A LITERARY STUDY ON AYURVEDIC MANAGEMENT ON ARSHA (HEMORRHOIDS): AN ANALYSIS OF TRADITIONAL AND MODERN APPROACHES

Abstract

Background: Arsha, commonly known as hemorrhoids or piles, is one of the most prevalent anorectal disorders and is classified under the Asthamahagada (eight great diseases) in Ayurvedic literature. The condition has been recognized for thousands of years and remains a significant health issue, with nearly half of the population experiencing hemorrhoidal symptoms at some point in their lives. The primary etiological factors include improper dietary habits, sedentary lifestyle, anatomical deformities, and hereditary predispositions. Clinically, Arsha is characterized by the engorgement of the hemorrhoidal venous plexus, along with the abnormal displacement and enlargement of the anal cushion, leading to symptoms such as inflamed or prolapsed pile mass, bleeding per rectum, and discharge. Objective: This study aims to explore the Ayurvedic understanding and management of Arsha, comparing traditional therapeutic approaches with modern medical treatments, particularly focusing on the recurrence rates and long-term efficacy. Methods: A detailed review of classical Ayurvedic texts, including Charaka Samhita, Sushruta Samhita, and Ashtanga Hridayam, was conducted to gather insights into the traditional classification, etiology, and treatment modalities for Arsha. The study also examines contemporary research on Ayurvedic treatments and compares them with modern medical procedures such as hemorrhoidectomy. The Ayurvedic treatments discussed include Bheshaj Chikitsa (conservative treatment), Kshar Karma (alkali therapy), Agnikarma (thermal cauterization), Shastra Karma (surgical excision), and Kshar Sutra therapy. Results: The review identifies multiple Ayurvedic treatment modalities based on the chronicity and severity of Arsha. Bheshaj Chikitsa involves dietary regulation and the use of herbal formulations like Triphala and Haritaki to manage symptoms in the early stages. Kshar Karma and Agnikarma are indicated for more advanced cases, providing minimally invasive options with a focus on reducing recurrence. Kshar Sutra therapy, a specialized procedure involving the application of a medicated thread, has demonstrated significant success in managing both internal and external hemorrhoids, with a lower recurrence rate compared to conventional surgical methods. Modern hemorrhoidectomy, while effective, carries a higher risk of disease recurrence and postoperative complications. Conclusion: Ayurvedic management of Arsha offers a comprehensive approach that addresses the underlying causes and provides long-term relief. The combination of dietary and lifestyle modifications, along with various therapeutic interventions like Kshar Sutra and Kshar Karma, presents a viable alternative to conventional hemorrhoidectomy, particularly in reducing recurrence rates. Further clinical research is needed to establish the comparative efficacy of these treatments in larger patient populations.

Keywords: Arsha, Hemorrhoids, Bheshaj Chikitsa, Kshar Sutra, Anorectal disorders.