Piles/Heamorroids are vascular enlargement of heamorroidal plexuses within anal canal.as shown in Fig 1.
These are of two types- Internal piles and External piles.
Internal piles when enlarged sufficiently and prolapsed with external piles then they are called externo-internal piles.
Internal piles are classified into four grades are called degree or stages of piles on the basis of prolapse of piles masses at the anal orifice.
First and second degree of piles masses that are not prolapsed at anal orifice are treated as conservatively,in which Ayurvedic drugs as Panchsakar Churna or Satsakar Churna,Abhayarista etc. and as medicated oils Jatyadi Tail or Anu Tail in the form of self retaining enema before defecation is used, for this purpose half cut plane rubber catheter of no.7 or 8 fitted in the nosal of disposable syringe of 5ml rather than needle, the device used as self retaining enema apparatus as shown in Fig 2.
Patient is also advised to take hot sitz bath or hip bath in a simple plastic tub filled luke warm water after defecacation for about 4-5 minutes as shown in Fig 3.
Patients are relieved from pain, swelling and bleeding within 3-4 weeks.
Patients with masses of externo-internal piles and internal piles masses of third and fourth degree treated through Kshar Sutra Therapy.
To take concent after the diagnosis and pathological investigations Kshar Sutra is ligated to prolapsed piles mass with the help of proper instruments under preventive and hygenic condition.
Piles mass may be more than one alone or associated with other ano-rectal diseases like fistula Kshar Sutra are ligated simultaneosly and after cleaning the part cotton soaked with Jatyadi Tail or Anu Tail put on the part that is supported with "T" bandge or tight underwear.
All procedure is done under local anesthesia.
After care management is same as conservative treatment as above.
Patient is also advised for walking 4-5 km. per day and mild work as person can.
Ligated piles masses are cut within a week and cutting wounds are healed in about 2-3 weeks.
