International Journal of Drug Delivery Technology
Volume 16, Issue 7s, 2026

A Case Study of Snuhi‑Based Palash Ksharsutra and Barron's Rubber Band Ligation in Treatment of Abhayantara Arsha W.S.R. to Internal Piles

Dr. Balendra Singh1, Dr. Divya Sinha2*, Dr. Praveenkumar Mishra3, Dr. Chanchal Sahu4, Dr. Akshar Vitthalbhai5, Dr. Darshna Bharati6

1Professor & HOD, Department of Shalya Tantra, NPA Government Ayurvedic College, Raipur, Chhattisgarh, India
Email: Drbalendrasingh@gmail.com

2*PG Scholar, Department of Shalya Tantra, NPA Government Ayurvedic College, Raipur, Chhattisgarh, India
Email: divyasinha750926@gmail.com

3Reader, Samhita Sidhanta, Govt Ayurved College, Bilaspur, Chhattisgarh, India
Email: drpraveenku.mishra@gmail.com

4PG Scholar, Department of Shalya Tantra, NPA Government Ayurvedic College, Raipur, Chhattisgarh, India
Email: chanchalsahu0209@gmail.com

5PG Scholar, Department of Shalya Tantra, NPA Government Ayurvedic College, Raipur, Chhattisgarh, India
Email: draksh228@zohomail.com

6PG Scholar, Department of Swasthavritta and Yoga, NPA Government Ayurvedic College, Raipur, Chhattisgarh, India
Email: Cma.kamal29@gmail.com


ABSTRACT

Background: Abhayantara Arsha (internal hemorrhoids) is a common anorectal disorder described in classical Ayurvedic texts. Modern medicine commonly employs Barron's rubber band ligation (RBL), whereas Ayurveda advocates Kshara Karma and Ksharsutra ligation for such conditions.

Objective: To evaluate and compare the efficacy and safety of Snuhi‑based Palash Ksharsutra and Barron's rubber band ligation in a case of Abhayantara Arsha (internal piles).

Methods: A 42‑year‑old male patient with Grade‑II internal piles at 3, 7 and 11 o'clock positions was treated. One pile mass at 3 o'clock was managed with Snuhi‑based Palash Ksharsutra, while another at 7 o'clock was treated with Barron's RBL. Assessment parameters included pain (VAS) after procedure, itching, bleeding and size of pile mass, grade, local healing, and complications over 8 weeks. One patient of each case was taken under study, both having internal piles mass at 3 o'clock position, one was managed with Snuhi‑based Palash Ksharsutra, while another at 3 o'clock was treated with Barron's RBL. Assessment parameters included pain (VAS) after procedure, itching, bleeding and size of pile mass and which one is more effective.

Results: Snuhi‑based Palash Ksharsutra produced gradual sloughing of the pile mass with minimal pain, complete cessation of bleeding by 3rd week, and good tissue healing. Barron's RBL showed rapid reduction in prolapse and early symptom relief but with slightly more post‑procedure discomfort. Both modalities were effective, with Ksharsutra demonstrating deeper tissue control and RBL offering quicker procedural ease.

Conclusion: Snuhi‑based Palash Ksharsutra and Barron's RBL are both effective in Abhayantara Arsha; Ksharsutra aligns more closely with Ayurvedic principles of Kshara Karma and Shodhana‑Ropana, whereas RBL is advantageous for OPD‑based, minimally invasive management. This case supports further comparative studies between Ayurvedic Ksharsutra and modern RBL in internal piles.

Keywords: Abhayantara Arsha, internal piles, Snuhi‑Palash Ksharsutra, Barron's rubber band ligation, Kshara Karma, hemorrhoids, Ayurveda.

How to cite this article: Singh B, Sinha D, Mishra P, Sahu C, Vitthalbhai A, Bharati D. A Case Study of Snuhi‑Based Palash Ksharsutra and Barron's Rubber Band Ligation in Treatment of Abhayantara Arsha W.S.R. to Internal Piles. Int J Drug Deliv Technol. 2026;16(7s): 982-986; DOI: 10.25258/ijddt.16.7s.106

Source of support: None

Conflict of interest: None