A pilonidal sinus is an infected tract under the skin between the buttocks. Treatment commonly involves an operation. After the operation you should keep the area free of growing hair by regular shaving or other means of hair removal.Ksharasutra therapy is another kind of treatment for pilonidal sinus without surgery with high success rate.
A pilonidal sinus is sinus tract which commonly contains hairs. It occurs under the skin between the buttocks (the natal cleft) a short distance above the anus. The sinus track goes in a vertical direction between the buttocks. Rarely, a pilonidal sinus occurs in other sites of the body. This condition used to be called 'jeep seat' as it was common in army jeep drivers.
It should be understand that mere oral medication definitely would not cure the disease. Therefore it should be treated by surgically. Surgery includes complete cutting of the tract with surrounding tissue. Fistula-in-ano disease is difficult to treat surgically because of severe pain, high rate of recurrence (is up to 30%) complex anatomy of the region, involvement of sphincters and severe complications like incontinence. Ksharasutra chikitsa in Bhagandara (mentioned in the SushrutaSamhita) has got advantages than surgery. Medicated (kshara) thread (sutra) passing through the tracts which cuts the tissues gradually simultaneous healing occur from opposite side therefore no loss of tissues or sphincter damage.
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The exact cause is not clear. There are various theories. For example, one theory is that the problem may develop from a minor congenital or hereditary abnormality in the skin of the natal cleft. This may explain why the condition tends to run in some families. Part of the abnormality in this part of the skin may be that the hairs grow into the skin rather than outwards.
Another theory is that you develop skin dimples (skin pits) in the skin between the buttocks. These may develop from damaged hair follicles (the small structures under the skin that make the hairs) due to local pressure or friction. Because of local pressure, growing hair in the natal cleft may get pushed into the skin pits.
Whatever the cause, once hair fragments become 'stuck' in the skin they irritate the skin and cause inflammation. Inflamed skin quickly becomes infected and so a recurring or persistent infection tends to develop in the affected area. The infection causes the sinus to develop which often contains broken pieces of hair.
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Most cases occur in young adults or teenagers. It is rare in children and in people over the age of 40. It is much more common in men (as they are more hairy than women).
A pilonidal sinus may not cause any symptoms at first. You may not be aware that you have one. Some people notice a painless lump at first in the affected area when washing. However, in most cases symptoms develop at some stage and can be 'acute' or 'chronic'
You may develop increasing pain and swelling over a number of days as an infected abscess (ball of pus and surrounding skin infection) develops in and around the sinus. This can become very painful and tender.
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You may develop some pain which is less intense than the 'acute' symptoms. Usually the sinus discharges some pus. This releases the pressure and so the pain tends to ease off and not become severe. However, the infection never clears completely. So, typically the symptoms of pain and discharge can persist long-term, or flare up from time to time, until the sinus is treated.
In most cases an operation will be advised. There are various operations which are done to cure this problem. The options include the following.
Wide excision and healing by secondary intention. This operation involves cutting out the sinus but also cutting out a wide margin of skin which surrounds the sinus. The wound is not stitched but just left to heal by normal healing processes (healing by 'secondary intention'). So, the wound can take several weeks to heal, and requires regular dressing until it heals.
Ayurvedic Treatment Of Pilonidal Sinus With Herbal Remedies |
Excision and closure. This means taking out the section of skin which contains the sinus. This is done by cutting the skin either side of the sinus (to form an ellipse shape around the sinus), taking out the sinus, and stitching together the two sides of the ellipse. However, the risk of a recurrence, or of developing an infection of the wound after the operation, is higher than the above procedure. In some cases where the sinus recurs or is extensive, a plastic surgery technique may be advised to remove the sinus and refashion the nearby skin.
There are variations on the above procedures which may be suggested by the surgeon, depending on your circumstances, the size and extent of the sinus, and whether it is a first or recurrent problem.
Surgeon will usually advise the wound be kept clean and any hair growing near to the wound should be shaved or removed by other means. Some surgeons recommend that even when the wound is healed, you should keep the area free of hair growing by shaving every few weeks, or by other methods to remove the hair. This reduces the chance or a recurrence of the problem.
What Is Pilonidal Sinus?
A simple treatment mentioned in a surgical text book of Indian system of medicine– SushruthaSamhitha. The disease is called nadeevrana. Treatment is called Ksharasutra chikitsa
A malleable probe to be passed, its tracts to be identified carefully, and then a medicated thread to be inserted to tract. This is to be changed every week. This helps effective curettage and drainage facilitates healing withoutrecurrence.In pilonidal sinus, a small hole or channel develops in the natal cleft (between the buttocks). The condition of pilonidal grows to be quite painful with time. The condition is also known as “Jeep Bottoms” or “Barber’s Disease”.
There can be various reasons for the formation of this abnormal channel. Excessive and coarse hair is one of the major causes of pilonidal sinus. When hair follicles enter the skin pits, an immune response is launched leading to the formation of a cyst around the hair. Hormonal changes also play a pivotal role in the condition. Also, friction and pressure-generating activities can increase the chances of the hair follicles entering the skin.
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Furthermore, there are many factors that contribute to increasing the risks of pilonidal sinus. These include previous injuries, hairy and deep natal cleft, obesity, sedentary jobs, and a family history of the condition.
The condition starts with the formation of a small dimple like structure between the buttocks. At the initial stages, pilonidal sinus does not have any symptoms and does not cause much discomfort. However, over time, the condition starts to worsen and symptoms start surfacing. The dimple-like structure starts getting filled with pus and fluid and the pilonidal cyst is formed at the bottom of the tailbone. This is a troublesome condition and causes severe pain and discomfort.
Adding to the misery, these pilonidal cysts are prone to get infected. When this happens, a discharge of blood and pus can be seen from the cyst. This discharge is accompanied by a foul odor. Pilonidal sinus can hinder your normal routine life. You may experience severe pain in routine activities like sitting and wearing clothes. (Also Read: How to care when you are suffering from Pilonidal Sinus)
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Now that you’ve seen the causes and complications of pilonidal sinus, you must be wondering how you can get rid of the problem and what treatment you can opt for.
You will be relieved to know that pilonidal sinus is completely curable. There are a variety of medicines that can provide temporary and symptomatic relief from pilonidal sinus. According to conventional medicine, the only permanent treatment for pilonidal sinus is surgery. However, the majority of the people are skeptical about surgical treatments for pilonidal sinus and want to opt for effective alternatives. (Also Read: Limberg flap for pilonidal sinus)
If you too are unsure about surgery and want to avoid it, you will be glad to know that pilonidal sinus can be treated through Ayurveda also. Ayurveda uses natural herbs and methods for the treatment and there is no risk of side-effects. Let’s now get an insight into how Ayurvedic treatment for pilonidal sinus works.
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In Ayurvedic terms, pilonidal sinus is known as Nadi Vrana. Ayurvedic treatment for pilonidal sinus involves a procedure called the Kshar Sutra. The procedure uses a specially prepared thread for treating pilonidal sinus.
The first step of the procedure is to prepare the Kshar Sutra. For this, a surgical linen thread gauge number 20 is coated with Snuhi latex 11 times, Snuhi latex and Apamarga Kshara 7 times and Snuhi latex and Haridra Churna 3 times. The ayurvedic doctor places this Kshar Sutra inside the pilonidal sinus. This is done by passing the thread through the external opening of the skin and then tying its ends.
The doctor replaces the thread with a new one every 7 days. This entire therapy of Kshar Sutra takes 4-8 weeks to complete depending upon the severity of pilonidal sinus. Eventually, the pilonidal ainua heals and the microbial infections come under control. Also, the unhealthy tissues are removed, and the drainage
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