Management Of Arsha (Haemorrhoids) With Guggulu-Based Ksharasutra: A Case Report

Abstract

Arsha (haemorrhoids) is a common anorectal disorder described in Ayurveda as a protrusion of mamsa (muscular tissue) obstructing the gudamarga (anal canal). Conventional surgical treatments may be associated with postoperative pain, bleeding, delayed wound healing and anal stenosis/stricture. Ksharasutra (medicated thread with alkali) ligation is an established Ayurvedic procedure traditionally using Snuhi (Euphorbia neriifolia Linn.) as the binding agent, however, Guggulu (Commiphora mukul) has been used as an alternative for better tissue tolerance and healing. A 56 year old male with bleeding, pain, burning sensation during defecation and chronic constipation was diagnosed with interno-external piles at 3 o’clock. He underwent Guggulu based Ksharasutra ligation under local anaesthesia. Postoperative bleeding and pain resolved by the fifth postoperative day and the ligated pile mass sloughed off by the eighth day. Complete wound healing was achieved within one month without any complications. The case demonstrates that Guggulu based Ksharasutra is a safe, minimally invasive and effective option for the management of Arsha.