Anal stricture is a type of Anorectal disorder.

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2. Introduction
 The anus and rectum are the terminal part of GIT
 Many diseases occurs at Ano-rectal region.
 Many patients have complains of improper evacuation of stool
 The stool passed on straining with difficulty & pain.
 The stricture of anus and rectum is common anorectal
problem.
 The similar disease mention in Ayurveda named as Sanniruddha
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Sanniruddhaguda:सन्निरुद्ध गुद रोग
 Mention in Ayurveda briefly in context to
Kshudraroga.
 Sushruta & Vagbhatta described the same
etiology & management.
 Now a days it nearer to stricture of Ano-rectum
as the narrowing of the anorectal canal is the
basic pathology behind the disease.
 The ulceration or inflammation at ano rectal
region produced cicatrical contracture which is
characteristics of Sannirudhaguda
Sushruta = Sanniruddhaguda
Vagbhatta - Rudhaguda

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Sanniruddha guda
References-
 Su.Ni.13/55-56
 Su.Ci.20/47
 A.H.U.31/22
 A.H.U.32/11

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Aetiology
• Postoperative causes - after surgery
of piles etc
• Iatrogenic cause – faulty surgical
procedure.
• IBD – ulcerative colitis, crohn’s
disease
• Cancer- CAAnus rectum
• Congenital
• Fissure in ano – Fibrotic anal canal
• Irradiation
• Lymphogranuloma venereum disease
in female

6. Clinical feature
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 History of Constipation
 History of surgery at anorectal
region
 Features of underlying cause
 Difficulty in defecation
 faecal matter come from
guda on excess straining with
similar as ribbon.

7. Differential Diagnosis
 Fissure in Ano
 Ca Anus & Rectum
 Ulcerative colitis
 Crohn’s Disease.
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Diagnosis
Anal stricture -Dr Mahesh Kumar
 Diagnosed clinically by per rectal
examination (DRE)
 The stricture feel like a tight
band or ring
 Barium enema
 Biopsy from stricture
 Sigmoidoscopy
 Colonoscopy

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Management
Anal stricture -Dr Mahesh Kumar
Treat the
underlying
cause
Anal
dilatation Stricture
resection
 Suppository- Liquid paraffin
 Gudavarti -
 Anal dilatation – gradual
dilatation
 Shastrakarma – surgeical
intervention

10. Sanniruddhaguda yantra (Sushruta)
 This instrument is similar to Nirudha prakasa yantra.
 The instrument advised to design it with increasing circumference for gradual
dilatation of the anal canal.
 This instrument is shaped like nirudha prakasa yantra made of iron, wood or lac
with two end use for srotovivardhana, in disease sannirudhaguda .
 The Sanniruddhaguda yantra is a blunt instrument used to dilate the stenosed
anal canal.
 It is similar to anal dilator which is used nowadays.
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12. Method of Anal dilatation (Ayurveda)
 Diagnose properly, screen the case.
 Aseptic part preparation
 Select anal dilator - An appropriate size iron, wood or lac made tube , which
is opened at both end, well lubricated with ghee or oils is inserted gradually
inside the narrowed lumen of the anal canal.
 The anal canal is well irrigated by Varaaha vasa and majja or vatanashak
chakrataila etc.
 Gradually increase the size of the tube for each dilatation procedure,
 Dilatation should repeat at thrice day interval for many times.
 After the procedure person takes snigdha anna.
 In present time different size dilators are used to reduce the distressing
symptoms.
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Method of Anal dilatation

14. Shastrakriya (Surgical management)
The Shastrakriya (surgery) is mentioned by Sushruta for
treatment of anal stricture, will do -
 with preventing the sevanies
 Treat like Saddhakshata treatment.
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15. Thank You…
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धन्यवाद ॥
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