mucus. Sometimes these glands can get clogged with dust, dirt, and hair. Harmful bacteria and liquid will build up inside the gland, usually called an abscess.

Treatment is quite essential at this stage. But some people neglect it. As a result, the abscess will grow and make a hole in the skin near the anus to drain all the gunk.

The fistula is the tunnel connecting the abscess to the external opening. The abscess is the most common cause of fistula. There can also be other reasons, like sexually transmitted diseases and tuberculosis. But they are extremely rare.The common symptoms of anal fistula are redness and swelling near the anus.

4. Hemorrhoids

Hemorrhoids or piles are common anorectal disorders. The condition is characterized by swollen veins either inside or outside the anus. The patient will experience pain, itching, and bleeding from the anus.

People of all ages, including teenagers, can have hemorrhoids. But few people have a larger risk of having hemorrhoids. We are listing them below.

  • Pregnant women
  • Individuals are eating a low-fiber diet.
  • Individuals spend most of their time in the toilet
  • Individuals who lift heavy objects daily.
  • Obesity
  • Straining during bowel movements

What Is Kshar Sutra Treatment?

Kshar sutra is a para-surgical Ayurvedic procedure that helps manage various anorectal problems(conditions that affect the anus and rectum of an individual). It involves using medicated thread to treat issues associated with your anus or rectum.

Herbs Used In Kshar Sutra

1. Latex of Euphorbia neriifolia

Snuhi or Euphorbia neriifolia treats cough, swelling, and anorectal disorders. It is a small tree that grows up to a height of 20 feet. It grows mainly in dry regions of India.

The leaves and latex of the tree are used in various Ayurvedic medicines. The fresh milk latex of Euphorbia neriifolia can be wrapped on the surgical thread and used in Kshar sutra treatment.

2. Curcuma longa

Curcuma longa, or turmeric, is a well-known spice in India. But it has various health benefits. It mainly turmeric is a good source of vitamin B6, potassium, calcium, zinc, and other vitamins and minerals that can treat liver problems, digestive disorders, skin problems, and many more. 

It can also be used to heal any type of wound. Curcuma longa or turmeric is coated over the surgical thread user in Kshar sutra and used for treating piles, anal fistula, and other anorectal issues.

3.Apamarga Kshara(Achyranthes aspera)

The Apamarg Kshar(Achyranthus aspera) is a small perennial herb that grows in many parts of India. It has healing properties and can heal any type of wound. This herb is coated on the surgical thread of the Kshar sutra to treat any problems associated with the anus or rectum.

Pre Operative Requirements Of Kshar Sutra Treatment

  • The patient has to sign a few documents before undergoing Kshar sutra treatment.
  • The pubic area of the patient is thoroughly washed and cleaned the night before the treatment procedure. The medical staff also applies some antiseptic solutions.
  • The patient is not allowed to eat food before 6 hours of surgery.
  •  The patient needs to have clean bowels. So medical staff can provide an enema on the night and two hours before the procedure.
  •  The patient has to undergo some sensitivity tests.
  • The patient is given tetanus toxoid.

Procedure Involved In Kshar Sutra

Kshar sutra involves the preparation of surgical thread. The surgical thread of gauge 20 is first coated with Euphorbia neriifolia(Snuhi latex) 11 times. It is followed by snuhi latex and Apamarga Kshara almost seven times and then snuhi latex and Curcuma longa nearly three times. 

The prepared thread is sterilized by ultraviolet radiation and kept in a glass tube.The antibacterial property of the thread hinders the development of germs and microorganisms in the anal and rectal areas. Again the PH of the medicated thread is inclined towards the alkaline side, which prevents the pathogen from entering inside the anus of a patient. Thus anorectal disorders can be treated successfully.

A.Kshar Sutra In Anal Fistula

  • The patient is first given anesthesia and placed in a lithotomy position on the operation table.
  • Kshar sutra is inserted inside the groove of a metallic probe.
  • It is then inserted into the external opening of the patient’s fistula.
  • The probe and the Kshar sutra are removed by passing the fistula’s internal opening.
  • The probe is carefully taken out.
  • Both ends of the Kshar sutra are adequately tied so that they will form knots.
  • The thread will be replaced every week to avoid infections.
  • The wounds start to heal after 30 days, and within 45 days, the Kshara sutra sheds itself.
  • The presence of the medicated thread in the tunnel will not allow it to close from both ends. Thus the pus will drain along with the medicated thread within a few weeks.
  • Kshar Sutra can successfully treat any type of complicated anal fistula.

B.Kshar Sutra In Pilonidal Sinus

  • The Ayurvedic doctor first cleans the sinus cavity by using Kshar paste.
  • The patient will be given anesthesia and laid in the lithotomy position.
  •  Kshar sutra and a metallic probe are inserted into the external sinus(tube or tunnel-like structure) and made to come out from the internal one. The probe is removed, and threads are tied together.
  • The thread will be changed weekly. After 30 -40 days, the thread automatically sheds off by tearing the sinus cavity.
  • The Ayurvedic doctors recommend applying some herbs at the wound site, and the patient is entirely recovered within 7-10 days.

C.Kshar Sutra In Hemorrhoids

  • The patient is first given anesthesia and laid in the lithotomy position.
  • The gel is applied on the anal area so the pile’s mass comes automatically outside the anus.
  • Sometimes the pile mass fails to come outside. In such cases, the Ayurvedic doctor uses forceps to bring the pile mass outside the anus. 
  • A cutting at the mono-cutaneous joint is then followed.
  • The metal probe and the Kshar sutra are inserted into one end of the pile mass. 
  • It is then allowed to come on the other side of the pile mass.
  • The probe is removed carefully.
  • Both the ends of the Kshar sutra or medicated thread are tied together.
  • The process is repeated in all the pile mass of the patient.
  • The pile mass is allowed to go back again to the rectum. 
  • The thread cuts off the blood supply.
  •  The pile mass dries off after a few weeks, along with the Kshar sutra.

Post Operative Guidelines To Be Followed After Kshar Sutra Procedure

After the surgical procedure, the patient is given various antibiotics and medicine to reduce pain and inflammation. For example, Panchavalkal (a combination of five herbs) is given to heal wounds faster. Additionally, the doctor recommends having a sitz bath at least three times in one week. The sitz bath will significantly help heal wounds and provide relaxation near the anal area.

The doctor even prescribes Guggulu, haritaki churna, and Triphala to take with lukewarm water every night before bed. The patient has to take it for almost two weeks after the Kshar sutra procedure.

The Ayurvedic doctor even prescribes jatyadi tel. It is herbal oil which enhances the healing process of anorectal disorders. It even gives you relief from itching and burning sensations. The Jatyadi tela helps to release the stool without any problem. It even reduces the swelling near your anal area. The patient must apply on the anal area almost two times a day.

The patient needs to take fiber-enriched foods and laxatives so that stool will pass from the anus quite easily.

The patient should stay active after the surgical procedure. Mild exercises like walking can be the best option for the patient.

The patient must avoid traveling long distances. Additionally, the patient must avoid sitting or standing for a long time.

Time Required To Recover After The Kshar Sutra Procedure

The surgical procedure is carried out only for 30-35 minutes, and the patient must stay in the hospital for approximately 5-7 hours. The time required for complete recovery will be only 3-5 days after the entire treatment.

Cost Of Kshar Sutra Treatment

The consultation fees for treating anorectal disorders are almost Rs200 to Rs300. However, the surgery cost is almost within Rs1500 to Rs 2000, which is affordable.

Are There Any Alternatives To Kshar Sutra Treatment?

Yes, there are alternatives to the Kshar sutra treatment. If the anorectal disorder is not in the third or fourth stage, you can take specific home remedies like fiber enriched diet and high water intake. It will help to pass the stool from the anus easily and will not even strain the anal or rectum muscles.

If the conditions worsen, the doctor recommends certain medications for treating the problems associated with the anus or rectum.

But the medications and home remedies will give temporary relief. If the condition becomes severe, then the doctor recommends surgery.

We recommend doing Kshar sutra, para surgical Ayurvedic treatment for anorectal disorder. It has very few chances of recurrence and has almost no side effects.

Difference Between Conventional Surgery And Kshar Sutra Therapy

  • Twenty percent of conventional surgery individuals can have a fistula or pile recur. But there is almost no chance of fistula recurring in Ksar sutra surgery.
  • Conventional surgery is usually done by giving general or spinal anesthesia. So, the patient can have side effects like back pain, urinary retention, or headache. But in Kshar Sutra treatment, local anesthesia is given. Hence the patient will not have any side effects.
  • The complications involved in conventional surgery are stool incontinence or hard-to-pass stool, infection, and bleeding. But such complications are not found in Kshar sutra therapy.
  • Conventional surgery can sometimes require Hospitilzion, particularly in the Anal fistula. But Kshar sutra therapy is an OPD procedure, and the patient is not hospitalized.
  • Conventional anal or rectum surgery is quite costly compared to Kshar sutra therapy.
  • Conventional surgery is usually followed by bed rest, whereas the patient doesn’t need to take bed rest in Kshar Sutra therapy. The patient can resume work after three days after the Kshar sutra procedure.

Who Can Do Kshar Sutra Treatment?

Anorectal disorders like pilonidal sinus, hemorrhoids, and anal fistula can occur in young adults, children, and even older adults. So, people of any age can have problems with their anus and rectum.

The doctor first tries to treat through medicine. But when the condition becomes severe, then the doctor recommends surgery. So, Kshar sutra treatment can be done by any individual except pregnant women, hepatitis, leprosy, and individuals with carcinoma in the rectum.

Advantages Of Kshar Sutra Treatment

  • The chances of recurrence are less after Kshar sutra treatment.
  • The patient can start his daily activities after 3-5 days of the procedure.
  • The patient needs slight bed rest after the process.
  • The whole Kshar sutra procedure is carried out under local anesthesia.
  • The patient has to stay in the hospital for almost 3-5 hours.

Side Effects Of Kshar Sutra Treatment

There are almost no side effects of Kshar sutra treatment. But the patient can have pain near the anal or rectal area after the procedure. But the pain usually goes away within 3-5 days.

The patients opting for the Kshar sutra are happy and satisfied after the procedure.


Having an anorectal disorder is quite painful. If your condition is severe, then the doctor usually recommends surgery. But conventional surgery is quite costly and can have side effects. 

But Kshar Sutra is an Ayurvedic surgical procedure that helps cure an anorectal disorder using medicated thread. The best thing is that this procedure has almost no chance of recurrence. 

We hope the article has provided helpful information regarding the Kshar sutra Ayurvedic treatment for anorectal disorders.

About Dr. Ankurman Handique 47 Articles
A registered Ayurveda Practitioner. Loves to spread the knowledge of this Ancient Medical Science. He completed his degree BAMS(Bachelor of Ayurvedic Medicine and Surgery) from Govt. Ayurvedic College, Guwahati, Assam, India

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