Protocol for a Comparative Clinical Study of Pratisarniya Kinshuk Kshara and Sclerotherapy in the Management of Abhyantar Arsha (Internal Haemorrhoids)

Background: Arsha (haemorrhoids) is one of the most frequently encountered anorectal disorders. In Ayurveda, it is categorized among the Ashta Mahagada (eight grave diseases) because of its chronicity, recurrence, and impact on quality of life. Various treatment modalities have been described, including Aushadha, Kshara, Agni, and Shastra Karma. Among these, Pratisarniya Kshara is considered an effective parasurgical therapy. Sclerotherapy using polidocanol is a widely accepted modern minimally invasive treatment for internal haemorrhoids. Comparative evidence between these two interventions remains limited. Objective: To evaluate and compare the clinical efficacy of Pratisarniya Kinshuk Kshara and injection polidocanol sclerotherapy in the management of first- and second-degree internal haemorrhoids. Methods: This prospective randomized comparative clinical study will include 40 patients diagnosed with Grade I and Grade II internal haemorrhoids. Participants will be randomly allocated into two groups. Group A will receive Pratisarniya Kinshuk Kshara application, while Group B will undergo injection polidocanol sclerotherapy. Patients will be assessed for bleeding per rectum, pain, constipation, prolapse, and proctoscopic findings over a follow-up period of 21 days. Expected Outcome: The study is expected to provide scientific evidence regarding the efficacy and safety of Kinshuk Kshara compared with sclerotherapy and may establish an economical, minimally invasive Ayurvedic alternative for haemorrhoid management.