Venous ulcers (stasis ulcers, varicose ulcers) are the wounds occurring due to inappropriate functioning of venous valves, usually of the legs. It is one of the most serious chronic venous insufficiency complications.

When a venous valve gets damaged, it prevents the backflow of blood, which causes pressure in the veins that leads to hypertension and, in turn, venous ulcers. Without cleaning and regular dressings, the ulcers usually spread quickly. Venous ulcers can be very painful and may limit mobility and quality of life.

The longer the duration of the venous ulcer, the more is the damage to skin and greater the difficulty in healing. Treating varicose ulcer is a difficult task to the physician and a nightmare for the suffering patient, though different types of treatment modalities are practiced in allied sciences.

In a recent research study ; patients with above conditions provided with Processed castor oil with Neem and Guduchi - 50 ml orally used for Nityavirecana with 50 ml Śunthikashāyam for 3 days. Nityavirecana is the specific therapy in Ayurveda in which the medicine may be processed in oil or as decoction is administered orally for cleansing the bowel and liver system.

This improves the Agni metabolism of the individual. This is the first and necessary step in any enema therapy.On day 4 of management, ManjisthādiBasti karma was started with BalagudūcyādiAnuvāsanaBasti (60 ml) in kālabasti pattern.

Noticeable improvement in the symptoms was seen, it was upto 60% in edematous swelling, burning sensation was reduced up to 40%, and pricking sensation was reduced up to 30% after Nityavirecana. Moreover, Basti karma, edematous swelling was reduced to 95%, Burning sensation to 70%, and pricking sensation was reduced to 80%. Healing of the ulcerous wound started with the proliferative stage by the 3 rd day of the Basti course and the wound got healed up to 90% after the whole course of Basti karma with no adverse event during the entire course of treatment.

Possible action of these therapies-Nityavirecana (bowel and liver system cleansing therapy) Basti karma (medicated drug enema):-
In Ayurveda, this condition is considered as dustavrana and better managed with specific śodhana therapy (Purification therapy).This can be treated successfully with śodhana (purification) and śamana (pacification) therapy. So, the fore mentioned benefits of Nityavirecana (liver and bowel cleansing therapy) and Manjishthābasti (decoction enema therapy) were assessed in alleviating the symptoms and in the healing process of varicose ulcer in the patient.

Digestive and assimilation capacity and enzymatic functions through the liver system was improved by the Nityavirecana. By the laxative actions it created osmotic effects in the gut to suck the extra fluid retained anywhere in the body and is ultimately helpful in the wound healing process. Three days of treatment with Nityavirechana resulted in good appetite, reduction in the edematous swelling around the foot, and starting of granulation tissue formation in the ulcerative wound.

This research concluded that AYURVEDIC THERAPEUTIC PROCEDURES, ŚODHANA (PURIFICATION THERAPY), LIKE NITYA VIRECANA (bowel and liver system cleansing therapy) AND BASTI KARMA (medicated drug enema)ACT ON NON-HEALING ULCERS AND HELP THEM HEAL.

(This research study was conducted by researchers of Department of Panchakarama, KLEU Shri B M K Ayurveda Mahavidylaya, , Belgaum, Karnataka and School of Pharmacy, Faculty of Medical Sciences, University of West Indies, Trinidad & Tobago, West Indies)


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