Comparative evaluation on efficacy of Habb-e-Rasuat versus Habb-e-Muqil in Internal Haemorrhoids of Grade I and II (Bawaseer Ghaira) – An open label Randomized clinical trial.

Background and Objective: Hemorrhoids are a prevalent anorectal condition worldwide, with substantial social and economic consequences. Conservative treatments typically include life-style modifications, increased fiber intake, and non-surgical methods such as Sclerotherapy and rubber band ligation. When these measures fail, surgical interventions are often required. Though effective, surgery carries potential complications like bleeding, pain, prostatitis, urinary retention, stricture formation, anal incontinence, and infections, prompting a shift towards less invasive options. In Unani medicine, remedies like Habb-e-Rasuat and Habb-e-Muqil treat internal hemorrhoids (Bawaseer-e-Ghaira) by relieving symptoms and addressing the root cause. Given the potential benefits of these treatments, it is essential to evaluate their efficacy using modern scientific parameters. A clinical investigation comparing the effects of Habb-e-Rasuat and Habb-e-Muqil on internal hemorrhoids could provide a viable alternative to expensive and painful surgical procedures. Materials and Methods: A randomized, open-label clinical trial was conducted at NIUM hospital involving 40 participants divided into two groups. Group A (20 participants) received Habb-e-Rasuat (200 mg; 2 pills twice daily), and Group B (20 participants) received Habb-e-Muqil (200 mg; 2 pills twice daily). The efficacy of the treatments was evaluated based on subjective and objective assessment parameters by using PNR-Bleed classification and HSS (Haemorrhoid severity score) such as rectal bleeding, prolapse of pile mass, Number of haemorrhoidal columns, rectal mucosa, grading of pile mass, bleeding points, and anal sphincter spasm. Results: Both groups showed significant improvement in symptoms. Group B (Habb-e-Muqil) demonstrated superior results in reducing rectal bleeding, (P-values < 0.001-0.002), while Group A (Habb-e-Rasuat) was more effective in alleviating prolapse of pile mass (P-value < 0.001). Both treatments were equally effective in reducing number of haemorrhoidal columns, anal inflammation, and sphincter spasm with no adverse effects observed. PNR-B and HSS scores have shown significant improvements in the symptoms of Haemorrhoides (P-value <0.001). Interpretation and Conclusion: The study suggests that both Habb-e-Rasuat and Habb-e-Muqil provide similar improvement in overall outcomes for treating internal hemorrhoids by addressing a broader range of symptoms. Habb-e-Muqil was better in reducing bleeding and Habb-e-Rasuat fared better in reducing the size of prolapsed pile mass, and mucosal inflammation.