A Clinical Study on the Management of Arsha (Haemorrhoids) with Ksharsutra Therapy in Shalya Tantra

Abstract

Arsha (Hemorrhoids) is a common anorectal disorder described under Ashta Mahagada in Ayurveda, characterized by bleeding, prolapse, and pain, significantly affecting quality of life. Ksharsutra therapy, a parasurgical intervention in Shalya Tantra, offers a minimally invasive alternative to conventional surgical procedures. The aim of the study is to evaluate the clinical efficacy of Ksharsutra therapy in the management of Arsha.A prospective clinical study was conducted on 30 patients diagnosed with Grade III-IV haemorrhoids at Greenland Hospital and Research Centre Pvt. Ltd., Gorakhpur. Patients underwent Ksharsutra ligation under local anaesthesia and were followed for 4 weeks. Clinical outcomes were assessed using bleeding per rectum (graded scale), pain intensity (Visual Analog Scale), and prolapse grading. Data were analysed using descriptive statistics.  Bleeding per rectum reduced from 90% of patients at baseline to 15% post-treatment, indicating an improvement of 83%. Mean pain score decreased significantly from 7.5 ± 0.8 to 1.8 ± 0.6, reflecting a 75% reduction. Prolapse regressed from Grade III–IV to Grade I-II or absent in most cases, with a 70% improvement. Sloughing of pile mass occurred within 5–10 days in 90% of patients. No major complications or recurrence were observed during the study period.  Ksharsutra therapy demonstrates significant clinical efficacy in the management of Arsha, with marked reduction in bleeding, pain, and prolapse, along with predictable sloughing and minimal complications. It is a safe andcost-effective, treatment modality.