Thrombosed haemorrhoids in ayurveda: A narrative review of pathogenesis and therapeutic approaches

Thrombosed haemorrhoids are an acute, painful presentation of haemorrhoidal disease associated with clot formation within haemorrhoidal vascular tissue. The clinical picture commonly includes sudden anal pain, swelling, tenderness and bluish or dark discoloration. Constipation, hard stools and straining may contribute to anorectal symptoms. Within Ayurveda, haemorrhoidal disease is commonly discussed under Arsha; however, thrombosed haemorrhoids do not have a precise one-to-one classical equivalent and should therefore be correlated cautiously on clinical grounds. Ayurvedic management may focus on Agni, bowel regulation, Vatanulomana and measures directed toward Shoola and Shotha. Lasunadi Vati is discussed in the available Ayurvedic literature for its Deepana, Pachana, Vatanulomana and Shoolahara properties, while experimental evidence has explored fibrinolytic activity of garlic. This narrative review summarizes the contemporary description of thrombosed haemorrhoids, their cautious Ayurvedic correlation, principles of management and the available evidence concerning Lasunadi Vati. The principal clinical evidence identified in the supplied literature is a single case report involving combination therapy; therefore, it cannot establish the independent efficacy or safety of Lasunadi Vati. Further controlled clinical research with standardized outcomes and adequate follow-up is required.