A Minimally Invasive Ayurvedic Approach to Complex Fistula-in- Ano Using IFTAK Technique

Complex horseshoe fistula-in-ano is a challenging condition, often associated with recurrent infection, pain, sphincter involvement, and prolonged healing. Conventional surgical management carries significant risks such as incontinence, delayed recovery, and psychological distress. In this case report a 48-years-old male was presented with an external opening in left perianal region with pus discharge and severe pain, along with a right-sided abscess. MRI confirmed a complex horseshoe fistula. The patient was managed using the IFTAK (Interception of Fistulous Tract with application of Kṣhārasūtra technique), which allowed precise localization and eradication of the infected crypt while preserving sphincter integrity. The intervention resulted in minimal scarring, early symptomatic relief, rapid return to daily activities, and a reduced risk of recurrence. This case demonstrates that the IFTAK technique is an effective, minimally invasive, and patient-friendly alternative for managing complex fistula-in-Ano, offering favourable clinical outcomes and improved quality of life.