A narrative review on Prathisaraneeya Kshara Karma in second degree internal haemorrhoids

Abstract

The ancient Ayurvedic procedure of Kshara Karma has been recognized by Acharyas as a valuable treatment option for effectively managing hemorrhoids (Arshas). Kshara Karma is a para-surgical procedure in Ayurveda that utilizes caustic alkaline substances to manage anorectal conditions. Acharya Sushruta outlines Kshara Karma  under arsho chikitsa adhyaya. Arsho chikitsa incorporates a four-part treatment modality, comprising medication (bheshaja), caustic alkaline therapy (kshara), thermal cauterization (agni), and surgical intervention (sastra). Prathisaraneeya kshara treatment is indicated for hemorrhoids characterized by being soft, extensive, deep-seated, and protruding. Kshara is a potent alkaline caustic substance derived from the ash of specific medicinal plants. It is the most crucial instrument among shastra and anusastra, as it performs functions like excision, cutting and scraping. It also effectively balances all three doshas (Vata, Pitta and Kapha). Moreover, Kşhara requires specialized techniques for its application.  Also studies proves that prathisaraneeya kshara effectively treats hemorrhoids through its corrosive properties.