NARRATIVE REVIEW OF AYURVEDIC SCLEROTHERAPY: ROLE OF SNUHIKSHEERA AND HARIDRA CHURNA LEPA FOR ARSHA (HEMORRHOIDS)

Hemorrhoids (Arsha), one of the most prevalent anorectal disorders, has been extensively described in Ayurvedic classics, particularly in Sushruta Samhita. The term Arsha literally translates to “as fatal as an enemy,” reflecting its chronicity and impact on quality of life. Contemporary science understands hemorrhoid pathogenesis as multifactorial, involving venous congestion, connective tissue degradation, and increased intra-abdominal pressure. Management options range from conservative measures to minimally invasive procedures and surgery. Sclerotherapy, a common modern intervention for grade II and III hemorrhoids, involves injection of chemical sclerosants to induce fibrosis and shrinkage of the hemorrhoidal mass. However, complications such as pain, ulceration, necrosis, thrombosis, and systemic adverse reactions remain concerns. In Ayurveda, Acharyas have advocated multiple treatment modalities for Arsha, including Bhaishajya Chikitsa, Kshara Karma, Agni Karma, and Shastra Karma. Among local applications, the combination of Snuhiksheera (latex of Euphorbia nerifolia Linn.) and Haridra Churna (powder of Curcuma longa Linn.) is described with potential therapeutic value. This narrative review critically explores their possible role as a natural sclerosant alternative, analyzing their Rasa, Guna, Veerya, Vipaka, and Karma along with pharmacological evidence from modern biomedical sciences. Snuhiksheera possesses corrosive, anti-inflammatory, and wound-healing properties, while Haridra exhibits proven anti-inflammatory, antioxidant, and antimicrobial effects through curcumin-mediated pathways. Together, they may exert sclerosing, hemostatic, and wound-healing actions comparable to contemporary sclerosants, but with potentially fewer side effects. This review highlights the scope of Snuhiksheera and Haridra Churna Lepa as an integrative, minimally invasive alternative in hemorrhoid management, warranting further clinical validation through well-designed studies.