A CASE STUDY: EFFICACY OF TAKRARISHTA IN THE MANAGEMENT OF ABHYANTAR ARSHA (INTERNAL HAEMORRHOIDS)

Background: Arsha (haemorrhoids) is a common anorectal disorder afflicting mankind, classified among the Ashta Maharogas due to its chronicity and difficulty in management. Ayurveda emphasizes Aushadha (medication) as the first line of treatment to correct the underlying Agnimandya (impaired digestive fire) and Apana Vayu vitiation. Takrarishta, a fermented buttermilk-based formulation mentioned in Charaka Samhita under Arsha Chikitsa, is indicated for its Deepana, Vatanulomana, and stool-binding properties. Case Presentation: A 45-year-old male patient presented with complaints of intermittent per-rectal bleeding, constipation, pruritus ani, and burning sensation for 8 months. Proctoscopic examination revealed Grade II internal haemorrhoids at 3 and 9 o'clock positions. The patient was diagnosed as Abhyantar Arsha (internal haemorrhoids) with Vata-Kapha predominance and Agnimandya. Intervention: The patient was administered Takrarishta 48 ml twice daily before food for 30 days. Assessment was done using a grading scale (0-3) for bleeding, itching, burning, and constipation at baseline, 15th day, and 30th day. Outcome: Marked improvement was observed in all parameters. Bleeding reduced from Grade 2 (drop by drop) to Grade 0 (nil). Constipation resolved completely, and itching and burning showed significant reduction from Grade 2 to Grade 1 by the 30th day. Proctoscopic re-evaluation showed regression of haemorrhoidal size without any adverse effects. Conclusion: Takrarishta demonstrated significant efficacy in managing Abhyantar Arsha by correcting Agni dysfunction and normalizing Apana Vayu movement. The formulation proved safe, well-tolerated, and effective as a conservative management option for Grade II internal haemorrhoids.