Kshar Sutra Treatment: Recovery Time, Procedure, and Benefits

Kshar Sutra Treatment Piles, Fissure, Fistula: Procedure, Recovery Time and Cost

Kshar Sutra Treatment is an ancient Ayurvedic para-surgical technique effective for treating anorectal disorders such as piles (Arsha), anal fissures (Parikartika), anal fistula (Bhagandara), and pilonidal sinus (Nadi Vrana). Rooted in classical Ayurvedic texts like Sushruta Samhita, it has been practiced for centuries due to its minimally invasive nature, high success rate, and low recurrence.

In today’s modern lifestyle, long hours of sitting, low fiber intake, and chronic constipation are silently contributing to a rise in anorectal disorders like piles, fissure, fistula, and pilonidal sinus. Many patients silently suffer due to embarrassment or fear of surgery. Fortunately, Ayurveda offers a non-surgical, time-tested solution — Kshar Sutra therapy, which heals from within, without the complications of conventional surgery.

What is Kshar Sutra Treatment?

Kshar Sutra is a medicated surgical thread prepared using herbal ingredients:

  • Apamarga Kshara (Achyranthes aspera extract)
  • Snuhi Ksheera (Euphorbia neriifolia latex)
  • Haridra Churna (Turmeric powder)

The thread is coated in 21 layers (11 Snuhi, 7 Kshara, 3 Haridra), providing alkaline, antiseptic, anti-inflammatory, and healing properties. It simultaneously cuts and heals the affected tissue with minimal risk of infection or recurrence.

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How is Kshar Sutra (Thread) prepared? 

Kshar Sutra is not just a simple thread. It is carefully prepared with precision and hygiene at every step.

  • First, a surgical linen thread of size 20 is selected. This thread is placed on special hangers inside a Kshar Sutra cabinet fitted with a UV lamp. The UV light helps maintain a sterile environment.
  • The coating process begins with Snuhi Ksheera, a medicinal latex. Clean, sterilized gauze is used to apply the latex evenly over the thread. Once coated, the thread is kept inside the cabinet to dry completely.
  • This coating with Snuhi Ksheera is repeated again and again. In total, it is done 11 times. Each layer is allowed to dry before the next one is applied.
  • From the 12th coating onward, the process changes slightly. After applying Snuhi latex, the wet thread is rolled in finely powdered Apamarga Kshar. The powder must stick evenly to the surface. If there is extra powder, the hanger is gently shaken to remove it. The thread is dried again in the cabinet. This step is repeated seven times.
  • At this stage, 18 coatings are complete.
  • Now comes the final phase. The thread is coated again with Snuhi latex and then rolled in fine turmeric powder, known as Haldi Churna. The turmeric must spread evenly across the thread. Any excess is gently shaken off. After drying, this step is repeated two more times. That makes three turmeric coatings.
  • In total, the thread receives 21 coatings. Once this process is complete, it is officially called Kshar Sutra and is ready for medical use.
  • Finally, the dried thread is cut into equal lengths of about 30 to 32 cm. It is then sealed in sterile packaging.
  • The UV lamp inside the cabinet is switched on daily for about 30 minutes. This keeps the environment clean and safe throughout the preparation process.

How Does Kshar Sutra Work?

The action of Kshar Sutra is both mechanical and chemical:

  • Gradual cutting through the tissue (mechanical pressure)
  • Chemical debridement via the alkaline action of Kshara
  • Antibacterial protection from Snuhi
  • Anti-inflammatory support from Haridra

This synergistic effect preserves sphincter function, avoids deep surgical trauma, and promotes clean wound healing.

Ayurvedic Background

Kshar Sutra is mentioned in Sushruta Samhita, under Shalya Tantra, where it’s recommended for managing Bhagandara (fistula-in-ano), Arsha (piles), and Nadi Vrana (sinus). Its time-tested application aligns ancient wisdom with modern clinical outcomes.

Conditions Treated with Kshar Sutra

1. Anal Fistula (Bhagandara)

A pus-discharging abnormal tract between the anal canal and skin. Kshar Sutra is threaded through the tract, allowing gradual, controlled healing.

Why it’s better than surgery:

  • Preserves sphincter
  • Low recurrence rate
  • Performed on an outpatient basis

Read our blog on Fistula in Ano Ayurvedic Treatment

2. Piles (Arsha)

Swollen veins in the rectal area. Kshar Sutra is tied at the base of the hemorrhoid, which sloughs off naturally within days.

Benefits:

  • Bloodless and stitch-free
  • Local anesthesia only
  • Prevents recurrence

3. Pilonidal Sinus (Nadi Vrana)

Common in the tailbone area, often recurrent post-surgery. After cleaning the sinus, Kshar Sutra is inserted along the tract.

Advantages:

  • No general anesthesia required
  • Minimal scarring
  • Early return to work

4. Fissure-in-Ano (Parikartika)

Chronic cracks in the anal lining. Kshar Sutra Suturing (KSS) is performed to remove fibrotic tissue.

Clinical results:

  • 86% had pain relief by Day 14
  • Faster healing with Lord’s anal dilatation

Step-by-Step Procedure of Kshar Sutra Treatment

  • Pre-procedure Assessment: Eligibility check, diagnosis
  • Preparation: Thread sterilization and herbal coating
  • Application: Local anesthesia, tract probing, thread insertion
  • Post-Procedure Care:
    • Weekly thread changes

    • Sitz bath with Triphala decoction

    • Oral medications: Triphala Guggulu, Gandhak Rasayana, Abhayarishta

    • Topical application of Jatyadi Taila

Kshar Sutra vs Modern Surgery

FactorKshar SutraModern Surgery
InvasivenessMinimally invasiveInvasive
Hospital StayOPD/Short Stay2–4 Days
Recovery Time2–4 weeks4–8 weeks
Recurrence RateVery lowModerate to high
CostAffordableExpensive
Sphincter PreservationYesNot always guaranteed

Ayurvedic Medicines Commonly Prescribed with Kshar Sutra

  • Triphala Guggulu: Anti-inflammatory and supports wound healing
  • Gandhak Rasayana: Detoxifier and antimicrobial
  • Panchasakar Churna: Gentle laxative for bowel regulation
  • Abhayarishta: Supports digestion and relieves constipation
  • Eranda Taila: Castor oil for internal cleansing and lubrication
  • Jatyadi Taila: Herbal oil for external application and wound healing

When Kshar Sutra is Not Recommended

  • During pregnancy
  • In patients with uncontrolled diabetes
  • Immunocompromised patients (e.g., HIV)
  • Severe bleeding disorders
  • Active abscess without drainage

Post-Treatment Care and Lifestyle Tips

  • High-fiber diet (fruits, whole grains, vegetables)
  • Hydration (2–3 liters of water daily)
  • Avoid constipation with Triphala or Panchasakar Churna
  • Regular sitz baths
  • Use Jatyadi Taila or recommended herbal ointments
  • Avoid long sitting and heavy exercise during healing

Recovery Time for Kshar Sutra Treatment

  • Initial Healing: 3–4 weeks
  • Full Recovery: 6–8 weeks
  • Complete Healing: Up to 3–6 months (depends on condition complexity)

Follow-ups are essential for monitoring and weekly thread replacement.

Clinical Outcomes and Research Highlights

According to studies in AYU, IJAR, and JAIMS:

  • 85 %+ of patients with fissure and fistula achieved full relief in 3–4 weeks
  • Minimal recurrence in pilonidal sinus
  • Reduced pain, discharge, and bleeding from week 1
  • Maintained sphincter integrity

Healing Timeline Overview

ConditionDurationKshar Sutra ChangesRecovery Time
Piles10–15 days1–22–3 weeks
Fissure-in-Ano10–15 days1–32–4 weeks
Fistula-in-Ano4–6 weeks3–66–8 weeks
Pilonidal Sinus5–15 weeks4–82–3 months

Expert Kshar Sutra Treatment at Adyant Ayurveda, Bangalore

At Adyant Ayurveda, we offer expert Ayurvedic proctology care under renowned doctors:

  • Dr. Deepa, BAMS, MS DIY – Leading Ayurvedic proctologist in Bangalore
  • Dr. Manjunath R. Joshi
  • Dr. Vasudha (BAMS, MS Shalya)
  • Dr. Srinivasa N. V

Our treatments blend classical Ayurveda with modern diagnostics (like proctoscopy, USG) and personalized recovery protocols.

Diagnosis and Evaluation at Adyant Ayurveda

We combine classical Nadi Pariksha with modern diagnostics to assess the condition accurately:

  • Digital Rectal Examination (DRE)
  • Proctoscopy
  • Ultrasound or MRI (for complex fistula or pilonidal sinus)
  • Blood tests (if infection is suspected)

Patient Testimonials and Success Stories

Our patients consistently report:

  • Full recovery from chronic fistulas and fissures
  • Pain-free healing process
  • Avoidance of surgical complications
  • Excellent doctor support and follow-up care

Kshar Sutra Treatment Charges at Adyant Ayurveda

At Adyant Ayurveda, we believe in making authentic Ayurvedic care accessible and affordable. The cost of Kshar Sutra treatment varies depending on the condition being treated, the complexity of the case, and the number of sittings required for thread changes.

Indicative Charges for Kshar Sutra Treatment:

ConditionApproximate Charges
Piles (Arsha)INR 15,000 – INR 25,000 (single session)
Fissure-in-AnoINR 20,000 – INR 35,000 (with KSS)
Fistula-in-AnoINR 30,000 – INR 60,000 (varies by tract length and complexity)
Pilonidal SinusINR 30,000 – INR 50,000 (multiple sittings may be required)

Note: Charges include consultation, procedure, herbal medications, and follow-up thread changes. GST may apply. Package discounts available for combined therapies or chronic cases.

Referances 

  1.  Clinical evaluation of Ksharasutra
  2. Efficacy of Ksharasutra therapy

Conclusion

Kshar Sutra Therapy offers a powerful Ayurvedic solution for chronic anorectal diseases. It is safe, minimally invasive, cost-effective, and backed by both classical texts and modern research. Choose Adyant Ayurveda for trusted care and lasting recovery.

Still wondering if Kshar Sutra is right for you? Don’t delay your healing. Call Adyant Ayurveda at 9972541009 or download the AyurCare App from the play store to schedule a free consultation with our expert proctologists.

Call 9972541009 to book your consultation
Download “AyurCare” app from the Play Store today

FAQs Related to Kshar Sutra Treatment

Is Kshar Sutra painful?

Done under local anesthesia. Discomfort is usually mild and manageable.

Piles: 10–15 days | Fissure: 10–15 days | Fistula: 4–6 weeks | Pilonidal Sinus: 5–15 weeks

Yes. Most resume work is completed within 1–2 days, depending on the condition.

Avoid spicy, oily foods. Follow a high-fiber, sattvic diet.

Minimal to none, especially when treated by experienced doctors.

Yes, particularly in complex or relapsed cases.

Weekly, until complete tract healing.

Rare. Some may experience mild discharge or swelling.

No. It’s a day-care outpatient procedure.

Yes, including high-level and complex tracts, with proper evaluation.

Over 85% success rate with proper follow-up.

Yes, but not during pregnancy.

Check with your provider—some cover daycare procedures.

Light activities after 3–5 days. Avoid strenuous workouts for 2–3 weeks.

Sitz baths, fiber intake, Triphala powder at night, and Jatyadi Taila help.

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