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Brief Summary
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Introduction: Hemorrhoids (Arsha) disease is the commonest problem which is seen in the anal region due to hereditary, anatomical deformities, physiological causes, diet, secondary to disease, pregnancy etc.. A large database survey conducted in the United States and England found a prevalence of approximately 4 percent. The prevalence was equal in both sexes, peaking between the ages of 45 and 65, and declining thereafter. Development of symptoms prior to age 20 was unusual.The main cause of haemorrhoids is constipation. Constipation over a prolonged period of time, and have to strain to pass stools, it can damage the lining of anal canal. The increased pressure in the blood vessels of anus causes them to swell, resulting in the formation of haemorrhoids. Overweight and lot of heavy lifting are more prone to haemorrhoids. Common symptoms of haemorrhoids include Itching around the anus, Bleeding from the anus after going to the toilet, Discomfort or ache around the anus and lower bowel (rectum), Pain during and immediately after a bowel motion, Visible swelling around the anus, feeling that bowels have not been completely emptied etc. Haemorrhoids vary in size, and can occur internally (inside) or externally (outside) the anus. Internal haemorrhoids develop in the back passage, about 2- 4cm above the opening of the anus. External haemorrhoids are less common, and develop on the outside edge of the anus. Modern system of treatment has adopted a variety of methods like sclerotherapy (injection of sclerosent agent in submucous spaces of piles), rubber band ligation, infra red coagulation (IRC), cryosurgery (using N2O gas), hemorrhoidectomy etc., according to the nature and degree of pile mass, but these procedures have their own merits and demerits with limitations. The ancient acharyas have described this disorder as one of the mahagada and as a surgical domain. This disease is largely confined to the Guda but also in Nasa, Netra, Karna, Twacha, etc. regions. Etiological factors are vitiation of doshas in Guda valis, injury due to thorn, stone, nail, riding on horse, vehicles, sitting on irregular surfaces, regular contact of cold water etc., Charaka has given more emphasis on the conservative treatment and prescribed suitable dietary regimes with drugs to the patients for curing of Arsha by improving deepan and pachan karmas of the agni (enhancement of digestive capacity) in the body. Further, he has also advised kshara treatment for different types of Arsha. However, every system of medicine has given its own way of treatment for treating the Arsha. Sushruta has described fourfold method of treatments of Arsha (Su. Ci. 6), which are Bheshaja, Kshara, Agni and Shastra. Bheshaja i.e.Medical/conservative treatment includes various Ayurvedic medicines which decrease intra abdominal pressure, act as mild laxatives and thus give relief in the particular situation. Some other Oils/like Kasisadi taila when used locally (Lekhana) imparts relief in Arsha. The commonly used medicines are – Abhayarishta, Draksharishta, Satsakara churna, Triphala churna, Satpushpadi churna etc. Locally Kasisadi taila and inflammatory conditions Jatyadi taila are prescribed In certain other cases Ksarakarma and Ksharasutra are used effectively. Plain thread ligation of prolapsible internal haemorrhoids is also a popular method of treating the haemorrhoids on OPD basis (Sharma, 1999). Raktavasecana, Agnikarma and Shastrakarma are some other methods. However the Shastrakarma needs general/spinal anaesthesia. Bheshaja (Medicine) treatment is the most suitable treatment in the Arsha because of It is safe and easily available method to prescribe medicines and patient’s acceptability is good. Bheshaja chikitsa can however be mixed with other techniques or therapeutic measures. Ayurvedic medicines Triphala Guggulu is described in the Sharangdhar Samhita (Madhyamakhanda adhyaya 7/82-83) and Kasisadi tail in Bhaisajyaratnavali (Arshorogadhikar 111-113) for the treatment of Arsha (Haemorrhoid). In the present study 50 patients will be studied in this IMR project. The observations and discussion will be made according to statistical analysis on different standard parameters and SF-36-Health Survey Score. The aim of this study is to evaluate of clinical efficacy of Triphala Guggulu and Kasisadi Taila in the Management of Arsha (Haemorrhoids). Composition of Triphala Guggulu: (Sharangdhar samhita Madhyakhanda 7/82-83) 1.Haritaki, 2.Bibhitaki, 3. Aamalaki, 4. Pippali, and 5. Suddha Guggulu
Composition of Kasisadi Taila : (Bhaisajyaratnavali Arsorogadhikar 111-112) 1. Kasisa, 2. Saindhav lavana, 3. Pippali, 4. Sunthi, 5. Kustha, 6. Langali, 7. Pasanbheda, 8. Karavira, 9. Danti, 10. Vidanga, 11. Citraka, 12. Haritala, 13. Manahsila, 14. Swarnaksiri, 15. Snuhi, 16. Arkapayas, 17. Tila taila and 18. Go Mutra.
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