A Randomized Comparative Clinical Study to evaluate the Rakta Stambhana effect of Yavanyadi Churna & Nagkeshara Churna in the management of Raktasrava with special reference to Anal Bleed

Bleeding per rectum is the commonest but alarming symptom of all the anorectal complaints of the patients. Acute overt Lower Gastro-Intestinal Bleed (LGIB) accounts for approximately 20% of all cases of GI Bleed1.

Rectal bleeding has a prevalence of 14% to 19% in adults1. 44.9% of general practitioner referrals for colonoscopy presenting rectal bleed found serious abnormalities. Since rectal bleeding is a cardinal symptom of many colorectal diseases including colorectal cancers, haemorrhoids, fissure in ano, fistula in ano, etc1. 1st and 2nd degree haemorrhoids present with bleeding- splash in the pan (bright red in colour), and mass per anum (2nd degree haemorrhoids)2. while Acute fissure-in-ano features as bleeding (dropwise or streak along the stool), pain and constipation3.

In classics Pittaja and Raktaja varieties of Gudagata Rogas having bleeding per rectum as the commonest symptom. Gudagata Raktasrava is mainly noted in Pittaja Arsha and Raktaja Arsha associated with Daha and Avagadha Pureesha4, while Parikartika is also due to Pittaprakopa presenting with Tivarashoola and Raktasrava from Gudpradesha5.

In classics we get various treatment modalities for Gudagata Vikara associated with Raktasrava. Acharya Vagbhata has mentioned about Yavanyadi Churna, which is indicated in the management of Atishonita Pravrutti (Profuse Bleed)6, whereas Nagakeshara Churna is said to be act as Shonita Sthapana in Bhavaprakash Nighantu7.

Yavanyadi Churna ingredients are Yavani, Indrayava, Patha, Bilwa, Shunthi, Rasanjana and all are having properties like Katu, Tikta, Kashaya Rasa which leads to Kaphashamana and Raktasthambhana, Ushna Veerya and Katu Vipaka leads to Kaphashamana, Aamapachana and Agnideepana8. Nagakeshara Churna having properties of Kashaya Tikta Rasa, Laghu Ruksha Guna, Katu Vipaka, Sheetoshna Veerya and works as Kaphapittashamaka which is said to be act as Shonita Sthapana7.

As both Yavanyadi Churna and Nagakeshara Churna are indicated for Shonita Sthapana, Hence the present study in undertaken to evaluate the Rakta Stambhana effect of Yavanyadi Churna and Nagakeshara Churna in the management of AnalBleed.