Topical Application of Triphala - Kumari Kalka in External Haemorrhoids

Abstract

External haemorrhoids, referred to as Bahya Arsha in Ayurveda, are a prevalent anorectal condition manifesting as pain, bleeding, itching, and local discomfort. Triphala–Kumari Kalka, a topical formulation composed of Triphala (Amalaki, Haritaki, Bibhitaki) and Kumari (aloe vera), is traditionally applied for its anti- inflammatory, wound-healing, and soothing properties. Case presentation: A 42-year-old male patient presented with a two-week history of painful perianal swelling associated with burning sensation, pruritus, and difficulty during defecation, along with a prolapsed swollen mass at the anal verge. Local examination revealed multiple lobulated external haemorrhoidal masses (three distinct nodular swellings) at the anal verge. The lesions were skin-covered, hair-bearing, edematous, and congested associated with local inflammatory changes. The masses were located below the dentate line, confirming the diagnosis of external haemorrhoids (Bāhya Arśa). Intervention and outcomes: The patient was managed conservatively with topical application of Triphala–Kumari Kalka applied locally twice daily and retained for approximately one hour, along with minimal appropriate internal Ayurvedic medications and dietary and lifestyle regulation. Marked regression leading to clinical resolution of the external haemorrhoidal masses, along with complete remission of symptoms, was observed within 15 days of intervention, without any reported adverse effects. Conclusion: This case report highlights the potential of topical Triphala–Kumari Kalka as a conservative treatment for external haemorrhoids (Bāhya Arśa). The observed improvement in symptoms and regression of the lesions suggests its therapeutic promise, while emphasizing the need for larger clinical studies to confirm its efficacy.