Clinical Efficacy of Shodhita Kasisadrava Basti in the Management of Arsha (Second-Degree Internal Haemorrhoids): A Case Study

Introduction: Arsha is a common anorectal disorder characterized by swelling of the anal tissues, often associated with pain, bleeding, and prolapse. In Ayurvedic classics, Arsha is described as a Tridoshaja Vyadhi, predominantly involving Apana Vata. Second-degree internal haemorrhoids, which prolapse during defecation and reduce spontaneously are often managed with conservative approaches. The present study explores the efficacy of Shodhita Kasisadrava Basti, a medicated enema using purified Kasisa - as a novel intervention in the management of second-degree internal haemorrhoids (Arsha). Methods: A single case of a 36-year-old male patient presenting with classical signs of second-degree internal haemorrhoids, bleeding per rectum, and prolapse during defecation- was selected based on the diagnostic criteria: Clinical symptoms and Digital per rectalexamination. A total of 9 Basti were administered over 3 weeks (3 consecutive Basti per week), prepared using 5 Ratti(625mg) of Shodhita Kasis Churna dissolved in 30 ml distilled water. The patient was assessed on baseline, weekly intervals, and at a 45-day follow-up post- treatment for symptoms including bleeding, prolapse, itching and discomfort. Results: Marked improvement was observed after the completion of 9 Basti. Bleeding per rectum ceased by the 6th Basti, and prolapse reduced significantly. Discomfort during defecation were alleviated. On 45-day follow-up, the patient reported no recurrence of or prolapse, and digital rectal examination revealed no significant internal bulge. No adverse reactions were noted during or after the intervention. Discussion and Conclusion: The use of Shodhita Kasisadrava Basti demonstrated promising results in reducing the clinical features of second-degree internal haemorrhoids(Arsha). The localized action of Kasisa on the vascular tissues and its Shankochan and Lekhana properties, when administered rectally, may help shrink the pile mass and alleviate symptoms without invasive procedures. This case study supports the potential of Kasisadrava Basti as a minimally invasive and effective Ayurvedic therapy for haemorrhoids, meriting larger clinical trials.