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Kshar Chikitsa
for Hemorrhoids

By  Dr P M Sharma

Kshar chikitsa or alkaline therapy in has been in practice since 500 BC. Kshars or alkalis are the herbal extracts of plants like Euphorbia nerifolia, Cassia fistula, Holarrhena antidysentrica, Adhatoda vasica, Caltropis giganteo, Alstonia scholaris, Achyranthus aspera, and Sesamum indicum.

An kshar can be a compound or mixture of many herbs or may be from single herb like Moolika kshar, Til kshar, Yavakshar etc.


There are 2 types of kshars

1. Paniya kshar: kshar for internal use
2. Pratisarniya kshar: for external use only

The pratisarniya kshar is further divided into 3 types

1. Mridu: mild in action

2. Madhya or modest: stronger

3. Teevra: strongest in action


Internal use:

Ayurvedic doctors are using the paniya (drinkable) kshars to treat many diseases like malaria, jaundice, urinary tract infections, indigestion, obesity, tumors, inflammation, flatulence, infections and cysts. Kshars have a very rapid action and safe to use.

External use:

The external or pratisarniya kshars are widely used to manage hemorrhoids, warts, corns, fistulae, sinuses, polyps and many skin problems. External kshars are a reliable and safe alternative to a number of modern medical surgeries. Therefore they are the first choice of Ayurvedic surgeons.

Kshar sutra or the medicated thread and its role in hemorrhoids will explain it further here. Let's see how it is made and used.


1. To make kshar sutra a strong and stout thread of sufficient length is taken.
2. Then a paste of the kshar of snuhee (Euphorbia nerifolia) and turmeric is made.
3. Now both ends of the thread are tied in the sunlight.
4 Thereafter the first coat of the paste is applied on it and allowed to dry.
5. Step # 4 is then repeated 21 times. Now the kshar sutra is ready. Before using it, it is properly sterilized.


This is a very popular treatment practiced in India in case of hemorrhoids or piles.

How it is used:

1. First a couple of laboratory investigations are conducted which include that of hemoglobin, blood sugar, clotting time, bleeding time, malignancy, and liver conditions etc.

2. If hemorrhoids are accompanied with swelling, it is to be treated first and when all conditions are conducive, main procedure is carried out.

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