What question did this study set out to answer?

The study aims to compare the efficacy of Arka Kadali and Apamarga Kshara Karma in treating Abhyantara Arshas equivalent to internal hemorrhoids.

February 6, 2026Open Access

A Comparative Clinical Study to Evaluate the Efffct of Arka Kadali Pratisaraniya Kshara Karma and Apamarga Pratisaraniya Kshara Karma in the Management of Abhyantara Arshas Vis-À-Vis Internal Haemorrhoids

Key Points

The study aims to compare the efficacy of Arka Kadali and Apamarga Kshara Karma in treating Abhyantara Arshas equivalent to internal hemorrhoids.
40 patients with internal hemorrhoids were selected from an outpatient and inpatient department.
Patients were randomly divided into two groups of 20 each for treatment.
Group A received Arka Kadali Pratisaraniya Kshara Karma, while Group B received Apamarga Pratisaraniya Kshara Karma.
Assessment criteria were established to evaluate the treatment outcomes.
The statistical analysis showed a p-value of 0.82, indicating no significant difference between the two treatment groups.
Both treatments exhibited similar levels of effectiveness in managing Abhyantara Arshas and internal hemorrhoids.

Abstract

Background: Arshas is a protrusion of Mamsa which obstructs the Gudamarga and afflict the person like an enemy. Acharya considered it under Ashtamahagada because its Deergakalanubandi and Dushchikitsya nature, as it is occurring in Guda which is one among the Sadyopranahara Marma. Due to Aharaja, Viharaja and Manasika Nidanas, Agni become Manda thus aggravates the Doshas. The aggravated Doshas enters Guda, vitiates Gudavalis to form Mamsapraroha called as Arshas. In contemporary science it can be correlated to Haemorrhoids. Haemorrhoids are the dilated veins within the anal canal in sub-epithelial region formed by radicles of superior, middle and inferior rectal veins. Acharya has mentioned four treatment modalities for Arshas, one among them is Kshara Karma. The Kshara is considered as Shreshta, as it does the functions of Chedana, Bhedana and Lekhana karma, which is used in Mridu, Prasrita, Avagada and Uchrita Arshas. Arka has Vranaropana, Vranashodana, Kandughna, Kaphashamana, Arshogna properties. Kadali Kanda has Kaphapittahara, Rakatashamaka properties. The present study was designed to assess the combined efficacy of Arka Kadali Pratisaraniya Kshara Karma in Abhyantara Arshas vis-à-vis Internal haemorrhoids. Methods: 40 patients fulfilling the inclusion criteria of Abhyantara Arshas vis-à-vis Internal haemorrhoids was randomly selected from OPD and IPD of Shalyatantra, teaching hospital attached to G.A.M. C, Bengaluru and is divided into 2 groups i.e., Group A and Group B comprising of 20 patients in each group. In Group A: Arka Kadali Pratisaraniya Kshara Karma, In Group B: Apamarga Pratisaraniya kshara Karma was done. The parameters were observed based on assessment criteria and recorded. Result: The p-value of 0.82 is greater than significance level of 0.05, indicating that there is no statistically significant difference between Group A and Group B in terms of their overall response. Conclusion: Arka Kadali Pratisaraniya Kshara Karma is as effective as Apamarga Pratisaraniya Kshara Karma in the management of Abhyantara Arshas vis-à-vis Internal Haemorrhoids.

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