ANAPILE TABLET

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.

  1. 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.

Ayurveda works on the root cause for the treatment of Arsha. During piles, the anal region and the sphincter gets damaged due to accumulation of toxins (Ama). The accumulated ama also disturbs the tridoshas. Thus, Ayurveda ensures proper digestion to eliminate the accumulated ama and helps to balance the vitiated tridoshas.The wound healing, anti-inflammatory, analgesic, and antioxidants drugs are used along with digestant drugs.

Each 30 gm contains:

Extract of: Kanchnar 100mg, Shuddha Guggulu 100mg, Haritaki 75mg, Rithavakal 50mg, Neem Beej Majja 50mg, Hirabol 50mg, Suran 50mg, Kutki 30mg, Daruharidra 30mg, Sonth 30mg, Ral 30mg, Trikatu 25mg, Loha bhasma 20mg

Kanchnar (Bauhinia variegate)
Kanchnar has Kapha and Pittahar properties. It also destroys Ama (toxins). In a study, the wound healing activity of extracts of root of Bauhinia variegate was evaluated. The extracts of root of 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

Suddha Guggulu (Commiphora mukul)
In Ayurvedic texts guggulu is mentioned as Sothahar (anti-inflammatory) and Arshohar (relieving piles). Guggul also possess Dipana (Appetizer) and Pachana (Digestive) properties and has tridoshar (Balancing tridosha). It also offers antimicrobial and analgesic properties. The results of several studies confirm anti-inflammatory property of guggul.

Haritaki (Terminalia chebula)
It will digest the undigested food residues by inducing or restoring normal peristaltic movement of the intestine by governing vata. Haritaki is a natural laxative and contains dietary fibers, which fights constipation. It also prevents the formation of gas or helps in expulsion of formed gas by combating flatulence. Therefore, relieves strain by relieving constipation.

Rithavakal (Sapindus trifoliatus)
Anti-inflammatory activity of seeds extracts of Sapindus trifoliatus was studied in wister rats using the carrageenan induced left hind paw edema, carrageenan induced pleurisy and cotton pellet induced granuloma model. The results indicated that the ethanolic extract produced significant anti-inflammatory activity when compared with the standard and untreated control.J Herb Pharmacother. 2004;4(4):43-50.

Neem Beej Majja (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.Pharmacology online 1: 70-77 (2010)

Hirabol (Commiphora myrrha)
In a study, the anti-inflammatory and analgesic effects of Commiphora myrrha  was evaluated and the data demonstrated that it possess analgesic and anti-inflammatory activities.Journal of Ethnopharmacology 134 (2011) 251–258

Suran (Amorphophallus campanulatus)
In a study the effect of  Suran tuber extract on croton oil induced hemorrhoids in rats was evaluated. Results indicate that tuber of Suran exhibited curative action on hemorrhoids through anti-inflammatory and antioxidant properties.J Ethnopharmacol. 2016 Nov 4;192:183-191.

A. campanulatus, described as “Deepan” in Ayurvedic texts, it helps to clear ama from the body and has been used traditionally for the treatment of piles and shown to possess analgesic, anti-bacterial, and anti-oxidant properties. It contains triterpenoids, steroids, limonoids, flavonoid glycosides, and simple phenolics, which have been found to possess analgesic, anti-inflammatory, and anti-microbial activities.

Kutaki (Picrorhiza kurroa)
In Ayurveda Kutaki is a well-known hepatoprotective plant which also has good digestant properties. Picrorhiza is used in India for the people with constipation due to insufficient digestive secretions.IJPRBS, 2013; Volume 2(4): 1-16

Daruharidra (Berberis lycium)
Anti-inflammatory and anti-granuloma activity of Daruharidra extract (BAHE) was evaluated in experimental models. The result of the study demonstrated the anti-inflammatory and anti-granuloma activity of BAHE which may be attributed to its inhibitory activity on macrophage-derived cytokine and mediators.

Sonth (Zingiber officinale)
Sonth or dried ginger is a traditional remedy for certain digestive problems. It is valued in medicines as a carminative and stimulant to the gastrointestinal tract. Shunthi is useful in dyspepsia, flatulence and colic. It has laxative properties that promote bowel activity and helps in providing relief from constipation. Zingiberene, Zingiberol and Gingerol are some active components of ginger which are reported to stimulate digestion, absorption, relieve constipation and flatulence by increasing muscular activity in the digestive tract.

Ral (Shorea robusta)
Extract of Shorea robusta was investigated for anti-inflammatory and antinociceptive activities. The extract produced a dose dependent inhibition of carrageenan – induced paw edema in rats. At the same doses, antinociceptive effect was also observed with hot plate device, Acetic acid induced writhing, formaline induced paw licking, Tail clip and Tail flick models in mice. The results of the study confirm the use of Shorea robusta traditionally for the treatment of painful inflammatory conditions.Pharmacologyonline 1: 9-19 (2008)

Trikatu
It is an ayurvedic formulation prepared by the combination of Pippali, sunthi and marich. They are well known for their rasayan property and they are also effective in treating amadosha (Products of impaired digestion i.e toxins) and agnimandya (Dyspepsia). It is widely used in digestive health and has laxative properties and therefore useful in occasional constipation. It also reduces inflammations and pain. Therefore, it is helpful in piles to relieve pain, itching, pricking sensation.

Loh Bhasma
Loh bhasma is the metallic preparation containing calcined iron. Iron compounds are particularly employed in diseases such as anemia and other debilitating conditions, where functions of hematopoietic system are disturbed and the blood has consequently become deficient in iron. In an experimental study, Lauha bhasma was evaluated for its haematinic activity. A statistically significant increase in mean haemoglobin level, total RBC count and haematocrit value was observed in Lauha bhasma with HgCl2- treated group in comparison to HgCl2 control group. The obtained results suggest that Lauha bhasma possess significant haematinic and cytoprotective activity.Indian J. Pharm. Sci., 2007, 69 (6): 791-795

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 tablet is specifically designed for the treatment of Hemorrhoids. It is prepared by the combination of Ayurvedic Herbo-metallic ingredients.

  • Ral, Hirabol, Daruharidra and Suran that helps to cure inflamed skin and the mucus membrane due to anti-inflammatory and its analgesic property helps to relieve pain.
  • Neem Beej Majja and Kanchnar accelerate wound healing.
  • Kanchnar, Haritaki, Kutaki, Trikatu and Sonth improve digestive function, remove ama from the body and balance the vitiated dosha.
  • Anapile tablet also reduces the tendency for constipation.
  • Loh Bhasma helps to treat anaemic conditions which arise due to blood loss in piles.
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