What is Pilonidal Sinus? – Causes, Symptoms and Ayuredic Treatment
Abstract
Due to a sedentary lifestyle the problem of pilonidal sinus has been raised to a great extent. The main leading cause of this disease is prolonged sitting habits. It can be seen in people having occupations which make them sit in one place for a long duration.
Introduction
The word pilonidal means ” nest of hairs” and sinus is “an opening tract found within the body” Pilonidal sinus is a disease in which there is formation of sinus/tract or small channel giving rise to a source of infection that opens to the surface of skin, typically occurs at cheek folds of buttocks or can also affects armpits ,navel and genital region. In ayurveda we can correlate it with “शल्यज नाड़ी व्रण” explained in sushrut samhita nidan sthan chapter 10 (‘विसर्पनाड़ीस्तनरोग’)
“शोफ़म न पक्वमीति पक्वमुपेक्षते यो यो वा व्रणम प्रचुरपूयम साधुवृत्तः |
अभ्यन्तरं प्रविशति प्रविदार्य तस्य स्थाननानि पूर्व विहितानि ततः स पूयः ||(9)
तस्यातिमात्र गमनाद गतिरित्यातश्च नाड़ीव यदवहति तेन मताः तु नाड़ी |
दोषैस्त्रि भिर्भवति सा पृथगेकश्च सम्मूर्छितैपि च शल्य निमित तो अन्या||”(10 (सु नि १० /१०)
It says that due to improper handling of a case if one considered a पक्व शोफ as
अपक्वone and does not treat an oozing wound then the pus start accumulating inside the body channel and give rise to a disease called गति/ नाड़ी(नाली में जल बहने की तरह पूय के बहने से ‘नाड़ी’ कहलाता है) .
It is of 5 TYPES(वातज ,पित्तज,कफज ,सनिपातज ,शल्यज नाड़ी व्रण).
About 3 per 10,000 people per year are affected by this and it occurs more often in young males as compared to females.
Causes
- Exact cause of the disease is not known; it is believed to be a combination of changing hormones levels within the body.
- Seen more often in the puberty phase of life due to increased hormone levels within the body.
- Due to excessive hair growth and friction from clothes, spending more time in sitting can force bodily hairs to ingrow beneath the superficial layer of the skin. The body starts considering it as a FOREIGN SUBSTANCE and starts launching an IMMUNE RESPONSE against it.
- Increased pressure on the coccygeal region of the body may lead to this .
- Trauma can be considered as a cause because it compels a person to stay in a resting position over a longer duration of time.
- Over sweating can also be taken as one of the causes.
Risk Factors
- Obesity is supposed to be a great risk factor in giving rise to the disease.
- Family history within the family members because people tend to inherit features like excessive hair growth,over sweating from their parents.
- Not engaging yourself in any kind of physical activities.
- Sedentary lifestyle
PATHOGENESIS
Due to above mentioned reasons Moisture can fill up a stretched hair follicle leads to creation of ‘low oxygen environment’ within the affected area.
Promotes growth of “ANAEROBIC BACTERIA” inside the pilonidal cyst or sinus.
Which hampers blood circulation and metabolism of the body leads to improper WOUND HEALING and exacerbates a forming pilonidal cysts.
SIGNS/SYMPTOMS
- Intermittent pain at regular intervals.
- Discomforts and swelling above or near the tailbone of the body.
- Opaque yellow purulent or bloody discharge.
- Unexpected moisture over the affected region.
- Felt pain in doing sit ups ,riding a bicycle or any other activity that can roll over the tailbone area.
- Reddened sore skin around the area.
- Fever is common as due to increased infection inside the body ,a defence mechanism starts acting against it by raising body temperature to fight this.
- Patient becomes restless and irritated.
- Shivering is also there.
- Patient’s Sleep cycle is altered and disturbed.
As we correlate this disease with “शल्यज नाड़ी व्रण” it is said that:
नष्टं कथाचित अनुमार्गामुदितरितेषु स्थानेषु शल्यंचिरेन गतिं करोति |
फेनिल मथित मच्छ असृग विमिश्रमुष्णं स्रवित सहसा स रुजा नित्यम||
(सु. नि.10)
It states that, when an external object goes inside the body and stays there for a longer duration leads to severe pain ,also there is a foamy,clear or bloody discharge and ache continues repeatedly for some time.
PROGNOSIS
As Mentioned in (सु. चि.17 विसर्पनाड़ीस्तनरोगचिकित्सा)
There are 5 types of nadi rog
- वातज
- पित्तज
- कफज
- सनिपातज
- शल्यज नाड़ी व्रण
The सनिपातज type is असाध्य takes time to cure.
Remaining four types are प्रयत्न साध्य which means if treated properly in early stage it can cure from the root and prognosis is also ‘Good’
Treatment of Pilonidal Sinus
As mentioned in ayurveda the line of treatment to be used in this disease is as follows:
“नाड़ी तु शल्य प्रभवाम विदार्य निर्हत्य शल्यं प्रविशोध्य मार्गम |
संशोषयते क्षौद्र घृत प्रगाढै स्तितैलस्ततो रोपणमाशु कुर्यात||”
(सु. चि.17)
According to this firstly we need to do vidaran karm of shalay- It means by applying pressure we need to remove the pus or ooze that gets collected in the cyst. Then, take out the shaly from the body and do samshodhana karm of the tract. Apply क्षौद्रघृत मिश्रित तिलकल्क on the wound to do ropan karm i.e healing process which makes wound to heal completely.
- As there is formation of sinus / tract inside the body –we can also use the क्षार सूत्र method to cure the disease.
- This treatment modality of ayurved is considered to be one of the oldest and peculiar cures present in today’s world.
- In this a herbal thread made up of herbal drugs like – haridra, apamarg kshar applied on it ,placed manually by physician inside the sinus tract and leave it there for some time for wound healing, it will gradually heals it and then physician take the thread out from the tract.
- संशमन चिकित्सा- in this as mentioned in ayurveda we need to use those herbs having anti inflammatory and anti bacterial properties such as:
1. Haridra(curcuma longa) contains antioxidant,antifungal and antibacterial properties.
2. Neem (Azadirachta indica) has antibacterial properties.
3.Guduchi(Tinospora cordifolia) having antipyretic properties.
Also there are some famous herbal formulations mentioned by PLANET AYURVEDA, one of the best organisations offering its services to make herbal wellness a part of every home in the world.it is dedicated to the promotion of natural herbs and bringing their benefits to the common man.
Some listed formulations are as follows:
1. Dashang Lepa
It includes Shirisha (Albizia lebbeck), Licorice (Glycyrrhiza glabra), Sandalwood (Santalum album), Cardamom (Elettaria cardamomum), Turmeric (Curcuma longa) etc. are the herbs are Ayurvedic powdered formulation that helps in treating various types of skin problems and helps to heal Pilonidal sinus.
Dosage– As advised by the physician
2. Nirgundi Oil
Is prepared from single herb called Vitex negundo (Nirgundi) which is an anti inflammatory and anti bacterial in nature that helps in relieving inflamed sinus.
Dosage– Apply it over the affected area.
3. Boswellia Curcumin
Shallaki (Boswellia serrata) and Curcumin (Curcuma longa) are used in the proper form to prepare these herbal capsules that work as a strong pain reliever and treats inflammation and infection of the sinus.
Dosage– 1 capsule twice daily with plain water after a meal.
4. Gandhak Rasayan
This is a tablet prepared from purified sulphur (Shuddha gandhak) and possesses many medicinal properties like antibacterial, antifungal, anti-inflammatory, anti tumor, etc. All the properties help in treating the sinus by relieving inflammation.
Dosage-2 tablet twice daily with plain water after meals.
According to modern methods used in treatment are
- Proper shaving and cleaning of the affected region is done with an antiseptic solution.
- In early stages – one can use antibiotics and analgesics twice a day.
- If production of infection is present – Incision and Drainage of the midline is prescribed.
- Marsupialization – is a surgical procedure of cutting the slit into an abscess and then suturing the slit to form a continuous surface from exterior surface to interior surface of the abscess.
CONCLUSION
Thus we can conclude that pilonidal sinus is a disease which can be treated from the root level by taking care of a few things like avoiding prolonged sitting, reducing overweight, trying to indulge yourself in physical activity, and proper shaving of body hairs.
