Abstract

LOCAL APPLICATION OF TILA NALA KSHARA IN THE MANAGEMENT OF ABHYANTAR ARSHA (INTERNAL HAEMORRHOIDS): A CASE REPORT

Vd. Jyoti S. Garule* and Vd. Vijay P. Ukhalkar

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Abstract

Arsha is gudmarmagat vyadhi. Arsha is an extremely common problem and it has been reported since thousands of years and its prevalence rate is highest among all anorectal disorders. It has been placed in group of “Ashtamahagada”. Arsha is clinically an engorged condition of haemorrhoidal venous plexus, which can be correlated with haemorrhoids. Vitiation of tridosha adversely affect the digestive system causing mandagni, leads to constipation, prolonged contact of accumulated Mala taints Gudavali & Arsha develops. In Ayurveda management of Arsha has been indicated viz. Bheshaj, Kshara Karma, AgniKarma, Shastra Karma. Local application of Kshara (pratisaran) is the best one treatment as per the available treatment modalities of Arsha. This parasurgical procedure, various forms of Kshara application are used in treating the Arsha i.e., Ksharasutra ligation, Ksharapatan etc. In this present study, Tila Nala (Sesamum indicum) Kshara, one among the best qualitative Ksharas, was locally applied directly on Abhyantar Arsha. Kshara has properties of excising (chedya), cutting (bhedhya), scraping (lekhya), tridoshagna. A male patient of age 31 yr, comes in shalyatantra opd, having complaints of per rectal bleeding, bulge comes out during defecation. the case was diagnosed as Abhyantar Arsha, at 3, 11 o’clock II degree internal haemorrhoids. This case was treated with application of Tila Nala pratisarniya Kshara, sit’z bath in lukewarm water & Triphala churna with lukewarm water internally. the complaints of mass per anum & PR bleeding resolved in 8days, patient has completely relieved within 21 days.

Keywords: Arsha, Internal Haemorrhoids, Tila Nala Kshara, Pratisarniya.