A controlled clinical study to evaluate the effect of Saindhavadya taila purana over Kasisadi taila purana in the management of Abhyantara arshas (Internal haemorrhoids)

Haemorrhoids are the dilated veins within the anal canal in the sub-epithelial region formed by radicles of the superior, middle and inferior rectal veins. Internal haemorrhoids are those which are within the anal canal and internal to anal orifice.

It’s incidence increases as age advances and at least 50%of the people over the age of 50 years have some degree of haemorrhoidal symptoms. The prevalence rate of piles is 4.4% in the world, in about 10 million people. Haemorrhoids may occur at all ages, but are uncommon below the age of 20 years and more than 65 years.

The modern modalities of treatment in 1st and 2nd degree internal haemorrhoids are Sclerotherapy, Rubber band ligation and Cryosurgery each procedure has its own complications like in sclerotherapy recurrence rate 15%, hypochondriac pain due to entry of drug into the portal system, ulceration, submucosal abscess etc. In Barron’s banding if applied low into skin it causes severe pain, discomfort, secondary haemorrhage and ulceration. In Cryosurgery after procedure profuse watery and foul smelling discharge which starts within 3 hours of the procedure and lasts for 2 to 4 weeks and recovery is prolonged So, modern science has very little to offer in terms of medical treatment of piles.

Arshas is one among the Gudagata vikaras which can be correlated to the Haemorrhoids. According to Acharya Vagbhata, Arshas are mamsankura (protrusion of mamsa) which obtructs Guda marga and torture the person like enemy . It is Deerghakalanubandhi, Dushchikitsa, Tridoshaja and it occurs in Marma sthana, so it is considered one among the Ashta Mahagada .

Arshas is manifested due to improper diet, sedentary lifestyle, prolonged standing, irregular sleep habits and Vegadharana which disturbes the digestive system and causes constipation and does dearrangement of tridoshas mainly Vata dosha. Vitiated dosha localizes in Gudavalli, pradhana dhamani and mamsadhara kala which vitiates twak, mamsa, medas and rakta resulting in maha sroto dushti.

Arsha which is formed within the Gudoushta (anus) is abhyantara arsha which is associated with symptoms of Mamsankura in guda , Shula, Raktasrava Acharya Sushruta has mentioned four treatment methods for Arshas such as Aushadha, Shastra, Kshara and Agni karma. Among the four modes of treatments mentioned, Aushada causes the least discomfort to the patient psychologically, physically and economically Hence effective management of this condition using an Aushadha is the need of the hour.

Acharya Charaka while explaining ’Saindavadya taila’  indications, Arshas and other diseases has been mentioned. So here an attempt is made to evaluate the effect of Saindavadya taila in the form of Guda purana with Kasisadi taila as its efficacy was proved to be effective hence it was taken as control drug in Arshas.