Fistula in ano is almost a complex disease which demands multiple treatment approaches as the recurrence rates are very high. It is a surgically treatable disease, which almost demands surgery. sharasutra is the best alternative to the conventional surgery and that is why sharasutra is the hallmark of Ayurvedic surgery. In the post sharasutra treatment, application of sesame oil in the form of pichu as what we call is very good and it will help in faster healing. Warm fermentation in the form of swiss bath or avagaha sweda acts as a supportive therapy. It eases the pain which is caused due to the therapy and it also keeps the site hygienic. So application of sesame oil or hot fermentation or warm fermentation are always helpful in fistula in ano, but it has to be post procedure but it has to be post procedure or post sharasutra.

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