A clinical study on the management of Arshas (Prolapsed Piles) by Jaloukavacharana

Background: Arshas is one among the Mahagadas (major diseases) which causes pain and obstruction in the anal passage. It is a rakta and mamsa doshaja vyadhi (disease related to blood and muscle). Arshas can be correlated to hemorrhoids. It is caused due to the varicosity of hemorrhoidal plexus which makes it a surgically curable disease. In Ayurveda, various treatments have been mentioned for the management of arshas (hemorrhoid) such as chedhana (excision), sweda (sudation), etc among which Visravana or raktamokshana (blood-letting therapy) plays an important role. Jalaukavacharana (leech therapy), a type of Asashtra krita Visravana (non-invasive blood-letting) has been mentioned as an alternate, non-surgical measure in the management of arshas (hemorrhoid). The arshas (hemorrhoids) which are swollen, prolapsed and containing more quantum of stagnated blood inside can be managed by leech therapy. The saliva of leech contains an anti-coagulant factor – Hirudin and a spreading factor – Hyaluronidase, which act as anesthetic and anti-inflammatory, thereby helping in the treatment of arshas (hemorrhoid). In the present study, raktamokshana (blood letting) was performed with jalauka or leech in patients with prolapsed pile mass. Materials and method: 30 patients fulfilling the assessment criteria were selected for the study. Result and conclusion: In the present study 26 patients were completely cured, 3 patients were cured with presence of mild symptoms and 1 patient had improvement from severe symptoms to moderate symptoms. Therefore, Jalaukavacharana (leech therapy) can give promising results in the management of prolapsed piles.