Become A Member

Bhagandar (fistula-in-ano) is a common anorectal disorder characterised by an abnormal communication between the anal canal or rectum and the perianal skin. Although it is not a life-threatening condition, its diagnosis and management are challenging owing to complex regional anatomy and the frequent occurrence of multiple ramifying tracks. Ayurvedic classical literature, particularly the surgical treatise of Acharya Sushruta (circa 1000 BCE), provides an elaborate description of Bhagandara, encompassing its aetiopathogenesis, clinical typology, and diagnostic methodology—closely paralleling modern understanding of fistula-in-ano. Sushruta advocated the use of specialised instruments such as the ashenaya (probe) and arsho yantra for systematic examination. The present review integrates the classical Ayurvedic diagnostic approach with contemporary clinical investigations—inspection, palpation, digital rectal examination, probing, proctoscopy, fistulography, trans-rectal ultrasonography, and magnetic resonance imaging (MRI)—to present a comprehensive framework for the diagnosis of Bhagandara/fistula-in-ano.

Keywords: Bhagandar; Bhagandara; Fistula-in-ano; Sushruta; Anorectal diagnosis; Arsho yantra; Ayurveda; Shalya Tantra