भगंदर नामक बीमारी एक गंभीर बीमारी है| जिसमें मलद्वार के आसपास यानी perianal area में फोड़ा या फुंसी हो जाता है| जिसमें से मवाद यानी पस या पानी जैसा पदार्थ बीच बीच में आता है फिर बंद हो जाता है और कुछ दिनों के पश्चात दोबारा आना शुरू होता है और यह प्रक्रिया चालती रेहति है| इस में दर्द तब होता है जब मवाद आना बंद हो जाता है| भगंदर अर्थात फिस्टुला का मुंह बंद हो जाता है या बीच बीच में कष्ट पहुंचाता रहता है और मरीज को सामान्य जीवन नहीं जीने देता| भगंदर के मुख्य कारण है उनमें Anal Cripts में इन्फेक्शन हो जाना जरूर है लेकिन जो सामान्य कारण है उसमें कब्जियत (कॉन्स्टिपेशन), हॉर्स राइडिंग (घुड़सवारी), दो पहिया वाहन की ज्यादा सवारी करना अथवा बहुत ज्यादा देर तक बैठे रहना मल वक्त अधिक जोर लगाना इत्यादि| इनमे से कोई एक या अधिक कारणों से भगन्दर हो सकता है| जैसा कि हम जानते हैं कि यह एक गंभीर समस्या है जिसमें सामान्य रूप से चिकित्सा कठिन है| आयुर्वेदिक दवाइयों, एलोपैथिक दवाइयों, होम्योपैथिक दवाइयों से क्षणिक लाभ तो मिल सकता है परंतु पूर्ण लाभ नही मिलता| आधुनिक शल्य चिकित्सा में सफलता दर केवल 50%-60% ही है अर्थात 40%-50% लोगो को आपरेशन कराने के बाद भगन्दर दोबारा हो जाता है |
आयुर्वेद चिकित्सा पद्धति मे क्षार - सूत्र चिकित्सा ही एकमात्र ऐसी विधा है, जिससे भगन्दर लगभग शत प्रतिशत (सफलता दर 98% - 100%) ठीक हो जाता है|
Fistula means pipe or tunnel like. It is a chronic granulating tubular tract consisting of fibrous tissues with two openings communicating between two cavities or cavity to cutaneous surface of the body. Thus anal fistula has two openings, one on perianal or perinial skin surface and other in anal canal. Prolong use of antibiotics or homeopathic medicine may lead the fibrosis of tubular tract. The fistula may remain silent for months or years without any symptoms or traces of discharge may persist without any inconvenience. Any boil or abscess in the vicinity of 4.0 cm area around the anus is initially a fistula.
1. Skin irritation around the anus.
2. Discomfort or severe pain while sitting, walking, coughing or passing the stool.
3. Foul-smelling abscess discharge from near your anus.
4. Bleeding or passing pus while passing the stool.
5. Swelling and redness around your anus accompanied by high fever due to infection.
6. Frequent bowel movements in some cases.
7. Skin irritation around the anus.
8. Discomfort or severe pain while sitting, walking, coughing or passing the stool.
9. Foul-smelling abscess discharge from near your anus.
10. Bleeding or passing pus while passing the stool.
11. Swelling and redness around your anus accompanied by high fever due to infection.
12. Frequent bowel movements in some cases.
This is the most common cause of anal fistula. The surgical anal spaces are filled with fatty tissues. Due to poor blood and nerve supply these spaces have poor resistance to infection. The route of infection may be anal crypts, hematogenic or retrograde from ulcers, injuries, scratches or contamination of perineal region by septic materials. Rarely impaction of foreign bodies like fish bones may cause anal abscess with fistula formation. Anal abscess with fistula formation may also occur from injection of sclerosing agents (i.e. injection therapy of piles),into the hemorrhoids or after hemorrhoidectomy .
Sometimes anal abscess may occur as complication of pulmonary tuberculosis. The infection from swallowed sputum enters into the anal spaces through minute ulcer in the anal canal. Retrograde infection may reach in the anal spaces through minute cutaneous scratches at anal region by finger nail contaminated by his own sputum.Incidence of tubercular abscesses with fistula formation varies from 6-16%.
This is the common cause of anal infection leading to abscess and fistula formation. Overstraining during the course of defecation to evacuate the rectum, excessive intercourse, sitting in unusual position and excessive riding ( like horse, two wheelers etc) obesity, dietary habits, sitting in awkward position, bowel habits and trauma are some other important causes of fistula.
Patient presents with complaints of discharging sinus at anal region, which developed after bursting of anal abscess /Boil/ furuncle(फोड़ा फुंसी) or after inadequate drainage of abscess. Commonly the pening is located at anal periphery within 3-4 cm distance from anal verge.some fistulous openings may occur beyond 4 cm and may be located at perineal,gluteal,sacrococcygeal and anterior perineal region up to the base of scrotal region.The maximum distance from verge may occur up to 13-14 cm.
The discharge might be intermittent or continuous, serous or purulent or mixed with blood, staining the underclothes. Occasionally opening may be closed, even fibrosed without discharge. Opening may be single or multiple. Openings may be single or multiple on one or both sides of anus. Pain in anal fistula is slight or absent .But when the opening is closed retaining the discharge, the abscess is formed. There is acute moderate to severe pain, which is relieved after the abscess is burst with discharge or it is surgically drained. Itching at anal region is due to irritating discharge from fistula.
