Comparative evaluation of the efficacy of Hydrocortisone suppository and Durvadi Gudavarti in Raktarsha – A randomized controlled clinical trial

Abstract

Background: Arsha, which is correlated to Hemorrhoids according to contemporary sciences, is a disease of yore. It is one of the most prevalent illnesses nowadays. It is the most common cause of bleeding per rectum in adults and the fourth leading diagnosis made in the gastrointestinal outpatient department. Aim and Objectives: This study aimed to compare the efficacy of Durvadi Gudavarti and Hydrocortisone acetate-based suppository in the management of Raktarsha (Bleeding Piles). Methods- A randomized active-controlled double-blind superiority clinical trial that involved 130 subjects between the age group of 20 to 60 years of Raktarsha, were assigned into two groups with equal allocation. The Control group (Group C) received Hydrocortisone suppository and the Experimental group (Group E) received Durvadi Gudavarti for rectal administration twice daily (12 hourly) after the proper evacuation of the bowel, for 2 weeks. Clinical evaluations were performed at Baseline, 5^th, 10^th, 15^th day post-inclusion. The main endpoint was the proportion of subjects with complete clinical response and reduction in the size of pile mass measured using a transparent millimeter ruler on the 15^th day. Results- Groups were homogeneous in terms of demographic and baseline characteristics. The Durvadi Gudavarti was found to be 34% and 32% more efficacious than the Hydrocortisone acetate-based suppository in terms of reduction in the size of pile mass and bleeding PR respectively. Interpretation & conclusions- Durvadi Gudavarti as rectal administration showed a significant advantage over a widely used standard treatment in the management of Raktarsha.

Keywords: Raktarsha, Bleeding Piles, Durvadi Gudavarti, Haemorrhoids, Hydrocortisone suppository, Ayurvedic suppository.