Abstract: Hemorrhoids are a prevalent anorectal disorder characterized by enlargement of anal vascular cushions, with clinical manifestations including rectal bleeding, anal itching (pruritus), protrusion of tissue (prolapse), and pain, particularly when thrombosed. Important risk factors include prolonged constipation, a low-fiber diet, and frequent straining during bowel movements. A 21-year-old male presented to the outpatient department with an acute thrombosed pile mass in the anal region and Grade IV haemorrhoids at 7 and 11 o’clock position, was managed through an integrative protocol, including Jalaukavacharana (~bloodletting using leech), Finger-guided Hemorrhoidal Artery Ligation (FGHAL), and Laser-assisted Hemorrhoidopexy (LHP). Leech therapy was opted in this case as per the treatment principles mentioned by Acharya Sushruta, which advocates Raktamokshana (~bloodletting) in conditions such as Shopha (~edema), Granthi (~nodular swellings), etc., The thrombosed pile mass (Grade IV) was managed with Jalaukavacharana initially, followed by management of Grade III hemorrhoids using FGHAL and LHP techniques, along with internal Ayurveda medication. Monitoring with regular clinical examination was done to assess the outcomes of the treatment protocol. The patient recovered completely after the treatment, inferring that the integrative protocol utilized in this case demonstrates positive outcomes with minimal invasions, minimal complications, and improved patient comfort as compared to the conventional hemorrhoidectomy.
Bansal et al. (Wed,) studied this question.