The term Fistula  is derived from a Latin word   which means pipe or tube. Fistula In Ano can be described as an abnormal inflammatory track which has  an internal opening in the anal canal or rectum and an external opening in the perianal skin .

Causes of fistula-in -Ano

  • An acute abscess in one or more potential spaces around anorectal canal.
  • Source of infection could be a number of predisposing conditions like :-
    • Infected and inflamed condition of the anal crypts (crypto glandular apparatus). Crypto -glandular – 90%
    • Infection from hair follicles.
    • Infection from an ulcer at the root of the pile mass.
    • Infected sebaceous glands.
    • Infected sweat glands.
    • Anal fissures
    • Foreign body penetrating from outside.
    • Traumatized mucocutaneous lining of anorectal canal due to undigested foreign body. e.g. fish bone etc.
    • Inflammed/ thromobosed previously existing pile masses.
    • Retained sutures after haemorrhoidectomy.
    • Injection of chemicals for treating pile masses.
    • Radiation burns from X-ray and Radiotherapy.

Contact us to book an appointment.

Clinical features:

Sex Ratio – (Male : Female ) = 5 :1

Symptoms :-

  • Swelling
  • Pain
  • Discharge
  • Pruritus ani
  • Fever

Symptoms of associated disease

History of Abscess

Park’s Classification of Anorectal Fistulas


  • Type 1 – Intersphincteric, most common abt -70%
  • Type 2 – Transphincteric abt-25%
  • Type 3 – Suprasphincteric / Supralevator abt-4%
  • Type 4 – Extrasphincteric abt-1%

RADIOLOGICAL CLASSIFICATION (St James University Hospital Classification)

  • Grade-1 – Simple linear intersphincteric
  • Grade-2 – Intersphincteric with abscess or secondary track
  • Grade-3 – Trans-sphincteric
  • Grade-4 – Trans-sphincteric with abscess or secondary track within ischio-rectal fossa
  • Grade-5 – Supralevator and Translevator extension

Management of fistula-in-Ano with Kshar Sutra Treatment

Purva Karma

The Karmas that are to be done before starting the Khsar Sutra Treatment are known as Purva Karma.


The main Kshar Sutra Karma is known as Pradhana Karma. This involves three main steps..


The Karmas after completing the main procedure are Paschata Karma.

Need a Personalized Health Advice?

Call Now (+91) 181-225-3571 and receive Top Quality Healthcare for you and your Family