A clinical control study of gunjadi varti and ghoshaphala varti in the management of abhyantar guda arsha (2nd degree haemorrhoid)

To compare the efficacy of Gunjadi varti and Ghoshaphala varti in the management of abhyantar guda arsha (2nd degree haemorrhoid)

It has become notorious to manage Arsha through surgical procedure due to post-operative pain associated with many more complications. Also, surgery is not possible in many cases like extremes of age, surgically unfit persons, pregnancy. Both modern and ancient Indian system of medicine mentioned conservative (bheshaja) treatment for foremost Consideration. Ayurveda advocated equal importance to sthanik chikitsa along with bheshaja chikitsa in the form of lepa (creams/ointments), avagahan (fomentation), parishek (sprinkling), raktamokshan (bloodletting), abhyanga (local massage), Dhupan (Fumigation). Other than many oral medications for symptomatic treatment in Arsha, patients mostly need and ask medicine for local application for instant relief, mental satisfaction and avoidance of oral preparations due to fear of gastric troubles & bad taste of some medicines especially herbal preparations. Herbal and contemporary ointments for local application available in the pharmacy for the management of haemorrhoids have plastic applicators which while application sometimes make trauma/hurt inside the anal canal. So, when medicine has to be applied internally in internal hemorrhoids Gudavarti or rectal suppository must be a better option to avoid trauma and also it is easy for the patient to administer it by self at home. Varti Kalpana has been mentioned in almost all the Ayurvedic treatises viz. Charaka samhita, Sushruta Samhita, Ashtanga hridaya, Rasarathna samucchaya, Bhaishajya ratnavali, and Chakradatta. Bhaishajya ratnavali widely contributes different Guda Vartis in different diseases. It has been used to attain quick relief from conditions like Udavarta, Mutrkriccha, Baddha Koshta, Shula, Basti vyapad, Arsha. It causes vayu anulomana which results in the elimination of mala and mootra along with the removal of sanchitha rakta sleshma pooya dosas. Contemporary Suppositories are the modified form of ancient Varties. Rectal suppositories are used to produce local action at the site of application but many of them are used to produce systemic actions. Presently most common rectal suppository used in the management of hemorrhoidal disease is corticosteroid based (eg. hydrocortisone) along with anesthetic (eg. lidocaine), emollient (eg. allantoin), protectant & astringent (eg. zinc oxide). Medicinal herbs have numerous bioactive molecules & could be traced for their therapeutic potentials and converted into various dosage forms for convenience in treatment. Recent advances hence could be utilized for moulding Varti into suppository and enhancing the scope of therapeutic dosage forms.

Conclusion:  Gudavarti causes vatanuloman & removes sanchitha rudira, stambha, shoola, kandu, shwayathu in arshas. It treats arshas from its roots (Arsh samoola nivratheye). Hence, it could be used as a safe, simple & efficacious first line treatment along with oral medications in the Management of arsha.