Effectiveness of Athimadhura Chooranam in the Management of Moolam (Hemorrhoids)

Abstract

Moolam (hemorrhoids) is a prevalent anorectal disorder described in Siddha literature, primarily resulting from the derangement of Vatham and Pitham. It is characterized by symptoms such as pain, bleeding per rectum, itching, and prolapse. Globally, hemorrhoids affect a significant proportion of the adult population, impacting quality of life. Athimadhuram (Glycyrrhiza glabra), a well-known Siddha drug, possesses demulcent, anti-inflammatory, and mild laxative properties, which may be beneficial in the management of Moolam. Objective: To evaluate the clinical effectiveness of Athimadhura Chooranam in the management of Moolam (hemorrhoids) and to assess changes in symptom severity after treatment. Methods: A non-randomized observational case series study was conducted among 20 patients diagnosed with internal hemorrhoids, attending the OPD. Athimadhura Chooranam was administered at a dose of 2gm twice daily with honey as an adjuvant for a duration of 45 days. Clinical assessment was carried out using the hemorrhoidal disease Symptom Score (HDSS), which evaluates pain, itching, bleeding, soiling, and prolapse. Results: The study demonstrated a statistically highly significant reduction in HDSS scores, with mean values decreasing from 8.90±2.49 before treatment to 0.95±0.94 after treatment (p < 0.001). Symptom-wise analysis revealed marked improvement in anal pain, itching, bleeding, and prolapse. Anal pain reduced in 60% of patients, itching in 70%, and bleeding in 50% of cases. The formulation showed better efficacy in patients with first- and second-degree hemorrhoids. Conclusion: Athimadhura Chooranam is effective in significantly reducing the severity of symptoms associated with Moolam and demonstrates potential as a safe, cost-effective Siddha therapeutic option, particularly in early-stage hemorrhoids. However, further large-scale randomized controlled trials are recommended to validate these results and establish standard treatment protocols.