An Integrative Approach in the management of Bilateral Ischiorectal Abscess: A Case Report
Abstract
Background: Ischiorectal abscesses frequently arise as complications of perianal abscesses. In contemporary medicine, management typically involves a two-stage procedure: initial incision and drainage (I&D), followed by secondary wound healing. In Ayurveda, this condition is recognized as Gudavidradhi, which is traditionally managed through Bhedan Karma (surgical incision) and Ropan Karma (healing measures). The case presented here was treated following this Ayurvedic protocol, utilizing Nimb-Patol-Erandmool Kwath for wound cleansing, Yashtimadhu-Lajjalu Tail for dressing, and internal herbal medications. Materials and Methods: This case study involves a 47-year-old male patient diagnosed with an acute bilateral ischiorectal abscess, Clinical features included severe pain, purulent discharge with foul odour, oedema, difficulty in walking and sitting. The condition was successfully managed through a comprehensive Ayurvedic regimen. Results: Significant clinical improvement was observed, with complete wound healing and resolution of associated symptoms. Discussion and Conclusion: The Ayurvedic approach, involving surgical and medicinal therapies rooted in traditional principles, proved effective in the management of a complex bilateral ischiorectal abscess. This case supports the potential of integrative Ayurvedic protocols in managing challenges in healing of Ischiorectal abscess.
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References
Abcarian H. Anorectal infection: abscess-fistula. Clin Colon Rectal Surg. 2011;24(1):14–21. doi:10.1055/s-0031-1272828
Parks AG. Pathogenesis and treatment of fistula-in-ano. Br Med J. 1961;1(5224):463–9.
Whiteford MH. Perianal abscess/fistula disease. Clin Colon Rectal Surg. 2007;20(2):102–9. doi:10.1055/s-2007-977465
Sahnan K, Adegbola SO, Tozer PJ, Watfah J, Phillips RK. Perianal abscess. BMJ. 2017;356:j475. doi:10.1136/bmj.j475
Rivadeneira DE, Steele SR, Ternent CA, et al. Practice parameters for the management of perianal abscess and fistula-in-ano. Dis Colon Rectum. 2011;54(12):1465–74. doi:10.1097/DCR.0b013e31823122b3
Malik AI, Nelson RL. Surgical management of anal fistulae: a systematic review. Colorectal Dis. 2008;10(5):420–30. doi:10.1111/j.1463-1318.2008.01435.x
Garcia-Aguilar J, Belmonte C, Wong WD, Lowry AC, Madoff RD. Anal fistula surgery: factors associated with recurrence and incontinence. Dis Colon Rectum. 1996;39(7):723–9.
Dash B. Materia Medica of Ayurveda. New Delhi: B. Jain Publishers; 2001.
Sharma PV. Sushruta Samhita (with English translation). Vols. I–III. Varanasi: Chaukhambha Orientalia; 2001.
Kaphle K, Wu LS, Yang NY, Lin JH. Herbal medicine and acupuncture for veterinary conditions: a review of the recent literature. J Vet Med Sci. 2006;68(9):963–70.
Garg P. Understanding and managing horseshoe fistula-in-ano: a review. Indian J Surg. 2016;78(2):103–8.
Abcarian H. Anorectal infection: abscess-fistula. Clin Colon Rectal Surg. 2011;24(1):14–21. doi:10.1055/s-0031-1272828
Biswas K, Chattopadhyay I, Banerjee RK, Bandyopadhyay U. Biological activities and medicinal properties of neem (Azadirachta indica). Curr Sci. 2002;82(11):1336–45.
Parks AG, Gordon PH, Hardcastle JD. A classification of fistula-in-ano. Br J Surg. 1976;63(1):1–12.
Shastri KA, editor. Sushruta Samhita, Chikitsa Sthana 1/68–69. Varanasi: Chaukhambha Sanskrit Sansthan; year unknown.
Singh A, et al. Pharmacognostic and phytopharmacological overview of Trichosanthes dioica. Asian J Pharm Res. 2022;12(2):75–82.
Burgos RA, et al. Biological activities of Ricinus communis and its derivatives. Fitoterapia. 2017;124:15–24.
Asha MK, et al. Wound healing and anti-inflammatory activity of Glycyrrhiza glabra. Indian J Exp Biol. 2014;52(4):358–66.
Kar A, et al. Phytochemical and pharmacological review on Mimosa pudica. Int J Res Pharm Chem. 2013;3(3):653–60.
Sharma PV. Dravyaguna Vigyan. Vol. II. Varanasi: Chaukhamba Bharati Academy; 2012.
Nelson R, et al. Management of anorectal abscess and fistula-in-ano. Clin Colon Rectal Surg. 2022;35(1):17–23.
