Abstract

AYURVEDIC CONSERVATIVE MANAGEMENT OF POSTPARTUM GRADE III BLEEDING HEMORRHOIDS (RAKTAJA ARSHA) ASSOCIATED WITH FISSURE-IN-ANO: A CASE REPORT

Dr. Pooja Yadav*, Dr. Ujjwala Gokral

Abstract

Background: Hemorrhoids are common anorectal disorders, particularly during pregnancy and the postpartum period due to hormonal changes, venous congestion, and constipation. In Ayurveda, they are described as Arsha, with Raktaja Arsha characterized by bleeding resulting from vitiation of Pitta, Rakta, and Apana Vata. Conservative Ayurvedic management may provide an effective non-surgical approach in selected postpartum patients. Case Presentation: A 36-year-old postpartum female following LSCS presented with Grade III bleeding hemorrhoids (Raktaja arsha) associated with Gudaparikartika (fissure-in-ano). She received a 30-day Ayurvedic treatment comprising Abhayarishta, Kaishora Guggulu, a polyherbal formulation (Vasa, Nagakeshara, Guduchi, Shweta Musali, Shatavari, and Godanti Bhasma), Niranjan Phala, along with local Triphala–Dadim Twak Kwatha sitz bath and Shatadhauta Ghrita application. Follow-up was conducted on Days 7, 14, and 30. Results: Progressive symptomatic improvement was observed throughout the treatment. By Day 30, rectal bleeding had completely ceased, the fissure had healed, pain had significantly reduced, and the hemorrhoidal mass showed partial regression. No adverse events were reported. Conclusion: This case highlights the potential of Ayurvedic conservative management (Bheshaja Chikitsa) as a safe and effective non-surgical approach for postpartum Grade III bleeding hemorrhoids with fissure-in-ano. Further clinical studies are required to validate these findings.

Keywords: Arsha, Raktaja Arsha, Grade III hemorrhoids, Bleeding hemorrhoids, Fissure-in-ano, Postpartum hemorrhoids, Ayurveda, Conservative management, Bheshaja Chikitsa.