• Dr.Ashwini Sheregar
• Dr. Gururaja.D
• Dr.Nikhil Vaidya
• Dr.Anusha Perur

Bhagandara, described in classical Ayurvedic surgical texts as one of the eight great and difficult-to-treat conditions (Ashtamahagada), corresponds closely to what contemporary medicine terms fistula-in-ano. Both systems of medicine converge on a shared clinical reality: a chronic, track-like communication between the anal canal or rectum and the perianal skin, most often arising from suppuration of a perianal abscess. Despite being described more than two millennia apart, Ayurvedic and modern surgical literature show striking parallels in their understanding of anatomical course, chronicity, and the challenge of achieving cure without compromising continence. This review draws together the classical Ayurvedic understanding of Bhagandara — its etymology, causation, staged pathogenesis, classification by dosha, and para-surgical management including Ksharasutra and Agnikarma — alongside the modern surgical understanding of fistula-in-ano, including anatomical classification systems, diagnostic modalities, and the expanding range of sphincter-preserving surgical techniques. The review highlights that while modern surgery has diversified considerably in the last two decades, recurrence and incontinence remain unresolved concerns, and that Ksharasutra therapy continues to be regarded by Ayurvedic surgeons as a dependable, minimally destructive alternative. An integrated understanding of both systems may better equip clinicians managing this persistently difficult condition.

Bhagandara, Fistula-in-ano, Ksharasutra, Ayurveda, Anorectal fistula, Ashtamahagada

"BHAGANDARA (FISTULA-IN-ANO): A COMPREHENSIVE LITERATURE REVIEW OF AYURVEDIC AND MODERN SURGICAL APPROACHES", International Journal of Emerging Technologies and Innovative Research (www.jetir.org), ISSN:2349-5162, Vol.13, Issue 10, page no.b636-b642, October-2026, Available :http://www.jetir.org/papers/JETIR2610163.pdf

"BHAGANDARA (FISTULA-IN-ANO): A COMPREHENSIVE LITERATURE REVIEW OF AYURVEDIC AND MODERN SURGICAL APPROACHES", International Journal of Emerging Technologies and Innovative Research (www.jetir.org | UGC and issn Approved), ISSN:2349-5162, Vol.13, Issue 10, page no. ppb636-b642, October-2026, Available at : http://www.jetir.org/papers/JETIR2610163.pdf