Ksharasutra ligation in the management of fourth degree multiple haemorrhoids in single sitting – A case report

Abstract

Haemorrhoids also known as piles are inflamed or swollen anal cushions. They are classified in four categories. When the haemorrhoidal mass remains protruded outside anus and cannot go inside the anal canal even with help of fingers is said to be fourth degree pile mass. Ksharasutra(medicated thread) treatment is in practise for Arsha(piles), Bhagandara(Fistula), Nadivrana(sinus)and Arbuda(cancer)and other pathologies mentioned in Ayurvedic texts. Due to its potential healing, sclerosing and antibacterial property it is found very effective in the treatment of piles. In this study, a 36-year-old patient with the complains of bleeding per rectum and protrusion of mass per ano having pile mass at 3 ,5, 7, 11 o’ clock position. His pile mass was ligated with Ksharasutra.Ksharasutra (medicated thread) ligation on all pile mass was done under spinal anaesthesia. The dressing was done daily with Panchawalkal Kawath (decoction of five herbs) and Jatyadhi Tail (Medicated oil). Complete sloughing of pile mass was noted in 5 days and healing of ulcer was achieved by 30 days along with resolution of all symptoms. The patient was relieved from all symptoms within two weeks. No complications were reported after the procedure.