Pilonidal Sinus (PNS) or Pilonidal Abscess or Pilonidal Cyst or Sacrococcygeal Fistula

Homeopathic treatment

Before delving into homeopathic treatment let us first discuss the conventional or allopathic treatment available.

The conventional or allopathic treatment of pilonidal abscess or pilonidal sinus includes only the conservative management and at the end surgery. For acute conditions with severe pain and discomfort broad spectrum antibiotics are given to knock back on infection. But complete cure with antibiotics is impossible, so don’t make the mistake of thinking that you can cure with antibiotics. The antibiotics only kill the immediate infection but it usually comes back again.

When pain is severe or cellulitis is present and in chronic and recurrent cases surgery is required. The surgery is also not very useful as the condition has more than 90% chances of recurrence after surgery. After surgery you will be surely at ease from discharge but only for few days and again it will get reinfected causing it to suppurate even before the stitches have healed up. This becomes more distressful as there is pain of stitches and cut in addition to the usual discharge and pain. Life becomes hell if you get a recurrence of infection after surgery.

So the various side effects of the surgery are:

• Recurrence of the condition after surgery.
• Infection of the wound and bleeding from it.
• Urinary retention.
• Increased pain and discomfort in the area.

Homeopathy is an alternative method of treatment based on the nature’s law of cure, “like cures like”. Homeopathic medicines with its ultra minute doses are non-toxic, absolutely harmless and bring about safe cure. These remedies are a better substitute to the antibiotics.

Homoeopathy is not against surgery. Surgery is done to produce cuts in the muscles surrounding the sinus and remove a big chunk of mass. The same goal can be achieved by the homeopathic medicines without the use of a knife. The medicines help to heal the sinus, drying up the pus and go a long way to prevent the recurrence of the condition.

How homeopathy helps:

• Medicines are an effective alternate to the antibiotics.
• Remedies act as strong anti-inflammatory medicines which reduce the pain, discharge, drying up of the pus and reduces the discomfort.
• Medicines are non toxic and brings about speedy recovery.
• The treatment helps in avoiding surgery unless urgent.
• Remedies work on the constitution of the person which reinforces the immune system, making it stronger and hence there are less chances of recurrence of the condition.
• The treatment also helps in slowing down the progress of the disease and the development of complications.
• Medicines can improve the quality of life of people suffering with pilonidal disease.

There are 144 homeopathy medicines which give great relief in pilonidal sinus (PNS) or pilonidal abscess or pilonidal cyst or sacrococcygeal fistula. However, the correct choice and the resulting relief is a matter of experience and right judgment on the part of the doctor. The treatment is decided after thorough case taking of the patient. Thus remedies are designer made unlike allopathy in which all patients receive the same surgery or drugs although trade name may be different.

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What is pilonidal sinus (PNS) or pilonidal abscess or pilonidal cyst or sacrococcygeal fistula

A pilonidal sinus (PNS) or pilonidal abscess or sacrococcygeal fistula occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work for thousands of young people (mostly men) annually.

Pilonidal actually means a ‘nest of hair’. It is a cyst, abscess or a pocket of infection below the skin near or on the natal cleft of the buttocks that often contains hair and skin debris. A sinus tract goes vertically between the buttocks, causing pain and discomfort. A sinus tract typically goes between a focus of infection in the deeper tissues to the skin surface, so the tract may discharge pus time to time. Not everyone who has a pilonidal abscess has a pilonidal sinus.

It affects men more than women and typically occurs between the age of 15-24 years.

The condition was widespread in the United States during the Second World War. More than 80,000 soldiers having this condition required hospitalization. It was termed as “jeep rider’s disease” as long riding in the jeeps was considered to be the causative factor. But now due to long sitting hours at work it is again becoming very common.

Causes

The exact cause of pilonidal sinus is not clear. The various assumed causes are:

• Hormones : Sex hormones first produced at puberty are known to affect the pilosebaceous glands, which coincides with the earliest onset of pilonidal disease.
• Ingrown hair may be responsible for its development.
• Obesity and excessive sitting is thought to predispose to pilonidal sinus or abscess as it causes increased pressure on the coccyx region.
• Friction between the buttocks is responsible for sucking keratin and hair into the distended follicles, which leads to infection of the follicle and abscess formation.
• Infection : Anaerobic bacteria (particularly bacteroides and enterococci) result in the development of infection of the follicles and abscess formation.
• Some researchers have proposed that pilonidal cyst or sinus may be the result of a congenital pilonidal dimple. This subsequently collects hair and debris resulting in abscess and pilonidal sinus.

Risk factors

• Obesity: A body mass index (BMI) of 30, or more.
• Having an above average amount of body hair.
• Having a family history of the condition.
• Having a job which involves doing a lot of driving, or sitting down for long periods (sedentary life style).
• Local irritation or trauma prior to the onset of symptoms.

Symptoms

• Acute pilonidal abscess: Increasing discomfort and swelling over a number of days is noticed by the patient and the pain may be severe by the time of presentation. On examination there is a fluctuant swelling in the midline of the natal cleft with overlying cellulitis. There is intolerable pain experienced by the patient on separating the buttocks for examination.
• Chronic (persistent) pilonidal disease: Patients present with chronic pain and discharge, often with a history of up to 2 years.
• On examination a single or multiple sinuses may be seen. Tufts of hair and other debris like clothing fibers can be seen arising from the sinus. Localized swelling and inflammation may be seen.
• Complex or recurrent pilonidal disease: This is due to the reinfection of the neighboring hair follicles or chronic infection from entry of hair or debris into the wound.

Diagnosis

A pilonidal sinus can be diagnosed by your physician based on your symptoms and the findings on the physical exam. In general, blood work or imaging studies are usually not necessary.

Home care

• Patient should be advised to keep the area clean.
• Early in an infection of a pilonidal cyst or abscess or sinus, the redness, swelling, and pain may be minimal. Sitting in a warm tub may decrease the pain and may decrease the chance that the cyst will develop to the point of requiring incision and drainage.
• Posture : Posture of sitting must be corrected as poor sitting postures can aggravate the condition.
• Cushions: A coccyx cushion can help to keep the pressure off your tailbone.
• Hair removal: Keep the area always shaved to prevent the hair getting embedded.

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