Effect of Acacia catechu and alum hot sitzbath on post-operative pain in patients treated with herbal seton

Abstract

Background: Post-operative pain is the major consequence of Kṣārasūtra, Seton technique employed in Ayurvedic management of Low anal fistula. Surgeons are forced to prescribe Opioids and NSAIDs with pronounced untoward effects. Non pharmacological measures like Balneotherapy are used to improve circulation and relieve spasm in contemporary sciences. Aim: To compare the efficacy of Khadira (Acacia catechu) and Sphaṭika (Potash alum) hot sitzbath with plain hot sitzbath in patients of low anal fistula treated with Kṣārasūtra. Method: The study was single blind, double armed; prospective, randomized control clinical trial in which 30 patients were randomly allocated into two groups of 15 each on the basis of inclusion and exclusion criteria. Group A received hot sitzbath using Acacia catechu and alum infusion twice daily for 21 days. Group B received hot sitzbath using warm water for 21 days. The assessments were made on pain, post-surgical satisfaction burning sensation, tenderness, discharge, constipation, itching and incontinence. Result: The disease was prevalent in the 4th decade of life, more in males (86.67%) involved in sedentary work (53.33%) residing in urban domicile, consuming mixed diet (100%). Both groups showed statistically significant improvement in outcome measures like pain, burning sensation, tenderness, discharge, constipation and itching. Conclusion: On comparative analysis Acacia and Alum hot sitzbath was more effective in outcomes like pain, surgical satisfaction, burning sensation and discharge. There was no difference in the effect of both interventions with respect to outcome measures like constipation, itching and incontinence.