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Ayu. 2018 Oct-Dec;39(4):213-219. doi: 10.4103/ayu.AYU_147_18.

Efficacy of Apamarga Kshara application and Sclerotherapy in the management of Arsha (1st and 2nd degree piles) - An open-labeled, randomized, controlled clinical trial.

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Department of Shalya Tantra, Ayurveda Campus, Tribhuvan University, Kirtipur, Kathmandu, Nepal, India.
Department of Shalya Tantra, IPGT and RA, Gujarat Ayurved University, Jamnagar, Gujarat, India.



Anorectal disorders are progressively increasing in the society. Out of many of the causes, some important are sedentary lifestyle, irregular and inappropriate diet, prolonged sitting or standing, and certain psychological disturbances. The prime cause of anorectal disorders is the instability of Jatharagni (digestive system), which further leads to constipation.

Aim and Objective:

To compare the efficacy of Apamarga Kshara application (AKA) and sclerotherapy (SCL) in the management of Arsha (1st and 2nd degree piles).

Materials and Methods:

In this study, 50 patients of Arsha (1st and 2nd degree piles) were selected and randomly allocated into two groups. In group AKA (n = 25), Apamarga Tikshna Kshara (alkaline of Achyranthes aspera linn.) application was done and in group SCL (n = 25), SCL was done in 1st and 2nd degree piles. The study was open prospective interventional clinical trial. Patients were assessed for relief in signs and symptoms at weekly interval for a month and another 1 month as follow-up period.


Patients of group SCL took more time than the patients of group AKA to get reduction in size of pile mass. In group SCL, maximum relief in bleeding as well as discharge per rectum was reported. AKA provided better results in ceasing the bleeding per rectum as well as reducing prolapse piles, than SCL.


The study concluded that AKA is a effective procedure of choice for the management of 1st and 2nd degree internal piles as compared to SCL.


Apamarga Kshara; Ayurveda; hemorrhoid; piles; sclerotherapy

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