ANAPILE OINTMENT

PILES / HAEMORRHOID

Piles or Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum. Basically, haemorrhoids are present naturally in every person. In healthy individual, haemorrhoids are like cushions composed of artery, veins & connective tissues that help in passage of stool. Abnormal changes in these structures make them swollen & inflamed.

Types of hemorrhoids:

  1. External hemorrhoids-

Hemorrhoids located outside of the anus are called external hemorrhoids. Here, swollen veins cause a soft lump that protrude out of anal opening. These lumps can turn hard if blood clot develops, and become painful thrombosed hemorrhoids.

Since the anus has many nerve endings, external hemorrhoids can be very painful or itchy. They cause extreme discomfort & pain. When clothing comes in contact with the external hemorrhoids, the sufferer experiences a sharp burning pain.

2. Internal hemorrhoids-

Internal hemorrhoids are located inside the rectum or anal canal, and are usually not painful. This is because the anal canal does not have many nerve endings.  Indeed, most people are not aware that they have internal hemorrhoids until a hard stool rubbing against them cause these hemorrhoids to rupture and bleed.

Apart from this classification, Haemorrhoids are further classified according to degree of clinical symptoms

  1. First-degree hemorrhoids: Hemorrhoids that bleed but do not prolapse.
  2. Second-degree hemorrhoids: Hemorrhoids that prolapse and retract on their own (with or without bleeding).
  3. Third-degree hemorrhoids: Hemorrhoids that prolapse but must be pushed back in by a finger.
  4. Fourth-degree hemorrhoids: Hemorrhoids that prolapse and cannot be pushed back in.

Fourth-degree hemorrhoids also include hemorrhoids that are thrombosed (containing blood clots) or that pull much of the lining of the rectum through the anus.

Aetiology of Haemorrhoids

  • Low-fiber diet-: Following a low-fiber diet usually triggers hemorrhoids as it causes small-caliber stools which result in straining during defecation. Aside from this, pregnancy and extremely high tension of the internal sphincter muscle & rectal veins also cause hemorrhoidal problem.
  • Constipation-: Constipation is defined as infrequent bowel movements or the difficulty in passing stool. As long as the stool remains in the colon it will become dry & hard. While passing this dry & hard stool straining is required that exerts pressure on the veins of the anus & leads to hemorrhoids.
  • Postponing bowel movement-: Usually, by postponing bowel movement, the urge to defecate goes away. While occasionally postponing bowel movement does no harm, doing it regularly can contribute to constipation & thus hemorrhoids.
  • Weak­ening of the connective tissue-: Another cause of hemorrhoids is the weak­ening of the connective tissue in the rectum and anus that occurs with age.
  • Genetics-: Inherited characteristics such as weak vein walls can result in tendencies to develop hemorrhoids.
  • Bouts of diarrhea-: In the case of diarrhea, the expulsive force of the watery stool can damage rectal veins and lead to hemorrhoids.
  • Extreme physical exertion-: Laborers and weightlifters often hold their breath while lifting heavy objects. This forces air exerts pressure on the diaphragm, which in turn exerts pressure on the abdominal organs and rectal veins.
  • Prolonged sitting or standing and lack of exercise-: Sedentary lifestyle, lack of exercise, as well as jobs which require prolonged periods of sitting and standing can lead to, or exacerbate, existing hemorrhoids.

 

PILES ACCORDING TO AYURVEDA

Piles is known as Arsha in Sanskrit. Arsha pertains to a disease occurring in Guda (Anal Canal) and it is torturing to the patients. Negligence of proper diet and lifestyle habits results in mandagni (reduced digestive fire). Mandagni means inability to digest food with proper pace and time leading to accumulation or stagnation of Ama (indigested food material) in the form of stool inside or expelling it before time in watery or semisolid form, which disturbs dosha at anorectal region.

Symptoms like itching, inflammation, pain and bleeding will be present depending on the type of Piles. In piles the astringent herbs are used to stop the bleeding in case of bleeding piles. These Astringent properties help to constrict tissues, heal mucus membrane and prevent bleeding. Along with Astringent herbs anti-inflammatory, analgesic, and anti-microbial herbs are used in the treatment.

Each 30gm contains:

Extract of: Kanchnar 2%, Shirisha 2%, Neem 2%, Haridra 3%, Kushtha 3%, Bhrigaraj 2%, Samanga 2%. 

Powders of: Yashad Bhasma 1%, Shuddha Tankan 1%

Kanchnar (Bauhinia variegata) 

Kanchnar has been reported to have anti-microbial properties. In a study, Excision and incision wound models the wound healing activity of extracts of root of Bauhinia variegata has been evaluated. In results, Bauhinia variegata produced significant wound healing by excision and incision wound models, which was comparable to that of standard (framycetin) in excision wound model. Asian Journal of Research in Pharmaceutical Science Year : 2015, Volume : 5, Issue : 3

Shirisha (Albizia lebbeck) 

The anti-inflammatory activity of the extracts of A. lebbeck was studied using carrageenan-induced paw edema and cotton pellet-induced granuloma models. The extract of A. lebbeck showed a significant inhibition of carrageenan-induced hind paw edema and granuloma. The extract of the leaves of A. lebbeck showed significant anti-inflammatory activity. J Tradit Complement Med. 2016 Apr; 6(2): 172–175.

The paste of bark is applied locally for healing wound, acne vulgaris, non-healing ulcers, boils, and abscess. It is also used to treat itching.

Neem (Azadirachta indica) 

A study revealed promising wound healing activity of extract of A. indica and provides a scientific rationale for the traditional use of the plant in the management of wounds. The healing effect produced by the plant extract, was assessed by rate of wound contraction, skin breaking strength and histopathology of healing tissue. The extract of leaves of A. indica significantly promoted the wound healing activity in both excision and incision wound models. Pharmacologyonline 1: 70-77 (2010)

Haridra (Curcuma longa)

In classical ayurvedic texts turmeric is used as kanduhara (anti-itching) and kusthaghna (curing skin diseases). In a study, Curcuma longa was investigated for its anti-inflammatory effects. The extract of Curcuma longa inhibited the development of oedema at the end of 3 hours. The anti-inflammatory activity exhibited by the extract was significant and comparable to that of standard drug used Aspirin. Int J Basic ClinPharmacol. 2018 Feb;7(2):229-233

 Kushtha (Saussurea lappa) 

The different bioactive compounds isolated from Saussurea lappa have inhibitory effect on inflammation in human and animals. The extracts from S. lappa were experimented and found that the extract have inhibitory effect on inflammation. The anti-inflammatory effect was proved through carrageenan induces paw edema.

Bhringraj (Eclipta alba) 

Bhringraj extract was investigated for anti-inflammatory activity. The extract showed significant anti-inflammatory activity in carrageenin and egg white induced hind paw edema which was compared with indomethacin (10 mg/kg) and cyproheptadine (8 mg/kg).

Analgesic effect was studied on albino mice using extract of Eclipta alba. Standard experimental models such as the tail clip method, the tail flick method and the acetic acid induced writhing response were used which showed that extract produced good analgesic activity in all the different models of analgesia used.

The crude extract has been found to have wound healing properties. Externally it is used for inflammation, minor cuts and burns and the fresh leaf-juice is considered very effective in stopping bleeding.

 Samanga (Mimosa pudica)

It has Sheet virya (coolant), Raktasravhara (arrest bleeding) and Vranaropana (Healing of wound) properties. In a study, the roots of M. pudica were studied for wound healing activity by incorporating the extracts in simple ointment base. Wound healing activity was studied in three types of model in rats viz. excision, incision, and estimation of biochemical parameters. Treatment of wound with ointment containing extract exhibited significant wound healing activity.

Yashad Bhasma

Yashad Bhasma used as antibacterial agent locally in the form of ointment since ancient times in Ayurveda. Due to its kashaya (Pungent) rasa it has a Sandhaniya karma (as it promotes Epithelisation of cells) hence used as Vranaropana (Healing of wound).

In a study on topical use of Yashada Bhasma along with other herbs shows that it has better wound healing properties as it contains essential nutrient for collagen formation and cell division. It also improves the binding power of the cell of skin soft tissues, improves cell migration and cell regeneration and hastens wound healing.

Shuddha Tankan-

Tankan or borax is used traditionally for local application on wounds as a disinfectant.

Hemorrhoids or piles are swollen veins in anus and lower rectum. Hemorrhoids can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). The symptoms like itching, inflammation, pain and bleeding will be present depending on the type of Piles.

Anapile ointment is specifically designed for the treatment of Hemorrhoids. It is prepared by the combination of Ayurvedic herbo-metallic ingredients that are having anti-inflammatory action to combat the inflamed skin and tissues.

  • Yashadbhasma accelerates the epithelial regeneration therefore it helps in healing of wound. The analgesic properties provide relief from pain and helps pain free evacuation.
  • The anti-itching properties of Haridra provide relief from itching.
  • Astringent properties of herbs like Samanga and Bhringraj are effective in treating bleeding piles.
  • Tankan bhasma act as a disinfectant on the pile mass.
  • Kanchnar, Neem, Haridra and Yashsad bhasma possesses antimicrobial properties, which prevents secondary microbial infections.
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