AN OBSERVATIONAL STUDY ON THE ROLE OF DIETARY AND LIFESTYLE
HABITS IN BHAGANDARA
Authors: Nadeer Nichu , C.V Deepthi , Valsalan Pravini 
Published: June 2024

Fistula in Ano is a chronic abnormal communication lined by granulation tissue which runs outwards from ano-rectal lumen to an external opening on perianal skin. In Ayurvedic classics, it was mentioned as Bhagandara, meaning ‘Darana’ around Bhaga, Guda and Basthi pradesha. Nowadays, everyone is bound by a busy and stressful schedule that leads to disruption of lifestyle, which harms the quality of life. Due to a lack of exercise and a sedentary life, most people suffer from various lifestyle diseases. The most common among them is ano-rectal diseases due to erect posture and habitat. Anorectal disorders are slowly progressing because of regular intake of junk food, low fibre diet and different lifestyle habits. Arshas (Piles), Bhagandara (Fistula in Ano) and Parikartika (Fissure in Ano) are the most common diseases among anorectal diseases. Among them, Bhaganda-ra is considered under Ashtamahagada (eight major diseases) by Acharya Sushruta due to its callous and chron-ic attitude. In Ayurveda, Ksharasutra ligation is the most effective treatment of Bhagandara; apart from that Acharyas also mentioned the concept of Pathya (wholesome foods and activities) and Apathya (unwholesome foods and activities) as a part of the treatment of this disease. Patients must have a diet that will keep their dhatus in good condition and not allow them to get vitiated. So, one should follow a healthy diet (Pathya) and lifestyle habits (vihara). Therefore, the retrospective cross-sectional observational study is reliable in finding the association between Fistula in Ano and dietary and lifestyle habits. Hence, looking forward to better manage-ment with harmony of food and lifestyle of a patient can prevent the incidence of Bhagandara without causing much effort to physician and inconvenience to patient.
The study's objective was to find the prevalence of everyday dietary and lifestyle habits with Bhagandara, create awareness of the necessity to adopt healthy nutritional and lifestyle habits, and break the chain of causation of Bhagandara. Also, I want to find out whether dietary and lifestyle habits have any significant role in the causa-tion of the disease bhagandara. A detailed literature review was compiled from relevant modern medical books.
Ayurvedic literature and the Internet on the disease, management, Nidanas, Pathyas and Apathyas.
A retrospective cross-sectional observational study with 69 participants of the age group 18-80 years who had fistula in Ano from O.P, Department of Salyatantra, satisfying inclusion and exclusion criteria was carried out. The participants were selected based on a purposive sampling technique. Then they were provided with the questionnaire, which was framed incorporating common Ahara and Vihara, which have been mentioned under Nidana of Bhagandara. Selected subjects having Bhagandara were provided with the questionnaire, and data was collected on the basis of a retrospective cross-sectional observational study.
The result was analysed based on the responses to questions framed based on Nidanas, Pathya Aahara, and Vi-hara. Since the data evaluated was based on the interpretation of the connection between two categorical varia-bles, such as the cause and the disease, the Chi-square test is an ideal choice for aiding in understanding and used to compare observed and expected results according to an assumed hypothesis.
The present study noticed a significant relation of Bhagandara with Nidanas and Pathya Aahara Viharas. Dietary and lifestyle habits both have important roles in the causation of disease. Each subject in the whole sample fol-lowed more than half of the lifestyle regimens incorporated in the study compared to dietary regimens.
Overall, both dietary and lifestyle habits have a significant role in the causation of Bhagandara, with a slight predominance of lifestyle regimen over dietary regimen in Bhagandara noted. Considering all observations, sta-tistical analysis was done, and conclusions were drawn. The study results assessed statistically reveals that the dietary and lifestyle habits already mentioned in Ayurvedic classics have a significant role in causation of the disease Bhagandara.