Reviving Classical Wisdom in the Management of Acute Perianal Vascular Disorders: Insights from a Single Case

Abstract

Jalaukavacharana, commonly known as leech therapy, is a traditional treatment in Ayurveda, used to address various inflammatory conditions, particularly those related to Raktaja and Pittaja vikara. The therapy's therapeutic effects are attributed to the bioactive compounds found in leech saliva, which are introduced into the body during the blood-feeding process. These compounds exhibit a range of beneficial properties, including anti-inflammatory, analgesic, thrombolytic, anticoagulant and circulatory enhancement effects. Thrombosed hemorrhoids, a critical condition resulting from elevated venous pressure, often lead to intense pain and discomfort in anal region. This study investigates the use of leech therapy in managing thrombosed external hemorrhoids. A 49-year-old female patient presented with severe anal pain and a palpable mass per rectum associated with bleeding, for the past three days, with a history of chronic constipation. For last 3 days, the pain has intensified to the extent that she finds it difficult to sit, walk, or travel. Following a thorough per rectal examination, reddish brown globular mass noted at 11’o clock position and the mass was solid and tender. The case was diagnosed as thrombosed external hemorrhoids. Jalaukavacharana was selected as the primary treatment approach along with internal medicines Chiruvilwadi Kashayam and Anuloma DS. The patient underwent six consecutive sessions. Pain relief was immediate upon application of the leeches, and the patient reported a significant reduction in discomfort. By sixth session, the patient experienced 90% improvement in symptoms. On seventh day of the treatment, the patient was completely symptom-free and expressed high satisfaction with the treatment outcome.