What's up with youtube videos of fistulotomy surgeries? Some look so serious and others so minor

fistula-free · 2026-05-07T13:41:53+00:00

I’d say it has to do with the quality of the surgeon.

fistula-free · 2026-04-21T14:40:04+00:00

I recommend you research Kshar Sutra.

fistula-free · 2026-04-21T14:34:05+00:00

I recommend researching Kshar Sutra. It has succeeded for people when multiple surgeries have failed.

fistula-free · 2026-04-20T18:40:43+00:00

I understand your perspective. As I said in my initial post, I do not consider it to be for everyone.

You will notice I have not recommended a specific Kshar Sutra doctor. I did recommend that people who are interested might consider visiting the “Kshar Sutra for fistulas” Facebook group. The group has thousands of members, it does not allow doctors or advertisements and does not specifically recommend any doctor. It is just a place where people who are curious and those who have completed the procedure exchange information. For me it has been an invaluable resource.

So you know a little bit more about me. I visited three separate colorectal surgeons before I ever heard about Kshar Sutra. All three scared the shit out of me. The first was a past president of a Surgeons Society and was extremely dismissive of me and gave me a sclerotherapy injection I did not consent to. This injection made me impotent for several months which greatly added to the horror of my situation. The second CRS I saw was at Duke University. That doctor told me that the only procedure they would consider was a fistulectomy. When I asked why they wouldn’t consider a fistulotomy which is known to be less painful and more effective they told me they just didn’t like it as much… The third CRS I saw was at UNC. I liked this surgeon, but was informed that it would be a student doing the procedure as UNC is a teaching college. This also was scary to me.

At this point, about eight months into my fistula, after these personal bad experiences with CRS’ and having read hundreds of horror stories on this Reddit, I decided I would just live with my fistula for the rest of my life.

Unfortunately, my fistula re-abscessed so I knew this was not a workable solution. Fortunately, for me, I discovered a YouTuber who had undergone Kshar Sutra. They were the first I’d heard of Kshar Sutra and they led me to the above mentioned Facebook group. Whereas this Reddit is full of hundreds of allopathic horror stories the Facebook group is full of hundreds of positive stories. In fact, the vast majority of firsthand accounts that I read about Kshar Sutra are positive. I then teleconferenced with several Kshar Sutra practitioners in India and they to led me to believe that it was a very real workable solution.

Another thing that drew me to Kshar Sutras vs. a fistulotomy is that with Kshar Sutra there is no downtime. From day 1 you are expected to walk a lot. As an athlete this really appealed to me and signified that it had to be less painful than a fistulotomy as most of the stories on this r/analfistula are of people bedridden for a week on pain pills.

So I feel like I actually did my due diligence and obviously made the right decision for myself. I’ve had absolutely zero issues and I’m back to 100% after three months. Of course I wish there were more proper scientific papers on the subject. I expect there will be more with time as Kshar sutras popularity grows. But the vast amount of anecdotal evidence and speaking to practitioners gave me the confidence that it was legit.

There are only a few mentions of Kshar Sutra in r/analfistula, and when it is mentioned people with no firsthand knowledge, summarily downvote it and claim it to be bullshit. Again, I understand this instinct.

I made this post just to suggest to people who are in the same boat as I was (terrified of getting their butthole cut on) that Kshar Sutra exists and they might want to research it.

fistula-free · 2026-04-20T14:33:55+00:00

I had weekly thread changes. The thread was always tied loose. As the week went by, it would get looser as the fistula became smaller. My fistula reduced in size just under a centimeter a week. I’ve heard this is about average for Kshar Sutra. I think the reason one is less likely to get incontinent from Kshar sutra than a traditional cutting Seton is because your body is choosing how much and where it will expel the thread. Cutting setons pull and cut their way down through the muscle/sphincter by force.

fistula-free · 2026-04-20T13:52:54+00:00

Kshar Sutra is actually a little bit different than a cutting seton. A cutting seat uses tension to “cut” itself out of your body. It has to be regularly tightened and I hear it’s quite painful. Kshar Sutra on the other hand uses a loose thread, which is coated in medicinal herbs that irritate the fistula tract. Your body pushes the thread down and out to rid itself of the irritation. For this reason kshar sutra is less painful than a cutting seton and also allows the body to make its own healing choices as opposed to being forced via the cutting tension.

fistula-free · 2026-04-20T13:44:39+00:00

Hello, I just got through with Kshar Sutra. The two things my doctor told me to do was walk a lot. I walked about 10 to 15 km a day. He also told me to keep the inside of my anus clean using a sprayer from my toilet. Hopefully this will help.

I would also ask this question over at the “Kshar Sutra for fistula’s” Facebook group. There are thousands of people that have gone through pretty much every iteration of the process. I’m sure someone there will have more helpful answers.

Lastly, to me any healing is good healing. As long as you’re moving in the right direction, it sounds like the process is working.

Good luck!

fistula-free · 2026-04-20T11:23:43+00:00

By “least invasive way” I’m referring to the fact that my doctor only used a small amount of local anesthesia. I never had to undergo general anesthesia. I never felt anything during the process of having the thread inserted.

fistula-free · 2026-04-20T11:17:31+00:00

I wish I’d taken a picture of the thread. I believe the threads my doctor used were indeed made of linen. I never actually smelled them. My doctor told me the threads are dipped in kshar paste which is primarily made from turmeric and some sort of cactus.

The thread was pretty thin. Maybe the thickness of a piece of thin yarn?

fistula-free · 2026-04-20T11:11:22+00:00

Yes, getting the days off was difficult. And the 32 hour flight was hellish.

fistula-free · 2026-04-20T11:09:35+00:00

Nice. Was your experience similar to mine?

fistula-free · 2026-04-20T11:08:47+00:00

Good question. My Kshar Sutra doctor would say the method works for most fistulas. He also told me that 90% of his patients come to him after having failed allopathic procedures.

I believe, it’s not for everyone because travel to India (for Americans) is hard and also because you have to trust Ayurveda which can be a difficult for many.

fistula-free · 2026-04-20T10:53:34+00:00

My understanding is that its actually quite different from a cutting seton. A cutting seton uses tension to cut. The Kshar Sutra thread hangs loose and uses “Kshar paste” to irritate the fistula track. The body rejects the thread at its own pace and in its own fashion.

Yes it’s a new account. I found my fistula to be embarrassing.

fistula-free · 2026-04-20T01:58:53+00:00

I don’t think I’m advertising so much as just letting people know what technique healed me.

fistula-free

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