Introduction
Ayurveda is an ancient system of health and healing, rooted from Atharvaveda. Its main goal is to maintain body's natural balance. The fundamental components of body include Doshas, Dhatus, Malas, and Agni. Doshas are classified into physical (Vata, Pitta, and Kapha) and mental (Rajas and Tamas), influencing both body and mind, and they exist in three states: decrease (Kshaya), normalcy (Sthana), and increase (Vriddhi).[1] The term "Kashaya" refers to a substance that helps restore balance in body by stabilizing physiological functions and promoting healing. The word itself is derived from three parts: ‘Ka’ representing body (Shareera), ‘Sha’ signifying its functions, and ‘Ya’ indicating regulation. Kalpana (formulations) refers to process of preparing medicines using either a single ingredient or a combination of multiple drugs. The Sanskrit term "Kwatha" refers to Kashayam and is derived from "Kwathana," which literally means process of boiling.[2]
Piles, or haemorrhoids, are a common health concern affecting people across all age groups, often causing significant discomfort and a decline in quality of life. These swollen or inflamed veins in the anal region can lead to symptoms like pain, itching, bleeding during bowel movements, and in more severe cases, prolapse. The causes typically include chronic constipation, prolonged sitting, low-fibre diets, and straining during defecation.[3]
Modern medicine offers various treatment options such as lifestyle changes, stool softeners, topical creams, minimally invasive procedures like rubber band ligation, and surgical interventions. Recurrence, post-operative pain, infections, and potential complications like anal stenosis or incontinence remain concerns, especially in advanced stages.[4,5]
From an Ayurvedic perspective, piles are described under the condition called Arsha, considered one of the Ashta Mahagada due to its chronic and stubborn nature. Ayurveda attributes its origin to the imbalance of Vata and Pitta Doshas, often aggravated by impaired digestion (Mandagni) and irregular bowel habits. Treatment, therefore, is focused not just on symptoms but on correcting the root imbalances—regulating digestion, pacifying Doshas, reducing inflammation, and improving circulation in the anal region.[6]
One such traditional Ayurvedic remedy is Dusparsakadi Kashayam, a classical decoction formulation known for its effectiveness in managing anorectal conditions like Arsha (piles) and Bhagandara (fistula-in-ano). The formulation comprises a combination of medicinal herbs, each contributing distinct pharmacological actions that support the management of piles (hemorrhoids). Tragia involucrata exhibits anti-inflammatory and analgesic properties, which help in reducing rectal inflammation and alleviating pain.[7] Aegle marmelos offers anti-inflammatory and gastroprotective effects,[8] aiding in mucosal healing and regulation of bowel movements, which is crucial in hemorrhoidal conditions. Trachyspermum ammi acts as an analgesic and antioxidant, providing pain relief and supporting tissue repair.[9] Zingiber officinale, known for its anti-inflammatory[10] and circulatory stimulant actions, helps reduce swelling and improve blood circulation in the affected anal region. Lastly,[11] Cyclea peltata demonstrates strong anti-inflammatory and wound-healing properties, promoting tissue regeneration and defending against oxidative stress. Together, these herbs create a synergistic formulation that addresses the core symptoms of piles, including inflammation, pain, mucosal damage, and poor circulation.
Although Dusparsakadi Kashaya has been used for generations in clinical practice, scientific standardization and quality control of this formulation are still in the early stages. As the global demand for traditional herbal remedies grows, ensuring consistency, safety, and efficacy through proper standardization is more important than ever. This includes evaluating sensory characteristics, establishing physicochemical parameters like pH, viscosity, and specific gravity, and identifying bioactive markers through techniques such as HPTLC or HPLC.[1]
This study aims to address these gaps by systematically standardizing Dusparsakadi Kashayam using modern analytical tools while respecting the formulation’s traditional roots. By doing so, it hopes to pave the way for broader clinical acceptance and improved therapeutic outcomes for patients suffering from piles.
As per the Charaka Samhita,[12] Pachavidha Kashaya Kalpana consists of five forms: Rasa, Kalka, Sritha, Seetha, and Phanta.