Background The management of fistula-in-ano remains a major surgical challenge and carries a significant morbidity affecting the quality of life (QOL) due to the disease and repeated operations but Ayurvedic para surgical treatment (ksharasutra) is considered as a safe in the side effect of surgery concern and least recurrences. The aim of the study was to assess the QOL before and after successful Ayurvedic para surgical treatment of recurrent fistula-in-ano using the gastrointestinal quality of life index (GIQLI) which is a validated instrument consisting of 36 questions for measuring quality of life in patients with gastrointestinal disorders including fistula-in-ano. All patients who underwent successful Ayurvedic para surgical treatment for recurrent fistula-in-ano over a period of24 months were prospectively analyzed using the GIQLI preoperatively and after a minimum of 20 months after complete cure following Ayurvedic para surgical treatment. The difference in the QOL scores was analyzed using Wilcoxon rank test. Results in the 100 patients recruited for the study there was a significant (P<0.01) difference between the average preoperative (97.02) and postoperative (116.14) GIQLI scores of all the areas assessed by the GIQLI questionnaire, greater statistical significance was seen in areas of emotions (P<0.01), social integration (P<0.01) and effects of treatment (P<0.01). Recurrent fistula-in-ano significantly affects the patients’ QOL, and also, successful Ayurvedic para surgical treatment results in significantly improved long-term QOL. This improvement shows the need for those patients with fistula-in-ano to be subjected to Ayurvedic para surgical treatment is the best intervention instead of surgery it carried significant risk to the analincontinence with recurrences.
