Everything about
Kshar Sutra Therapy
Safe, effective, minimal invasive non-surgical treatment for Piles, Fistula, Fissure, and Pilonidal Sinus
Ksharasutra Therapy is an Ayurvedic Parasurgical Technique. Great Indian Surgeon Sushruta narrated in his teachings the use of Kshara for cure of fistula in ano and other anorectal diseases. The work of Sushruta was later compiled as “Sushrut Samhita” in the 5th century A.D. Acharya Chakrapani Datta (10-11 Century A.D.) and Acharya Bhav Mishra (16-18 century A.D.) have described in their classical Ayurvedic texts, the method of preparation and treatment of fistula in ano by use of Kshara Sutra (K.S.). It is being used for the successful treatment of Anorectal Diseases from many years.
In this technique, a specially prepared thread (Kshar Sutra) is used to cure diseases. Kshar Sutra acts by “Herbal Chemical Cauterisation” and removes the disease from the body.
Many studies have been published by Ayurvedic doctors recently with encouraging results for treatment of fistula in ano and other anorectal diseases by use of Kshara Sutra
It is a time-tested ayurvedic para-surgical technique used to treat all kind of simple and complex cases of Piles (hemorrhoids), Fissure, Fistula, and Pilonidal Sinus. It is known for its high success rates and low recurrences.
What is Kshar Sutra?
Kshar Sutra or Alkaline Medicated Thread is the thread that is used to treat various anorectal problems. This thread is specially prepared by high potency ayurvedic herbs and can be used in many ways.
Preparation of Kshar Sutra:
Requirements:
Method of Preparation:
For the preparation of thread, surgical linen thread gauge number 20 is manually coated eleven times with the latex of Euphorbia neriifolia, followed by seven coatings of the latex and the alkaline powder of Achyranthus aspera alternatively, and dried. In the final phase, three coatings of latex and powder of Curcuma longa is to be given alternatively.
The thread thus prepared is sterilized by ultra violet radiation and placed in a polythene bag or glass tube
The first mechanism of Kshar Sutra involves the precise application of specialized alkaline herbal coatings (Kshar) onto the fistula tract. When tied, these medicinal properties gently destroy the unhealthy, infected tissue lining the tract while simultaneously facilitating natural disinfection. This chemical cauterisation cleanses the wound bed thoroughly without the thermal trauma associated with conventional electrosurgery, preparing the tissue efficiently for the subsequent healing stages.
As the medicated thread is snugly tied, it exerts a continuous, gentle pressure on the fistulous tract. Over a scheduled course of days, the alkaline coating slowly cuts through the fibrous walls of the fistula while simultaneously encouraging drainage and debridement of dead tissue. This unique staged-cutting design avoids sudden surgical incisions, reducing patient discomfort and minimizing the risk of complications like sphincter injury during anorectal treatments.
While the thread progressively divides the diseased tissue, it concurrently stimulates robust granulation tissue formation and localized healing from within. The alkaline herbs promote collagen deposition and healthy scar formation (fibrosis) right behind the cutting edge. This means the tract heals sequentially as it is opened up, effectively obliterating dead space, preventing recurrence, and ensuring complete, natural tissue repair.
Most important benefit of Kshar Sutra Therapy over Modern Surgeries is that the muscles that supports the Anus and helps in controlling the bowel movements are not dissected and hence the possibility of Anal Incontinence (loss of power to hold stools) is not there.
Common questions on Kshar Sutra Therapy
Kshar Sutra is a medicated ayurvedic thread used to treat various anorectal conditions like piles, fissure, fistula and pilonidal sinus.
Kshar Sutra works through a three-step mechanism: herbal cauterisation to destroy infected tissue, staged cutting to gradually divide the tract without surgery, and simultaneous healing through collagen promotion and healthy tissue repair.
While there may be mild discomfort or a burning sensation following the procedure, Kshar Sutra is generally well-tolerated. Because it avoids deep surgical incisions and extensive tissue damage, post-procedure recovery is typically much smoother and less painful than conventional surgery.
Kshar Sutra boasts a remarkably high success rate—often exceeding 90% for complex fistulas—with a significantly lower recurrence rate compared to conventional surgical excision, largely due to its simultaneous healing and fibrosis process.
No, most of the piles and fissures can be treated through ayurvedic medicines. Only in advanced cases Kshar Sutra Therapy is recommended.
Yes of course, it can be done in all new and previously operated cases of pilonidal sinus. The only difference is that in previously operated cases the treatment duration may be more.
No, constipation cannot be treated through any kind of therapy or surgery. You have to maintain a healthy diet and lifestyle to keep the constipation away. You may take ayurvedic treatment for constipation if the problem is worse.
No, it is done in clinic as a day care procedure. Hospital admission is not required, you may go home within a couple of hours after the therapy.
Immediately after the therapy
General advices. Patients are advised strictly:-
Don’t just take our word for it, see what everyone else is saying!
Ayurveda has successful treatment for anorectal problems through pure ayurvedic treatment. Kshar Sutra Therapy is reserved for those cases who are at advanced stages and not responding well to medicines.
It was heartbreaking to see my 22-year-old son go through three unsuccessful surgeries for his pilonidal sinus. We were losing hope and we decided to undergo Kshar Sutra therapy by Dr Rathi. First two weeks of the treatment were a bit painful for him, but the doctor guided us through it. After those initial days, the discomfort was very minimal, and he was able to manage his daily routine much better than with previous surgeries. Took 14 weeks of treatment in total, but the patience paid off. The healing was thorough and we feel confident that the problem is finally resolved. I am very satisfied by the pilonidal sinus treatment. Thank you dr rathi for his expert treatment. Visit Clinic Page
After two years of struggling with a fissure and failed treatments elsewhere, i finally found relief at Piles and Fistula Care Centre. Dr. Rathi is an exceptional doctor—very genuine and skilled. Thanks to his treatment, i healed completely in just two months. I am deeply grateful to Dr. Rathi for resolving this issue. If you are looking for the best treatment for piles, fistula, or fissure, I highly recommend visiting this clinic. Visit Clinic Page
De. Deepak really puts the patient at ease with his medicine expertise and intellactual counselling. Visit Clinic Page