Efficacy of Yava Kshara Sutra Transligation in the Management of Arshas (3rd & 4th Degree Haemorrhoids)- A Randomised Controlled Clinical Study

Abstract

Arsha is named as one of the most common Guda Vyadhis. According to Acharya Vagbhata, Arshas are defined as Mamsankura. which obstruct Guda Marga and thus affect the person like an enemy. In contemporary terminology, Arshas is comparable to piles or hemorrhoids, which represent pedunculated growths due to the engorgement of radicles of superior, middle, and inferior rectal veins. As per the Sushruta Samhita text, the management of Arshas involves Bheshaja Chikitsa, Kshara Karma, Agnikarma, and Shastra Karma. Chikitsa of Arshas by the use of kshara is minimally invasive as well as cost effective and is a potent alternative for surgical procedures. Apamarga (Achyranthes aspera) has shown its efficacy in the management of anorectal disorders and has been used widely for Kshara preparation. The only limitation to its usage is its seasonal variation in growth; thus, there is a need of alternative Kshara dravya. Yava (Hordeum vulgare Linn.) commonly known for its Lekhana action described by Acharya Sharangadhara, is employed for Kshara Sutra preparation in this study. Objectives: To evaluate Yava Kshara Sutra as an effective, easily available, and economical alternative to Apamarga Kshara Sutra in the management of Arshas (3^rd & 4^th Degree Haemorrhoids). Materials & Methods: A minimum of 40 patients diagnosed with symptoms of Arshas attending O.P.D & I.P.D of Shalya Tantra Department, S.J.G. Ayurveda Medical College and Hospital, Koppal, Karnataka, selected for the study. Outcomes: All 40 patients diagnosed with Arshas (3^rd & 4^th degree Hemorrhoids) were randomly divided in Group A and Group B and subjected to Kshara sutra transligation procedure of management. Conclusion: This case study demonstrates the therapeutic efficacy of Yava kshara sutra and comparison with standard Apamarga kshara sutra transligation in the management of Arshas (3^rd & 4^th degree Hemorrhoids).