A Controlled Clinical Evaluation of the Efficacy of Gunja Kushmanda Lepam in the Management of Arshas (II & III Degree Haemorrhoids)

Abstract

Background: Arshas (hemorrhoids) are a prevalent anorectal disorder characterized by painful defecation, bleeding, and mass prolapse. Ayurveda recognizes Arshas as one of the Ashta Mahagadas requiring a multi-modal approach. This study evaluates the efficacy of Gunja Kushmanda Lepam, a traditional Ayurvedic topical formulation, in comparison with Kaseesadi Tailam for managing II and III degree hemorrhoids. Methods: A randomized controlled clinical trial was conducted with 40 patients divided into two groups. Group A (trial group) received Gunja Kushmanda Lepam, while Group B (control group) was treated with Kaseesadi Tailam. Treatment involved local application on every 3^rd day for five sittings followed by a 15-day observation. Outcomes were assessed based on clinical parameters such as bleeding per rectum, pain, constipation, itching, and size of pile mass. Results: Group A showed statistically significant improvements in all measured parameters, notably constipation (92.50%), bleeding (88.33%), pain (86.66%), and pile mass size reduction (76.66%). Group B also showed improvement but to a slightly lesser degree. The p-value (<0.0001) confirmed high statistical significance in Group A. Conclusion: Gunja Kushmanda Lepam demonstrated superior efficacy over Kaseesadi Tailam in reducing symptoms of II and III degree hemorrhoids. This topical Ayurvedic formulation offers a safe, non-invasive alternative with promising results. Further large-scale studies are recommended.