Arsha, described in Ayurvedic classics as Mamsankura formation in the Gudamarga causing obstruction and producing pain like an enemy, closely resembles hemorrhoids. Hemorrhoids are characterized by dilatation of the hemorrhoidal venous plexus and displacement of the anal cushions, presenting with bleeding, swelling, discomfort, and constipation. They are among the most prevalent anorectal disorders, affecting nearly half of the population by the age of 50, and pose a significant global health burden. Conventional management includes rubber band ligation, sclerotherapy, and infrared coagulation, particularly for Grade I–II hemorrhoids; however, these procedures may cause recurrence or complications.

Ayurveda considers Arsha as a Tridoshaja Vyadhi, with both Shushka and Sravi varieties described based on clinical presentation. Classical texts highlight several formulations possessing Arshoghna properties. Shigrumooladi Lepa, containing Shigrumoola Twak, Arka Patra, and Aja Mutra, demonstrates Katu, Tikta, and Kashaya Rasa contributing to Kaphashamana and Raktastambhana. Its Ushna Veerya and Katu Vipaka facilitate Amapachana, Agnideepana, and reduction of local congestion.

Considering the need for safe, cost-effective, and non-invasive treatment options, the present study aims to evaluate the clinical efficacy of Shigrumooladi Lepa in the management of 1st and 2nd degree hemorrhoids. This research intends to provide scientific evidence supporting its therapeutic benefits and contribute to integrative anorectal care.