ABSTRACT
Arsha (Hemorrhoids) is one of the most common conditions affecting peoples since time immemorial. The prevalence is equal in both sexes, peaks between the ages of 45 and 65 and declining thereafter. The main cause of hemorrhoids is constipation over a prolonged period of time and has to strain to pass stools, it can damage the lining of anal canal. Sushruta the Father of Surgery advocated four method of treatment of Arsha, which are Bheshaja, Kshara, Agni and Shastra. Under Sushrutas operative procedure local application of Pratisharaniya Kshara in the prolapse piles mass helps to reduce pile mass effectively (Ref.Su.Chi.6). It is safe, cheap, effective, simple, easily approachable procedure and ambulatory treatment and the patients acceptability is good to overcome such problem. Aims & Objective is to evaluate the clinical efficacy of Apamarga Pratisharaniya teekshna kshara in the management of Arsha. & to evaluate the safety of Apamarga Pratisharaniya teekshna kshara in the management of Arsha. Material and Methods: 30 patients were enrolled for the study within a period of one year and Teekshna pratisharaniya kshara was applied on piles mass intra anally under operative procedure with the help of a instrument proctoscope. Observation and result: Reduction in the piles mass evident by Inspection/ proctoscopy /Visual perception was observed remarkably.Bleeding and pain were also reduced remarkably in all the piles patient. 100% relief in bleeding, reduction of pile mass and total reduction in size of pile mass was recorded. Conclusion: Recently these Oldest technique advocated by Sushruta have been proven to be most effective and free from post-operative complications.
ABSTRACT
Abstract Rectal Prolapse is a condition where the rectum protrudes beyond the anus. The explanation of this condition can be traced back to ancient Ayurveda text like Susruta Samhita, Ebers Pappyrus of 1500 B.C., etc. The exact cause of rectal prolapse is unclear but it is predominant on female gender and on people having constipation, previous anorectal surgeries etc. Both partial and complete varieties of rectal prolapse are extremely debilitating because of the discomfort of the prolapsing mass and variety of symptoms like rectal bleed, intermittent constipation or fecal incontinence. Although, diverse modalities of surgical management of rectal prolapse are present, no single optimal procedure is proved and the choice of operation is determined by the patient's age, sex, degree of incontinence, operative risk, as well as by the surgeon's experience. In Ayurveda, Guda Bhramsa (Rectal prolapse) is explained by Acharya Susruta under Kshudra Rogas (chapter of minor diseases) and has elaborated it's conservative management very beautifully. In this case, a female with partial rectal prolapse was treated with Kshara application and managed without complications. So, Kshara application can be a safe and effective alternative for the management of rectal prolapse.
Resumo O prolapso retal é uma condição em que o reto se projeta para além do ânus. A explicação desta condição foi relatada em antigos textos Ayurveda como Susruta Samhita e Ebers Pappyrus, datados de 1500 aC. A causa exata do prolapso retal não é clara, mas essa condição é predominante no sexo feminino e nas pessoas com constipação e histórico de cirurgias anorretais anteriores. Tanto o prolapso retal parcial quanto total são extremamente debilitantes devido ao desconforto da massa prolapsante e da variedade de sintomas como sangramento retal, constipação intermitente ou incontinência fecal. Embora diversas modalidades de tratamento cirúrgico para corrigir o prolapso retal tenham sido relatadas na literatura, nenhum procedimento é consensual; a escolha da operação é determinada pela idade, sexo, grau de incontinência, risco operatório e experiência do cirurgião. Na Ayurveda, Guda Bhramsa (prolapso retal) é explicado por Acharya Susruta no Kshudra Rogas (capítulo de doenças menores) e seu manejo conservador é descrito de forma bastante completa. No presente caso, uma paciente do sexo feminino com prolapso retal parcial foi tratada com aplicação de Kshara e administrada sem complicações. Assim, a aplicação de Kshara pode ser uma alternativa segura e eficaz para o manejo do prolapso retal.
Subject(s)
Humans , Female , Adult , Cautery , Rectal Prolapse/surgery , Medicine, Ayurvedic , Rectal Prolapse/therapy , India , Medicine, Ayurvedic/historyABSTRACT
A 66-year-old male patient came to the anorectal clinic, Outpatient department, AVT Institute for Advanced Research, Coimbatore, Tamil Nadu, with complaints of prolapsing pile mass during defecation and bleeding while passing stool. The case was diagnosed as “Raktarsha” - 11 & 7 ‘o’ clock position II degree internal hemorrhoids, deeply situated, projecting one and caused by pitta and rakta; with bleeding tendency. Kshara karma (application of caustic alkaline paste) intervention was done in this case to internal hemorrhoids under local anesthesia. The pile mass and per rectal bleeding resolved in 8 days and the patient was relieved from all symptoms within 21 days. No complications were reported after the procedure. The patient was followed up regularly from 2004 onward till date and proctoscopic examination did not reveal any evidence of recurrence of the hemorrhoids.