Integrating Traditional Ayurvedic Approaches: A Case Study on the Efficacy of Ksharasutra Ligation for Fourth-Degree Hemorrhoids

Abstract

Introduction: The Sushruta Samhita, a seminal Ayurvedic text, emphasizes the surgical management of conditions like Arsha (hemorrhoids), which are increasingly prevalent with age. While modern treatments such as rubber band ligation and haemorrhoidectomy exist, they often present complications. Sushruta's methods include Ksharasutra, a caustic treatment for hemorrhoids. Case History: A 51-year-old female presented with a non-reducible anal mass and intermittent bleeding for 1.5 years. Examination revealed fourth-degree intero-external hemorrhoids. Laboratory tests were normal, and the patient was deemed fit for Ksharasutra ligation under local anesthesia. Pre-operative Preparation: Informed consent was obtained. Pre-operative protocols included administration of Swadishta Virechana Churna, fasting instructions, and enema. Operative Procedure: Under aseptic conditions, local anesthesia was administered, and hemorrhoids were surgically managed using Ksharasutra ligation at multiple clock positions. Proper hemostasis was ensured before postoperative care began. Post-operative Care: Hydration was maintained with IV fluids, and antibiotics were provided. Sitz baths and Ayurved medications were prescribed. The patient followed a specific diet and was monitored for complications. By the fifth post-operative day, necrosed hemorrhoids sloughed off, and the wound healed by the 15th day, with no complications noted by the 21st day. Conclusion: Ksharasutra ligation proved effective and safe for treating fourth-degree hemorrhoids, with no significant complications. The combination of traditional Ayurvedic treatments facilitated the patient’s recovery and highlights the potential of integrating Ayurvedic practices into modern surgical protocols.