A clinical study to eveluvate the efficacy of injection therapy and apamarga kshara in arshas

Arshas which is compared to haemorrhoids in the contemporary science is the commonest   ano-rectal condition seen in the practice of proctology. The dilated veins within the anal canal in the sub-epithelial region formed by radicles of superior, middle and inferior rectal veins are called as Haemorrhoids. Incidence of this disease can be traced since Vedic period. Its incidence increases with advancing age, at least 50% of people over the age of 50 years have some degree of haemorrhoidal symptoms. Now a day’s most of the persons suffer from any one of the complaints of piles during their life time.

The ancient medical authorities like Acharya Charaka and Acharya Sushruta both have described four types of measures for the treatment of Arsha.These are Bheshaja, Kshara, Agni and Shastra. Acharya Sushruta speaks much about Kshara, Agni, Shastrakarma. While going through the chapter of treatment of the disease Arshas, it becomes quite evident that Kshara Karma has been indicated for all the varieties of Arshas, that even the pedunculated and Arsha of a very big size can also be successfully treated with the help of Kshara Karma. Hence the repeated advocacy of Kshara Karma by almost all the ancient Acharya in the disease Arshas has given an inspiration to work on the disease Arsha with the help of Pratisaraneeya Kshara, because of its simple technique and it has important properties like Chedana, Lekhana, Ropana.

Pratisaraneeya Kshara described as an upakrama, substitute for surgical instruments, can be used safely in patients who are afraid of surgery. The detailed description of many Kshara preparations are available in Susruta Samhitha.

According to modern surgery haemorrhoids, which are not treated properly or neglected, may lead to complication such as strangulation, thrombosis, portal pyaemia, suppuration, haemorrhage etc. The management of haemorrhoids in modern medical science is changing from conventional surgical procedure i.e., Haemorrhoidectomy to other procedures like Injection Therapy, Rubber band ligation, Cryosurgery, Laser therapy etc. Injection therapy is a form of sclerotherapy, where 5% Phenol with Almond oil is injected submucosally causing fibrosis in submucosal region and thereby fixation of the anal cushions which do not prolapsed.

Hence an effort is made to compare and evaluate the efficacy of Injection therapy and ApamargaPratisaraneeya Kshara in Arshas.