Ayurvedic Management of Gudabhramsha (Partial Rectal Prolapse) with Kashish Drava Basti and Modified Thiersch Procedure Using Ksharasutra: A Single Case Report

Abstract

Ayurveda describes various anorectal disorders, one of which is Gudabhramsha, classified under Kshudrarogas (minor ailments) by Acharya Sushruta. Clinically, Gudabhramsha presents as a circumferential descent of the rectum through the anus, closely resembling the modern medical condition of rectal prolapse. This condition is more commonly observed in women, the elderly, and individuals with a history of chronic constipation, diarrhea, or excessive straining. In contemporary medicine, rectal prolapse is identified by the protrusion of the rectal wall beyond the anal opening, often accompanied by discomfort, mucus discharge, bleeding, and impaired quality of life. Ayurvedic management strategies for this condition include Snehana (oleation), Swedana (sudation), Anuvasana Basti (medicated oil enema), herbal medications, and Ksharasutra therapy (medicated thread smeared with Kshara). These interventions offer a comprehensive approach involving internal treatment, topical applications, and minimally invasive surgical procedure. This case report presents a 60-year-old male patient diagnosed clinically with history taking and examination as partial rectal prolapse, interpreted as Gudabhramsha within the Ayurvedic framework. The condition was effectively treated through a combined approach involving Kashish-drava Basti, the Thiersch procedure integrated with Ksharasutra therapy, and Ayurvedic medications. Managed as a surgical case, the treatment followed established protocols and yielded successful outcomes. This report underscores the effectiveness of Ayurvedic methods in addressing Gudabhramsha.