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Piles, fistula in ano & fissure in ano are the major diseases affecting anorectel area. Ayurveda helps in effective correction and management of the disease. It mainly includes ksharakarma and ksharasoothra. These are the procedures which has maximum success in arorectal cases without any recurrence.kshara sutra includes tying of medicated thread around the mass and it will fall off within 10 days. it’s a painless procedure and done in opd