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MCDPA THERAPY


It’s the primary & FIRST LINE treatment for most of the ANO-RECTAL diseases which refers:

M: Medication: Administration of modern Ayurvedic drugs & Ointments

C: Constipation: As the most prominent cause of most of the ANO-RECTAL diseases is

constipation, the Ayurvedic formulations like fibers & metabolizers, laxative etc are used to

increase intestinal movement & digestion.

D: DIET: Diet & lifestyle changes to treat the root cause of disease.

P: PHYSIOTHERAPY: The exercise & YOGAS of pelvic floor provides improvement in bowel

symptoms which leads to reduce the use of laxatives & medicines with time to the patient &

improves the ANO-RECTAL function.

A: AYURVEDIC OIL THERAPY: Various combination of Ayurvedic medicated oils are used

for local application & enema depending on disease especially in chronic cases where oral

medicines & local application of ointments do not give desirable relief in symptom.




KSHAR KARMA THERAPY


KSHAR KARMA IN HEMORRHOIDS /PILES:


A special kind of Kshar paste made up of different kind of Kshar and Herbo-mineral Ayurvedic medicines are applied locally on the Piles of grade1or2 (also in grade3 if administered by skilled Kshar karma specialist doctor/proctologist).

This procedure do not need any kind of general/spinal anesthesia, bed rest or hospitalization and the patient can go home and can do daily routine works after procedure so it's an outpatient/OPD ambulatory procedure. Main procedure may take 1to3 settings for one Pile & in a single sitting two or more hemorrhoid/piles can be treated easily by a skilled trend Kshar sutra /Kshar karma expert.

The Kshar karma in hemorrhoid/piles is done under local anesthesia by applying some numbing ointment or spray in anus & on the Hemorrhoid /Piles mass.

The procedure commonly takes about 5 to 10 minutes and in most of the cases there is no need of chemical synthetic oral “analgesic/painkillers or antibiotics”, the procedure is beneficial in the hemorrhoid /piles of grade1&2 which are broad and hard to capture by forceps to do Kshar sutra ligation therapy or RBL therapy (rubber band ligation).

The postoperative pain is nearly no or easily tolerable, sometimes in rare cases few patient complaints for mild burning or itching sensation in anus (for about 3to7days) postoperatively specially after bowel movement which can be easily subside by Ayurvedic ointments and oils.

The procedure has high success rate when performed by skilled Kshar sutra specialist doctor/proctologist along with the MCDPA therapy.


KSHAR KARMA IN ANAL FISSURE:


The PRATISARANIYA KSHAR is applied on fissure bud to do cauterization of bleeding fissure and to promote healing of fissure bud, and the Kshar Sutra is implanted on the bleeding blood vessel to stop bleeding by helping vessel and muscles of anus to relax and along with the MCDPA Therapy. This outpatient (OPD treatment) ambulatory treatment which is commonly done under local anesthesia which takes about 15 to 20 minutes without any hospitalization, bed rest or precautions& the patient can go home and can do all daily work just after the procedure. Average recovery time is about 1to2 weeks depending on severity of case and physical condition of patient.


KSHAR KARMA IN PYOCELE (PUS IN HYDROCELE), INJECTION ABSCESS & OTHER ABSCESS ETC: In case of Pyocele the Ayurvedic Para surgical technique is used to make the incision which is very shorter than the incision used to made in western contemporary surgery, if the testicle is not involved then there is no need of “orchidectomy/removal of tentacles” or scrotum and after small incision (only about 1 inch to 1.5 inch long) the pus is drained out and Pratisaraniya Kshar Karma is done to exercise out the dead sluggish infectious tissue and to promote the growth of new cells.

Nearly same procedure is followed to treat abscess and injection abscess and sometime in dermal sinus to treat with Kshar karma where the incision is much smaller In comparison to the incision made in contemporary western surgery, dermal cyst etc are also treated in the same way.

In most of the cases the need of analgesic/pain killer is dependent on the pain bearing capacity of the patient and rarely some western chemical synthetic antibiotics are used because in most of the cases the modern Ayurvedic Herbo-mineral immunomodulatory medicines are used which can perform the antibacterial action & the antiseptic media if followed properly as per treatment protocol.



KSHAR KARMA ON DIABETIC FOOT ULCER & VARICOSE ULCER:

The removal of dead necrosed infectious tissues from ulcer is done by application of bandage & solutions of specific kind of Pratisaraniya Kshar and Ayurvedic oils/ointments which are used along with the modern Ayurvedic Herbo-mineral natural medicines for dressings and for internal/oral use to promote immunity system of the patient & to increase the new healthy micro/capillary blood circulation by hirudotherapy PRP/PRF bloodletting & oxygen therapies are used.

In case of diabetic foot ulcer the treatment of diabetes has to be done under the supervision of diabetologist. If the patient do not have any systematic disease like cardiac diseases, hypertension, nephritic syndromes or disorders then there is no need of hospitalization or bed rest depending on the physical health of patient.

The time for performing Kshar karma on diabetic foot ulcer and varicose ulcer takes about 20 to 30 minutes and the number of sittings depends upon the physical condition of patient and severity of case, the need of hirudotherapy PRP PRF bloodletting and oxygen therapy also depends on the physical condition and severity of case.



KSHAR KARMA IN FOURNIER’S & WET GANGRENE: 


The bandage, oil and ointment along with the Kshar paste (Pratisaraniya Kshar) are used to remove the infectious sluggish dead necrosed tissues from the gangrene and modern Ayurvedic Herbo-mineral medicines & immunity boosters are used to promote cell growth and healing, if there is no septicemia (infection in blood) then the use of chemical synthetic antibiotics is not needed and the modern Ayurvedic Herbo-mineral medicines to promote healing and immunity are prescribed.

To increase the micro/capillary blood circulation leech/hirudo-therapy oxygen therapy PRP/PRF/blood-letting & sudation & irrigation therapies by modern Ayurvedic Herbo-mineral medicines are done along with the Kshar karma on Fournier’s and wet gangrene, if the patient is moveable/physically active and has strength to do his/her routine daily works without any help(escort) then there is no need of hospitalization or bed rest depending on patient's other systematic diseases (like diabetes hypertension etc).

The dressing/therapy usually takes about 20 to 30 minutes and the number of sittings depends on the severity of case and size types of gangrene, if other systematic diseases like hypertension diabetes are present then the patient can continue the treatment of those diseases and the need of hospitalization is dependent on these systematic diseases.



KSHAR KARMA ON WARTS, CORN ETC:

The Pratisaraniya Kshar paste/ointment is applied on the wart, corn like growth under the local anesthesia by applying some numbing ointment and spray which cauterize/removes the growth of wart & corn with modern Ayurvedic Herbo-mineral natural oil/ointments are used along with oral medicines to promote healing and immunity, the number of sitting for procedure commonly takes about 5 to 10 minutes and the number of sittings depends upon the physical condition of patient and the severity & size/numbers of wart &corn depending on other systematic diseases like diabetes hypertension etc..



KSHAR KARMA ON EXTERNAL GROWTH (LIKE ANAL POLYP, CYST, CENTENNIAL TAGS,DERMAL TAG, LIPOMAS ETC):

is done by using Pratisaraniya Kshar after removing the anal polyp, cyst, centennial tags, dermal tag, Lipomas by classical Ayurvedic minimal invasive Para surgical procedures which is nearly bloodless treatment and commonly done under local anesthesia and has approximately 50 to 70% less incision size in compare to contemporary western surgery , the use of oral analgesic/painkiller is dependent on pain bearing capacity of patient and the use of chemical synthetic antibiotics is commonly replaced by Ayurvedic Herbo-mineral natural immunity boosting medicines, if there is no septicemia then the need of hospitalization or bed rest is not recommended and the patient can go home and do all daily works just after the procedure which commonly takes about 10 to 20 minutes and the number of sittings depends on the physical condition of patient.



KSHAR KARMA IN ULCERATIVE COLITIS, APTHOUS ULCER & STOMATITIS, AND CROHN’S DISEASE: In such conditions where the ulceration of the mucosa of digestive track (colone, rectum, stomach, oral cavity etc) starts erosion of tissues. in colon and rectum the ulceration of mucus membrane leads to ulcerative and inflammatory conditions, the local use of modern Ayurvedic Herbo-mineral natural oil as enema or for irrigation of specific Ayurvedic procedure called Basti karma(enema) or kaval dharan(gargle) etc are done along with the MCDPA therapy with the help of modern Ayurvedic Herbo-mineral natural medicines to maintain the healthy gut flora and ph of digestive track, helping in healing of ulcer and promoting cell growth, these therapies are also beneficial in the patient of hyperacidity, stomatitis, constipation, indigestion etc.



KSHAR KARMA IN GASTROINTESTINAL DISEASES:

Paaniya Kshar with modern Ayurvedic Herbo-mineral oral medicines are used to treat gastric/ peptic ulcer and IBS constipation Stomatitis/ mouth-ulcer like diseases, the use of Kshar is helpful to maintain the ph of digestive system by increasing the ph value from acid to base which helps gastric/stomach & intestinal mucosa to heal, the hyperacidity is revealed and when the ph of intestine are maintained then the healthy bacteria or good bacteria of colane get the favorable condition to germinate and leading to better bowel movement revealing constipation, along with Paaniya Kshar oral/internal modern Ayurvedic Herbo-mineral medicines are to enhance the intestinal health and immunity.



KSHAR KARMA IN NEPHRO-URO-LOGICAL AND GYNECOLOGICAL DISEASES:

The removal or breakdown of Nephrolithiasis / kidney stone or Urolithiasis /stone of bladder can be done with the help of Paaniya Kshar karma along with the modern Ayurvedic Herbo mineral medicines and local use of oils/solutions. In case of Dysuria, burning micturition & cervicitis where the erosion of mucosa is creating the problem because of the ulceration & the low ph value is there, in such cases the use of Paaniya Kshar and irrigation of Pratisaraniya Kshar is done with the Ayurvedic oils and Kshar solutions along with the modern Ayurvedic Herbo-mineral natural medicines which are used to boost immunity and healing of mucosa under the supervision of Kshar Karma specialist with nephro-uro-logist & gynecologist in special cases where other systematic diseases are present.





KSHAR SUTRA THERAPY / TREATMENT



KSHAR SUTRA ON ANAL FISSURE:

This unique technique is developed by Dr.Mittal which is basically taken from the ancient literatures of modern Ayurveda with calibration of contemporary surgery, on a whole we can say that it’s a nearly blood less procedure in which the concept of anal dilation and sphincter (the muscles of anus) are relaxed without using blade. the procedure is done under local anesthesia where the Kshar sutra is implanted at the anus for about 2 to 3 weeks and the patient can go home and do all the daily routine works just after the 15 to 30 minute of main procedure, Kshar karma is done on fissure which cauterizes the fissure wound/cut & coagulates the oozing blood vessels, during the procedure generally there is no need of hospitalization as there is no use of general/spinal anesthesia or bed rest because there is no incision or cut is made, even as it is outpatient (OPD) ambulatory treatment so the patient do not need to take any special rest at home too. The need of chemical synthetic oral analgesic/painkiller is replaced by some local Ayurvedic applicants like ointments and suppositories & the in most of the cases there is no need of chemical synthetic antibiotics as the Herbo-mineral Ayurvedic medicines are used during the therapy along with the MCDPA therapy.







KSHAR SUTRA on HAEMORRHOID/PILES, CENTENNIAL TAGS, ANAL POLYPS:

the Kshar sutra is a time tested (500+years bc~25000years) therapy, now which is in modern Ayurveda is also called the “Kshar sutra /alkaline thread” ligation therapy which is very much popular for treating hemorrhoid/piles of grade 1, 2, 3 even in the hemorrhoid/piles (centennial tags, anal polyps) of grade 4 and in strangulated piles too if treated by skilled Kshar sutra doctor/therapist.

in most of the cases there is no use of general/spinal anesthesia, hospitalization even the use of oral chemical synthetic analgesics/painkiller is rare and depends on the pain bearing capacity & willpower of patient, the use of oral chemical synthetic antibiotics is replaced by modern Ayurvedic Herbo-mineral medicines. So on a whole we can say that it’s an outpatient (OPD), ambulatory treatment for all hemorrhoid/piles, centennial tags, and anal polyps etc which do not need any special rest for admission. the hemorrhoid/piles (or centennial tags, anal polyps etc) is captured by a special forceps generally under local or surface anesthesia and the selected Kshar sutra is implanted at the base of the hemorrhoid/piles, centennial tags, anal polyps etc mass which stops the blood supply to the mass and causes necrosis/death & the mass falls off with Kshar sutra commonly in 3 to 7 days during the normal bowel movement. Post surgical/operatively in majority's of cases there is no need of hospital stay or bed rest even the patient can do all daily routine works with the combination of MCDPA therapy for better faster & healthy recovery.







Kshar sutra on anal fistula, Pilo-nidal sinus (PNS), dermal sinus:

The Kshar sutra is a time tested (500+years BC~25000years) therapy, now which is in Modern Ayurveda is also called the Kshar sutra ligation therapy which is very much popular for treating anal fistula, Pilo-nidal sinus (PNS), dermal sinus and even in complex, high level, surgery (western contemporary surgery) failed anal fistula, Pilo-nidal sinus (PNS), dermal sinus etc with multiple tracks if treated by skilled Kshar sutra doctor/therapist.

in most of the cases there is no use of general/spinal anesthesia, hospitalization even the use of oral chemical synthetic analgesics/painkiller is rare and depends on the pain bearing capacity & willpower of patient, the use of oral chemical synthetic antibiotics is replaced by modern Ayurvedic Herbo-mineral medicines. the anal fistula, / Pilo-nidal sinus (PNS), / dermal sinus track/tracks is/are dilated by a thin probe generally under local or surface anesthesia and the selected Kshar sutra is implanted in the track/tracks & the both ends of thread/ Kshar sutra which curates the dead necrosed tissues and drains the pus along with the gradually cutting & healing of track/tracks with each sittings, on an average a track of 1c.m. length takes about 2to3sittings to cured and the duration of treatment depends on length type number & severity of track. Post surgical/operatively in majority of cases there is no need of hospital stay or bed rest even the patient can do all daily routine works with the combination of MCDPA therapy for better faster & healthy recovery.

So, on a whole we can say that it’s an outpatient (OPD), ambulatory treatment for anal fistula, Pilo-nidal sinus (PNs), dermal sinus etc which do not need any special rest for admission.




KSHAR SUTRA in ANAL STENOSIS:


The Stenosis or narrowing of the anus is caused because of long time spasmodic or inflammatory disease of anus like fisher or hemorrhoid/piles and in post operative cases (contemporary surgery/ fistulectomy /fistulactomy) of anal fistula which can be treated by Kshar sutra.

This technique of dilating or increasing the circumference of anus by Kshar sutra is design and developed by Dr.Mittal for which there is no cut or incision is made on anus and the patient can do all the daily routine jobs just after the main procedure, generally there is no need of any kind of general or spinal anesthesia, hospitalization or any special bed rest, this 20to30 minute outpatient (OPD) procedure is commonly done under local anesthesia and special kind of Kshar sutra are implanted in anus, the complete therapy generally takes about 4 to 6 weeks with weekly or 2 sittings per week, the sitting/dressing generally requires about 5to10 minutes only & the patient can do all the daily routine works along with the treatments without the fear of fecal incontinence, the procedure is done along with the MCDPA therapy for better & healthy recovery. In most of the cases patient do not requires any special chemical synthetic oral analgesic/painkiller and pain could be managed with the help of some local application of medicines like Ayurvedic ointments and suppositories, the need chemical synthetic antibiotics is also replaced by Ayurvedic Herbo-mineral medicines which boost up the immunity too.





TREATMENT OF PILES


SCLEROTHERAPY Internal Hemorrhoids/Piles, Fissure:

This is an outpatient (OPD) ambulatory 15minute treatment which is the part of pratisaraniya Kshar karma of modern Ayurveda where the solution made of special kind of Kshar is injected on in sub mucosa (the uppermost layer) of internal Hemorrhoid/piles and if being used by a trained Kshar sutra specialist on Fissure bud too. this treatment is done by a very fine small needle which is normally called "insulin needle or insulin syringe" so the pain of treatment is negligible or easily tolerable, that's why there's no need of hospitalization or bed rest in this technique & patient can do all the daily routine works just after the procedure.

"SCLERO means hardening" so in this therapy we apply some special agents on internal bleeding hemorrhoid/piles and fissure & this causes the hardening of blood vessels and capillaries resulting in shrinkage of blood vessels and final result is the coagulation of blood for few days which gives adequate time to MCDPA therapy to work on hemorrhoid/piles & fissure. the sclerosing or pratisaraniya Kshar karma solution is generally injected on the internal hemorrhoid/piles of grade 1&2 and if being used by a trained proctologist or doctor then on 3 also which sometimes may need 2or more sittings depending on the grade & severity of disease. in western chemical synthetic medical system there are few popular sclerosing agent which are being used by trained proctologist globally, at our (Dr.MITTAL’S Kshar sutra & proctology centre) centre we do use the Herbo-mineral Ayurvedic medicines along with the special kind of pratisaraniya Kshar karma with sclerotherapy, in some cases we also use the globally accepted western sclerosing agents but the focus and priority is always given to the Ayurvedic system. it is a useful technique when used with the combination on Kshar sutra & Kshar karma for the treatment of grade 3&4 hemorrhoid/piles where the most of the sclerosing agent are not in use, the sclerotherapy alone has a little less effectiveness on hemorrhoid/piles & fissure in comparison to Kshar sutra but when the sclerotherapy is combined with pratisaraniya Kshar karma & Kshar sutra then it gives unbelievable results.The MCDPA therapy is a needed treatment system with the sclerotherapy.


RBL in Hemorrhoids/Piles: 

the rubber band ligation therapy is an outpatient treatment (OPD) procedure for the grade1 & grade2 internal hemorrhoids/piles and if done by a skilled proctologist then it can also be used on grade3 internal hemorrhoid/piles, it's an ambulatory OPD procedure which generally takes about 10 to 15 minutes without any general/spinal anesthesia or hospitalization, the need of bed rest is very rare which might be of 3 to 12 hours only depending on severity of case and number of hemorrhoids concerning the physical condition of patients.

in RBL procedure there is a small medicated/medical grade rubber band which is implant at the base of hemorrhoid/pile mass generally under local anesthesia with the help of and special surgical instrument stopping the blood supply to hemorrhoid/piles pile mass, the hemorrhoid/piles will shrink and die within few 3to7 days and fall off with the band during the normal bowel movement. the pain during the procedure is very rare as the main procedure is done under local anesthesia for which commonly numbing ointment or spray is used and the postoperative pain is also very less/ easily tolerable by an physically active patient even in most of the cases patient do not need to take oral analgesic/painkiller so the use of chemical synthetic analgesics/painkillers are very rare and depends on the pain bearing capacity &will of patient. at our centre (Dr.Mittal Kshar sutra & proctology center) we do the RBL procedure with the addition of Kshar karma and Kshar sutra for higher success rate which also replaces the use of chemical synthetic antibiotics with modern Ayurvedic immuno booster medicines leading to faster and better recovery, along with the MCDPA therapy.




OTHER TREATMENT / THERAPIES



LEECH THERAPY (JALAUKAVACHARAN /HIRUDO) therapy & RAKTAMOKSHAN (BLOOD LETTING):-

Leeches (Jalaukas) & Bloodletting (Rakta Mokshan) are one of the oldest Para-surgical instrument & procedure used from East Asia to western Rome & China for about 2500+BC to Increase blood flow & oxygen level in diseased organ to promote cell regeneration & healing.

In case of NON HEALING CHRONIC WOUNDS and especially in the cases of DIABETIC FOOT & VERICOSE ULCERS where the main cause of disease is the reduce blood flow, the enzymes in the leech saliva increases the blood flow and the blood thinners in saliva increases the blood & oxygen supply to the tissue resulting in regeneration of the cell with time.

Rather than leech other modes of blood-letting are CUPPING, ALABU, VENO PUNCHERS, PRP-PRF etc are done as per individual need of patient.

This is a an outpatient/OPD, ambulatory, easy and globally accepted technique for BLOOD LETTING which increases the blood flow and oxygen supply to the necrosed tissues , the increased blood flow helps revealing inflammation and edema also, the enzymes which are secret by leech in the bloodstream also works as blood thinner so the blood clots get removed from the site and the enzymes in the saliva do their anti inflammatory & anti-edema action to subside the symptoms.

In case of external inflamed & thrambosed hemorrhoid & other diseases where impaired blood flow because of blood clote.ge. Berger’s disease, Venous thromboembolism, peripheral artery disease, Atherosclerosis, lymphedema, varicose vein etc which generally requires surgery to remove clots or even organ/tissue amputation in severe case but the blood thinning property of leech saliva dilutes the blood clot & increases the blood flow so the clot get diluted & goes with the blood flow.


OXYGEN THERAPY IN non healing wounds: 

One of the most prominent factors for cell growth and cell regeneration is oxygen supply, in cases of non healing chronic wounds the main cause of impaired healing is loss of blood and oxygen supply to the needed tissue or cell. there are several therapy available to promote the blood supply in modern Ayurveda which increases the oxygen flow to the tissue like hirudotherapy, bloodletting, sudation therapy, Kshar karma & PRP etc. the oxygen therapy is a mechanical or artificial channel to supply hyperbaric oxygen to the desired organ where it is needed, the oxygen is supplied in the same way as we do to give oxygen to the patient who is in hospitalization for breathing/oxygen need by oxygen mask to the patient, in the cases of impaired wound healing the oxygen is supplied with sudation therapy to the desired organ where the sudation increases the blood flow and the artificial channel of oxygen increase the oxygen level of tissue which also deals with anaerobic bacteria’s.


PRP/PRF & BLOODLETTING in diabetic foot & varicose ulcer, non-healing

Wounds etc:

to increase the blood floor and oxygen supply to promote the cell regeneration is done by these mechanical techniques in the case of diabetic foot ulcer and varicose ulcers and non healing wounds and sometime in foreign years and with their names the increased oxygen supply by increase blood flow is the necessity of every living tissue for the regeneration in this techniques the PRP is done by taking the patients on fresh blood and separating the plasma from the blood and that it is then injected locally to the tissue in bloodletting procedure depending on the type of procedure is depends on the case and severity of case the techniques is to increase the vascular circulation of blood naturally by forcing blood flow by mechanical procedures to the organs by which the increased web flow leads to the increased blood supply does resulting in cell regeneration. This outpatient OPD ambulatory treatments do not requires hospitalization or bed rest depending on the physical condition of patient & systematic disease.


IMMUNOTHERAPY / VAJIKARAN RAMAYANA chikitsa for immune compromised:

Patient: along with globally accepted detoxification therapy of Ayurvedic PanchKarma & yoga the Ayurvedic Herbo-mineral natural medicines are used for the treatment of patients who are suffering from post surgical/traumatic too.