Comparative Efficacy of Guggulu-based Ksharasootra and Apamarga Ksharasootra in the Management of Arsha (3rd and 4th Degree Piles): A Randomized Clinical Trial

A BSTRACT Background: Among all anorectal conditions, piles are the most common condition, among which only 4% of patients are symptomatic. The Ksharasootra is a parasurgical measure capable to perform excision slowly by virtue of its mechanical pressure and chemical action in Arsha . Material and Method: This study aimed to assess the comparative clinical efficacy of Guggulu -based Ksharasootra ligation (GKSL) with standard Apamarga Ksharasootra ligation (AKSL) for the management of Arsha (3 rd and 4 th degree piles). In this study, 30 patients of Arsha were registered and allocated into two groups by computer generated randomization method and treated with AKSL and GKSL in single sitting, respectively, in Group A ( n = 15) and Group B ( n = 15). Sitz bath with 100 mL of Panchavalkala Kwatha twice a day followed by 10 mL of Jatyadi Taila P/R instillation once a day. Triphala Guggulu , two tabs of 500 mg thrice a day with lukewarm water after meal and Erandbhrishta Haritaki Choorna , 5 g with lukewarm water at bed time daily was given orally in both the groups from 2 nd postoperative day to 3 weeks. Result: The result was assessed using Wilcoxon signed-rank test within group and Mann–Whitney rank sum test between the groups. Highly Significant results were observed in bleeding per rectum, pain in ano, and slough out of pile mass in Group A. Significant results were observed in bleeding per rectum, pain in ano, and slough out of pile mass in Group B. Conclusion: Hence, this study concluded that AKSL (conventional/standard) seems to be better than GKSL (innovative) treatment modality on overall effect .