Management of Siraja granthi (~Varicose veins) through Jalaukavacharana and Sahacharadi taila: An experience

Varicose veins are enlarged and twisted veins commonly found in the lower limbs. In an erect posture, the leg veins become engorged due to stasis of blood and incompetency of the valve. In the later stage, superficial thrombophlebitis, eczema, pigmentation, lipodermatosclerosis, hemorrhage, ulceration, and an increased risk of deep vein thrombosis are developed. Varicose veins can be treated with conservative as well as surgical options based on the clinical condition. However, the patients are opting for Ayurveda treatment to avoid surgical intervention and nonrecurrence. In Ayurveda, ample treatment modalities are available for its management. Here, case of a 38-year-old female patient with the complaints of pain, heaviness, dilated superficial veins, and skin discoloration in the bilateral lower limb for two years is being presented. On venous color Doppler test of lower limbs, she had an incompetent right saphenofemoral junction, dilated bilateral Great Saphenous Vein (GSV) and Short Saphenous Vein (SSV) at the inguinal, knee, and right ankle level, respectively, with multiple incompetent perforators along the right GSV and bilateral SSV. She was diagnosed as a case of Varicose vein with Clinical Etiological Anatomical and Pathophysiological (CEAP) score of Grade 3 and Visual Analog Scale (VAS) score of 8 for pain. The line of management was done as per treatment principles for Siraja granthi (~varicose veins) mentioned in Ayurveda and included four sittings of Jalaukavacharana (~blood-letting using leech application) along with oral administration of Sahacharadi taila capsule. After one month of treatment, remarkable improvement was found in the CEAP Score, VAS, with relief in complaints of heaviness, along with reduced dilated superficial veins. In this study, the Short Form survey-36 questionnaire was also used to assess the Quality of Life (QOL) before and after treatment. This case report demonstrated the beneficial effect of combined approach, including Jalaukavacharana and oral administration of Sahacharadi taila capsule in decreasing the progression of the disease with significant reduction in venous congestion, further rejuvenating the perforators and superficial veins, thus subsiding the symptoms and improving the QOL.