J.R.A.S. Vol. XXXI, No.3, July -Sept. 10 pp.

1-14

A COMPARATIVE CLINICAL STUDY ON THE

EFFECT OF SOME COMPOUND AYURVEDIC
PREPARATIONS IN THE MANAGEMENT
OF ARSHA (HAEMORRHOIDS)
M. Mruthyumjya Rao: Anukul Chandra Kar~ P. Bhattacharya)
and Jayram Hazra"

Abstract
A single blind clinical trial to evaluate the efficacy of "Kankayana vati,
Kaseesadi taila vasti & Triphala churna in one group (Group -1) and Kravyadi
rasa, Kaseesadi taila vasti & Triphala churna" in another group (Group - 2) in
the management ofArsha (Hemorrhoids) was carried out at Ano-Rectal Clinic,
Central Research Institute (Ay.), Kolkata during the period from May 1999 to
March 2004. This trial was conducted on 477 patients of Arsha as per the
proforma designed by CCRAS, New Delhi.

In group - 1, out of247 cases who received the above regimen, 42.91
percent patients got complete relief, 27.12 percent patients got "marked" relief,
10.93 percent patients got" moderate" relief, 4.04 percent patients got "mild"
relief, percent patients got "No" relief while 13.36 percent patients were dropped
out. In group - 2, out oj230 cases who received the above regimen, 37.39 percent
cases got complete relief, 26.08 percent got marked relief, 14.78 percent got
moderate relief and 6.52 percent got mild relief, while 15.21 percent of cases
were dropped out. After analyzing the results it was observed that the differences
in the improvement among both the groups were minimal and negligible and
hence it is concluded that the drug combination of both the groups are similarly
ejfective in the management of Arsha.

1. Asstt. Director (Ay.) Central research Institute (Ay.) Unit-I, Bhubaneswar 2. Research Officer(Ay.)
CCRAS, New Delhi 3. Reasearch officer CAy.) & 4. Assist Director IIC Central Research Institute
(Ay.) Kolkata
M. Mruthyumjya Rao et al.

Introduction haemorrhoidectomy etc. This

For centuries the human race has
been plagued with a disease called
'Haemorrhoids'. The patients who
complain of piles may have one or
more of a number of individual
problems, that no single treatment
method can be advised for all patients
and that several different methods may
achieve actually good result. The
haemorrhoidal tissues (piles) are
normal structures which are thought to
play some part in anal continence.
Their size, shape and details of
anatomical configuration vary in the
population who do not complain of
any local problems. But any
classification of clinical disease must
be based on patients' symptoms
assigning from or caused by ill defined
derangement of anal canal function.
These symptoms may occur singly or
in combination: pain, bleeding,
prolapse, mucus discharge, peri-anal
itching, constipation and incontinence
to flatus and/or faeces.
Since the hemorrhoid problem is
not a threat to life excepting few
conditions, the least invasive
procedure/treatment is most desirable.
Several surgical/conventional
therapies are now in practice
depending upon condition
haemorrhoids like sclerotherapy,
rubber band ligation, anal dilatation,
photo coagulation, cryosurgery,
increasing number of therapies
themselves proves that there is no
universally acceptable technique in the
management ofhaemorrhoids.
Sushruta (800 B.C.), the father of
ancient surgery, has described 'Arsha'
one among of the mahagadas and
methodologically classified the
disease, and recommended different
drug regimens, which are widely
acceptable and practicable even today.
They are :
1. Aushadha Chikitsa
(Employment of medicinal
remedies)
2. Kshara Chikitsa
(Application of Kshara (alkali) i.e.
chemical Cauterization).
3. Agnikarma
(Thermal cauterization)
4. Sashtrakarma
(Surgical management).
Out of four therapeutic regimens,
the Kshara & Agni Karmas are
regarded as para-surgical procedures,
which can be carried out without much
preparation. In Sushrut Samhita, we
of can also see some external
applications apart from some oral
remedies.

2
A COMPARATIVE CLiNICAL. ...

Based on the treatment strangulated pile masses, and

descriptions given by Sushruta, the haemorrhoids associated with
present drug regimen is kept on trial on malignancy were excluded from the
477 patients selected from Ano-rectal study. The cases were randomly
clinic ofC.R.I.(Ay.), Kolkata as per the selected irrespective of age, sex,
selection I exclusion criteria laid down chronicity, prakriti and type of
by the Council and the results were haemorrhoids and follow-up was
analyzed and assessed on various made at interval of 7 days during the
parameters. study period of 21 days and at interval
of 15 days up to 6 weeks thereafter.
Materials and Methods
B. Drug
The study was conducted at
Anorectal clinic of C.R.I.(Ay.), I) Kaseesadi tail a 10 ml to be
Kolkata using specially devised administered per rectally half an hour
protocol & proforma, designed as per before defaecation daily once in the
both Ayurvedic and modern morning with the help of syringe and
parameters. Essentially, the trial aimed plain rubber catheter no. 7.
to evaluate the efficacy of this
2) Kankayana vati or Kravyadi rasa
Ayurvedic drug combination in terms
500 mg. daily three times with warm
of the days taken to check the bleeding
water after food.
as well as alleviation of associated
symptoms and to see the recurrence of 3) Triphala churna-5 gm. at bed time
bleeding & other symptoms even after with warm water.
complete healing.
C. Supply of drugs: Both Kaseesadi
A) Selection of cases:A total no. of tail and kankayana vati were supplied
477 patients with complains of by C.R.l.(A Y), Cheruthuruthy,
bleeding per rectum during and/or Kravyadirasa was supplied by C.R.I.
after the defecation with or without (Ay.), Kolkata and Triphala churna by
other symptoms like, itching, C.R.I.(Ay.), Patiala ofCCRAS.
discharge, constipation, with lor
D. Diet to be taken: Ghee, milk, rice
without pain were examined
and plenty of liquids.
perrectally and confirmed by
proctoscopic examination were To avoid: Non-veg. and spicy foods.
admitted for the study. The cases of

3
M. Mruthyumjya Rao et al.
E. Criteria adopted for assessment
ofthe response oftherapy:
Since the bleeding is the mam
symptom in the bleeding
hacmorrhoids, the days taken to arrest
the bleeding is noted along with
alleviation of other associated
symptoms and the result was assessed
in the following manner.
1. Complete relief: when the
bleeding is checked completely within
7 days of therapy and complete
disappearance of associated symptoms
if any and no recurrence up to 6 weeks
of the follow-up.
2. Marked relief : When the
bleeding is checked after 7 days but
Before 14 days of therapy and
complete disappearance of associated
symptoms if any and no recurrence up
to 6 weeks of the follow-up.
3. Moderate relief : Arrest of
bleeding after 14 days but before 21
days of the therapy and complete
disappearance of associated symptoms
if any and no recurrence up to 6 weeks
offollow-up.
4. Mild relief: Arrest of bleeding
after 21 days but before 30 days and
complete disappearance of associated
symptoms if any and no recurrence up
to 6 weeks offollow-up.
5. No relief: No checking of blood
4
before 30 days or checked after 30
days and/or recurrence even after
complete recovery from the
symptoms.
6. Drop out/LAMA
1. Discontinuation ofthe treatment
during the trial
2. Development of any senous
complications.
3. Aggravation of the disease.
Results / Conclusions
1) Condition of patients on
admission
1.1 Out of 477 patients admitted
for clinical trial, 357 were males
and 120 were females. Max imum
number of (119) patients belong to
the age group of 21- 30 yrs while
minimum of 52 cases belong to
below 20 yrs.
1.2 Out of 477 cases about 55
percent of patients reported to be
of Pitta Prakriti, about 36 percent
of VataPrakriti while minimum of
about 9 percent of Kapha Prakriti.
1.3 About 78 percent of patients
had constipated bowel habits
which is the main reason for the
bleeding per rectum in those cases
while minimum of about 10
percent had regular bowel habits.
A COMPARATIVE CLINICAL ..
1.4 Among 477 cases about 96
percent were non - vegetarians while
remaining were Vegetarians.
2)The characteristic of Arsha /
hemorrhoids on admission
2.1) About 57 percent of patients
had the disease for at least one year
while minimum number of patients
(6.07%) had the duration of illness
above three yrs. and 47 percent
patients had acute onset.
2.2) About 10 percent of patients
had previous history of anal surgery,
about 64 percent of patients had taken
medicines for this purpose while 26
percent of cases were reported as
afresh.
2.3) The type of Hemorrhoids was
recorded maximum as internal in
about 60 percent of patients while
minimum number of cases (9.85%)
were foundwith external type of
Hemorrhoids;
2.4) A maximum no. of 34.38
percent of Arsha was found to be of
Pittaja type followed by Raktaja with
the incidence of about 19 percent
while minimum number (5.03%)
found to be of Sahaja type of Arshas.
2.5) About 55 percent of hemorrhoids
was positioned at 3° clock followed by
5°, 11 & 7 clock positions with the
0 0
incidences of 45.7 %, 38.78 %,32.28
% respectively.
5
3) Clinical findings noticed on
admission
All patients had bleeding per
rectum and prolapse in 37.3 1percent,
40.46 percent had pruritis, ~5.55
percent had discomfort at peri-anal
region, 22.86 percent had pain
during/after defecation, and 32.07
percent had mucous discharge.
4) Haemoglobin levels recorded
on admission
In Group I: About 26.14 percent
had the mean hemoglobin of
6.5 gm%., about 63.15 percent had the
mean Hb% of 9.8 gm% percent while
remaining patients (7.69) had either
mild anemia or normal level of
hemoglobin with mean of 11.5 gm%
About 41.7 percent had moderate
bleeding, about 34.81 percent and
23.48 percent had mild and profuse
bleeding per rectum respectively.
In Group-II: About 12.14 percent
and the mean hemoglobin of6.8 gm%
about 49.56 percent had the mean
Hb% of 8.5 gm% percent while
remaining patients (38.69)% had
either mild anemia or normal level of
hemoglobin with mean of 10.8 gm%
About 60.43 percent had moderate
bleeding; about 9.13 percent and
30.43 percent had mild and profuse
bleeding per rectum respectively.
5) The speed of recovery from
bleeding and other associated
symptoms (Summarized in Tables
from I To VI):
M. Mruthyumjya Rao et al.

Table-l
Speed of Recovery from bleeding and other associated symptoms:(n = 477)

SI. Result / Recovery No. of patients Total

No
Group - 1 I Group -2

1 Complete relief 106 (42.91) 86(37.39) 192(40.25)

by 1 week
2 Marked relief 67(27.12) 60(26.08) 127(26.62)
by 2 weeks
3 Moderate relief 27(lO.93) 34( 14.78) 61(12.78)
by 3 weeks
4 Mild relief 10(4.04) 15(6.52) 25(5.24)
by 4 weeks
5 No relief 04(0.61) 00(00.00) 04(0.83)
after 4 weeks
6 Drop out IRecurrence 33(13.36) 35(15.21) 68( 14.25)
7 Total 247(100.00) 230(100.00) 477(100.00)

(i) (Table- I) but all of them (04 patients) had the

In Group-I : Healing took place in
211 patients with varying degree of
duration starting from one week to
four weeks. a) Out of 247 cases 33
patients were dropped out from the
study. b) About 42.41 percent patients
had healing (complete relief) by Ist
week, c) 27.12 percent had (marked
relief) by two weeks, d) 10.93 percent
had (moderate relief) by three weeks
and about 4.04 percent had (mild
relief) by four weeks. But after four
weeks 0.61 percent had the recovery
recurrence within 30 days.
In Group-II : Healing took place in
195 patients with varying degree of
duration starting from one week to
four weeks. a) Out of 230 cases 35
patients were dropped out from the
study. b) About 37.39 percent patients
had healing (complete relief) by 1st
week, c) 26.08 percent had (marked
relief) by two weeks, d) 14.78 precent
had (moderate relief) by three weeks
and e) about 6.52 percent had (mild
relief) by four weeks.

6
A COMPARATIVE CLINiCAL ..

Table- II
Speed of recovery according to Age: (n=477)
Age Results of the treatment (Percentage)
Group group
(in yrs.)
CR
I MR I MDR I MLR I NR I DO
I Total

Up to 20 7(2.83) 7(2.83) 3(1.21) 0(00) 2(0.80) 6(2.42) 25(10.12)

21-30 37(14.97) 10(4.04) 6(2.42) 2(0.800 0(0.00) 3( 1.21) 58(23.48)
31-40 31 (12.55) 13(5.26) 8(3.23) 1(0.04) 1(0.04) 10(4.04) 64(25.91)
41-50 18(7.28) 20(8.09) 7(2.83) 3( 1.21) 1(0.04) 7(2.85) 56(22.67)
51 & 13(5.26) 17(6.88) 3(1.21) 4(1.61) 0(0.00) 7(2.85) 44( 17.81)
above
Total 106(42.91) 67(27.12) 27(10.93) 10(4.04) 4(0.61) 33(13.36) 247(100.00)

2 Up to 20 13(5.65) 08(3.47) 0(0.00) 0(0.00) 0(0.00) 06(2.60) 27( 11.73)

21-30 32(13.91) 9(3.91) 5(2.17) 3( 1.30) 0(0.00) 4(1.73) 53(23.04)
31-40 15(6.52) 25(10.86) 10(4.34) 0(0.00) 0(0.00) 5(2.17) 55(23.91)
41-50 16(6.95) 11(4.78) 17(7.39) 3( 1.30) 0(0.00) 1(0.43) 48(20.43)
51 & 10(4.34) 7(3.04) 2(0.86) 9(3.91) 0(0.00) 19(8.26) 47(20.43)
above
Total 86(37.39) 60(26.08) 34(14.78) 15(6.52) 0(0.00) 35(15.21) 230(100.00)

(ii) (Table- II) In Group-II: Out of86 cases who had

In Group-I: Out of 106 case who had
complete relief, 37 patients fall under
the age group 21-30 yrs, 31 cases
under 31-40 yrs while minimum of 07
cases up to the age of20 yrs .. Out of67
cases who had marked relief,
maximum cases (20) were in the 41-50
yrs. age group, while minimum (07) up
to the age of 20 yrs. Out of 27 cases
who had moderate relief, the number
was almost equally distributed in all
the age groups. Out of 4 patients who
were under No response category, two
were in the group up to 20 yrs and one
each under 31-40 & 41-50 yrs. Relief
was found in all of them but recurrence
had observed in four cases.
7
complete relief, 13 patients fall under
the age up to the age of 20,32 cases
under 31- 40 years while minimum of
10 cases under the age of 50 & above.
Out of 60 caes that had marked relief,
maximum cases (25) were in the 31-40
yrs. age group, while minimum (07) up
to the age of 50 & above. Out of 27
cases who had moderate relief, the
number was maximum (17) in the age
group 41-50, while minimum (2) in the
group 51 & above. out of 15 patients
who were under mild response
category, 09 were in the group, 51 &
above and three each under 21-30 &
41-50 yrs. 14.
M. Mruthyumjya Rao et al.

Table-III
Speed of recovery according to type of Arsha ( n = 477)

Results of the treatment (Percentage)

Type of
Group
Arsha I---C-R---'Ir---M-R--r-I-M-D-R---'Ir--M-L-R~I-N-R---'Ir---D-O-I"----~-ot-a-I -

Vataj 9(3.64) 5(2.02) 8(3.23) 3(1.21) 1(0.04) 4(1.61) 30(12.14)

Pittaja 47(19.02) 25(10.12) 6 (2.42) 1(0.04) 0(00) 12(4.85) 91(36.84)
Kaphaj 14(5.66) 9(3.64) 2 (0.80) 0(0.00) 1(0.04) 0(0.00) 26(10.52)
Sannipataja 10(4.04) 11(4.45) 4 (1.61) 5(2.020) 2(0.80) 9(3.64) 41(16.59)
Raktaj 16(6.47) 15(6.07) 7 (2.83) 1(0.04) 0(00) 6(2.42) 45(18.21)
Sahaj 10(4.04) 2(0.80) 0(0.00) 0(0.00) 0(0.00) 2(0.08) 14(5.66)
Total 106(42.91) 67(27.12) 27(10.93) 10(4.04) 4(0.61) 33(13.36) 247(100.00)

2 Vataj 5(2.17) 5(2.17) 10(4.34) 4( 1.73) 0(0.00) 4( 1.73) 28(12.17)

Pittaja 37(16.07) 20(8.69) 4( 1.73) 6(2.60) 0(0.00) 6(2.60) 73(31.73)
Kaphaj 7(3.04) 12(5.21) 4( 1.73) 01(0.43) 0(0.00) 0(0.00) 24(10.43)
Sannipataja 19(8.26) 5(2.17) 8(3.47) 01(0.43) 0.(0.00) 14(6.08) 47(20.43)
Rakta] 16(6.95) 16(6.95) 6(2.60) 01(0.43) 0.(0.00) 9(3.91) 48(20.86)
Sahaj 2(0.86) 2(0.86) 2(0.86) 2(0.86) 0(0.00) 2(0.86) 10(4.34)
Total 86(37.39) 60(26.08) 34(14.78) 15(6.52) 0(0.00) 35(15.21) 230(100.00)

(Hi) (Table-III) In Group -II : Data shows maximum

of the Pittaja type of Arsha (37) had
In Group -I: Data shows maximum of
complete relief followed by
the Pittaja type of Arsha (47) had
Sannipataja (19) and Raktaja (16)
complete relief followed by Raktaja
type. Under marked relief category
(16) and kaphaja type. Under marked
maximum of20 patients of pittaja type
relief category maximum of 25
while minimum of 2 cases of Sahaja
patients ofpittaja type while minimum
type of Arsha. Under moderate
of 2 cases of Sahaja type of Arsha.
response category 10 cases were found
Under No response category 2 cases
to be vataja, 06 in Raktaja while 04
were found to be of Sanipataja and
each to be of kaphaja and pittaja type
one each to be of kaphaja and Vataja
ofArsha.
type ofArsha.

8
A COMPARATIVE CLINiCAL ..

Table-IV
Speed of recovery according to the duration of the illness (n=477)

Duration Results of the treatment ( Percentage)

Group of CR MR MDR MLR NR DO Total
illness
(in yrs.)
Up to 1 81(32.79) 39(15.78) 17(6.88) 4(1.01) 1(0.40) 8(3.23) 150(60.72)
t -2 18(7.28) 22(8.9) 7(2.83) 4(1.61) 2(0.80) 9(3.67) 62(25.10)
2-3 3( 1.21) 3(1.21) 2(0.80) 2(0.80) 0(0.00) 15(6.07) 25(10.12)
3& 4(l.61 ) 3(1.21 ) 1(0.40) 0(0.00) 1(0.40) 1(0.40) 10(4.04)
above
Total 106(42.91) 67(27.12) 27(10.93) 10(4.04) 4(0.61) 33(13.36) 247(100.00)
2 Up to 1 62(26.95) 34(14.76) 17(7.39) 4(7.39) 0(0.00) 4(1.73) 121(52.60)
1- 2 \6(6.95) 17(7.39) 9(3.91 ) 7(3.04) 0(0.00) 16(6.95) 65(28.26)
2-3 4( 1.73) 5(2.17) 6(2.60) 3( 1.30) 0(0.00) 8(3.47) 25(10.86)

3& 4(1.73) 4( 1.73) 2(0.86) 1(0.43) 0(0.00) 7(3.04) 19(8.26)

above
Total 86(37.39) 60(26.08) 34(14.78) 15(6.52) 0(0.00) 35(15.21) 130(100.00)

(iv) (Table-IV)

In Group -I : Analysis was made In Group-II: The maximum number

about the response in reference to the
duration of the disease and it shows the
maximum number (81) who
complete relief (106) had the duration
of illness less than one year. Out of 67
who had marked relief, 39 had illness
less than one year followed by 22 cases
up to 2 years. Out of27 cases who had
moderate relief, maximum
(17) had the illness less than one year.
(61) who had complete rei ief (86) had
the duration of illness less than one
had year. Out of 60 who had marked relief,
34 had illness less than one year
followed by 17 cases up to 2 years. Out
of 34 cases who had moderate relief,
maximum number 17 had the illness
less than one year.
number

9
M. Mruthyumjya Rao et al.

Table-V
Speed of recovery according to the type of haemorrhoids (n=477)
Typeof Results
ofthetreatment (Percentage)
Grouphaemorrhoidl----......-----r----"T----r---.-------.------
CR MR I
MDR MLR NR I DO I I I I Total
External 2(0.80) 7(2.83) 6(2.42) I(0.40) 1(0.40) JO(4.04) 27(10.93)

Internal 71(28.79) 37(14.97) 15(6.07) 4(1.61) 1(0.40) 12(4.85) 140(56.68)

Intero-ext. 33( 13.36) 23(9.31) 6(2.42) 5(2.02) 2(0.80) 11(4.45) 80(32.88)

Total 106(42.91) 67(27.12) 27(10.93) 10(4.04) 4(0.61) 33(13.36) 247(100.00)

2 External 6(2.60) 4(1.73) 2(0.86) 2(0.86) 0(0.00) 6(2.60) 20(8.69)

Internal 5h(24.34) 47(20.43) 18(7.83) 9(3.91) 0.40 17(7.39) 147(63.91)
Intero-ext. 24( 10.43) 9(3.91) 14(6.08) 4(\.73) 0.80 12(5.21) 63(27.39)
Total 86(37.39) 60(26.08) 34(14.78) 15(6.52) 0(0.00) 35(15.21) 130(100.00)

(v) (Table-V) In Group-II: A maximum no. of 56 &

47 internal hemorrhoids cases had
In Group-I: A maximum no. of71 &
complete and marked relief
37 internal hemorrhoid cases had
respectively and a total of 63 of cases
complete and marked relief
of intero-external hemorrhoids, 24
respectively and a total of 80 of cases
cases had complete, 09 had marked,
of intero-external hemorrhoids, 33
14 had moderate relief while minimum
cases had complete, 23 had marked
of 04 cases had mild relief.
while minimum of 2 cases had no
relief.

Table-VI
Improvement in the Hemoglobin level (n=477)
Group Level of Hemoglobin on After 30 days After 4S days.
Hb% admission Hb% Hb%
<7gm.% 72(29.14) 15(6.07) 4(1.61 )
(mean=6.5gm.%) (mean=6. 8gm.%) (mean=6.2gm.%)
7-10gm.% 156(63.15) 193 (78.13) 138(55.87)
(mean=9.8gm.% (mean=9.6) (mean=
>10 gm.% 19 (12.5) 39 (15.78) 105(42.51)
(mean=I1.5) (mean=11.01) (mean=I1.3)

JO
A COMPARATIVE CLINICAL ..

2 <7gm.% 27(12.14» 20(8.69) 14(6.0 8)

(mean=6.8gm.%) (mean=6.9gm.%) (mean=6.2gm.%)

7-10gm.% 114(49.56) 112 (48.69) 87(37.82»

(mean=8.5gm. % (mean=8.9) (mean=8.7)

>10 gm.% 89 (38.69) 98 (42.60) 129(56.08)

(mean=10.5) (mean= 10.3) (mean=10.8)

(vi) (Table-VI) improvement in hemoglobin levels

after 45 days of the therapy in both the
It has also been observed from the
groups.
study that there is a significant

Discussion Secondly, the Hemorrhoids are

'Burkitt' (1977) conducted an
epidemiological study and reported
that "when traditional diet in a
community gives way to more refined
toads; the incidence of haemorrhoids
always rises before that of varicose
veins". In the present study also it was
found about 95.80% patients were
non-vegetarians and were very fond of
spicy, fast foods etc. Firstly, the
diagnosis of Arsha is simple but the
choice of treatment is difficult,
because one therapy can not be said to
be applicable to all the type of Arshal
Haemorrhoids, which is capable to
cure the disease. The disease itself has
diverse manifestations and
accordingly the treatment has got to be
based on individual merits.
regarded as a surgical disease. The fact
that so many operative and para-
surgical techniques nowadays are in
vogue themselves prove that there is
no standard treatment procedure
available in the treatment of A rsha.
Kaseesadi taila for per rectal
application will help in producing a
soothing effect and will help easy
descent of the faecal column. This
process should be carried out half an
hour before defecation daily
irrespective of whether the patient
moves his bowels once or twice. The
main ingredient is Kaseesa (Cu S04)
and due to its Vrana Ropana &
Sodhana properties, it heals the eroded
portion ofthe haemorrhoid vessels and
facilitates & promotes quick healing.

11
M. Mruthyumjya Rao et al.
Both Kankayan vati and Kravyadi
Ras improves the digestive fire,
reduces the Ama formation. Since the
root cause of the disease mentioned in
Ayurveda is Ama or metabolic
disturbances, Kanakayana vati was
selected in order to eliminate or treat
the basic cause i.e. amadosha to
achieve the ultimate/better results of
the treatment.
Some drug is needed to take care of
patients evacuatory process especially
who have chronic or habitual
constipation which is regarded as one
of the major causes for the disease,
hemorrhoid bleeding. So Triphala
churna was selected for its laxative
action on the bowel.
Since the earlier studies revealed
the refined foods, fast foods and non
veg. diet rises the incidence of
References
1.Anderson H.G. 1909
2. Burkitt 1972
3. Fielding L.P. et at:
12
hemorrhoid bleeding, the patients
were kept on Milk, rice diet and plenty
of liquids which also helps in the
prevention of the recurrence. On the
basis of the results of this single blind
clinical trial in both the groups,
although the results were shown in
Group - 1 appears better than that of
Group - 2, but the difference was very
minimum and negligible and hence it
is concluded that the drug combination
tried in both the groups were similarly
effective in the management of A rsha.
Acknowledgment
The authors are highly indebted to
the director, CCRAS, New Delhi for
his financial and technical support. We
are also thankful to the patients who
gave their consent to carry out the
study.
the after results of the operative
treatment of hemorrhoids
pre.med.J.2: 1276.
Varicose vein, Deep Vein thrombosis
and Hemorrhoids (Epidemiology and
Suggested Etiology,) Br.M.1.2,556
Management of patients with
symptomatic hemorrhoids an
introduction - (page 462-63)
A COMPARATIVE CLINICAL ..

4. Sharma S.K. et al: 1994-95 Kshara sutra.therapy in Fistula-in-

ano and other Ano rectal diseases
Rastreeya Ayurveda Vidyapeeth
publication, New Delhi

5. SharmaB.N 1999 Ayurvedic management of Arsha

(Hemorrhoids )-CCRAS publication

6. Rob & Smith Operative surgery Lippin cott

company-a" edition.

7. Stanely.M.Goldburgetal 1980 Annals of Ano - Rectal Surgery, J.P.

publication Susruta,

8. Susruta Samhita Samhita (commentary by Ambika dutta

Sastri), Chawkamba Sanskrit Series
Office, Varanasi.

9. Watts, 1.M. et.al 1965 A controlled study of pain after

different forms of Haemorrhoidectomy,
Surg,gynoec, obstet.120: 1037.

10. M.M.Rao et. al 2004 A Clinical study on the effect of

Kravyadi ras, Kaseesadi thaila
vasti and Triphala chuma in the
management of Arsha (Haemorrhoids)
1.R.A.S., New Delhi

11.M.M.Rao et. al 2004 A Clinical study on the effect of

Kankayanavati., Kaseesadi taila and
Triphala chuma in the management
of Arsha (Haemorrhoids), 1.R.A.S.,
New Delhi

12. M.M.Rao et. al 2006 The role ofPichu (Taila) application in

the management of Arsha
(Haemorrhoids) 1.R.A.S., New Delhi

13. M.M.Rao et. al 2006 A clinical study on the management

of Arsha (haemorrhoids) by
Ayurvedic drug regimen, 1.R.A.S.,
New Delhi

13
M. Mruthyumjya Rao et al.

14. M.M.Raoet. al 2006 Therapeutic evaluation of compound

Ayurvedic formulations in the
management of Arsha(Haemorrhoids)
-A Clinical Study, lR.A.S., New Delhi

.
~il~IVT
"~ -q ~ ~ ~~ ~~ ~ ~1{TCI ~ ~

2<1~ IfJ"I cp ~ 3Tun:r-=r"

(~. ~\ifIf XlCl, ~ iI~IC1?;1(, -qj. ~clilllll ~ \JillxPi ~)

>R-(jTI W~ if x Cft11~lqx- cp1cpp::r;::f CJtT, C1?I\(:f1\(i I~ CfcYf m~Gi LflC.YII~ cfi

>l1Wl cpr '1R PI C1?1C.YI~ cfi ~ ~ ~-1 if R1 f4)fBlll -cma=ruT fcrKTI TT<n 3tR
~ffi" ~-2 if ¢fJ~I~ ffi, C1?1'l:f1'liI~ Cfc;r m ~ GiLflC.YI1~ cfi >l1Wl qx-
31ur<l'l fcrKTI TT<n I <:rg 31~ cfi~ ~~ ~tlR m~ cfi ~.,.
R1PcPf'!:""l1fcl~, if ~
Cf>1C.YIC1?ld1 1999 ~ l1Tif 2004 ClCf) fcrKTI TT<n I <:rg 31~
477 '11ITI~1 qx- ~ cfi qtf?f ~ fcrKTI TT<n I

~-1 if 247 '11ITI~1 cp) \3Q'11Cft1 qv:rrq~ ~ >rfld" S31T %, ~ ~ 42.

91 ~d em ~ c:;fFT fiic;rr, 27.12 l'lfd~ld cp) ~q) Cff+1"fiic;rr, 10.93 l'lfd~ld
cp) ~ (1[+1" flic:;rr, 4.04 l'lfd ~ Id cP) fcl) R1 d Cff+1" fiic;rr, 1.61 l'lfd ~ 1d cP) ~
Cff+1"~ flic;n ~ 13.36 l'lfd~ld R1PcPf'!:""l1W11 ~ ~ CR ~ I ~-2 if
230 cPT BLRrCITf qv:rrq~ ~ >rfld" S31T ~ I ~ ~ 37.39 l'lfd~ld cPT ~
Cff+1 fiic;rr, 26.08 l'lfd ~ Id cPT ~q) Cff+1 fiic;rr, 14.78 l'lfd ~ Id ~ mf1'rc1 cYfT+1"~ 6.
52 l'lfd~lC1 cPT RhR1d cYfTl1fiic;rr ~ 15.21 l'lfd~ld R1PcPf'!:""l1W11 ~ ~ CR
~ I~ 31~ cfi Q R 0 lili cpr x:ncr~ ~ -cma=ruT -m cfi ~ <:rg ~ cPT
fiic;rr ~ fcn ~ ~ cfi Xj~ if ~1 d li 3tR ~ 31m fiic;rr 3tR 3Td" if <:rg
f.1oh:T fcrKTI TT<n ~ fcp ~ ~ cBT ~~ ~tf cpr ~ >l1Wl ~ ~ I

Approved on 10-11-2008

14