CURRENT ADVANCES IN THE MANAGEMENT OF ARSHA: A LITERATURE REVIEW
DOI:
https://doi.org/10.5281/zenodo.21943834Keywords:
Arsha, Hemorrhoids, Ayurveda, Kshara Karma, Kshara Sutra, Agnikarma, Bhaisajya Chikitsa, Integrative Medicine.Abstract
Background
Arsha (hemorrhoids) is one of the most prevalent anorectal disorders described in Ayurvedic classics and is characterized by the development of fleshy projections (mamsankura) in the guda (anal canal), leading to pain, bleeding, prolapse, discharge, and impaired quality of life. Acharya Sushruta described Arsha as a Mahagada owing to its chronicity, recurrence, and therapeutic challenges. Contemporary medicine recognizes hemorrhoids as enlarged and symptomatic vascular cushions of the anal canal caused by increased venous pressure, connective tissue degeneration, and inflammation.
Objective
To comprehensively review the current understanding of Arsha with emphasis on Ayurvedic concepts, modern pathophysiology, recent therapeutic advances, and evidence-based integrative management strategies.
Methods
A narrative literature review was conducted using classical Ayurvedic texts including Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, and contemporary scientific literature retrieved from PubMed, Scopus-indexed journals, Google Scholar, AYUSH Research Portal, and other peer-reviewed databases published primarily between 2021 and 2026. Studies focusing on conservative treatment, Kshara Karma, Kshara Sutra, Agnikarma, herbal formulations, dietary interventions, and comparative management approaches were critically reviewed.
Results
Current evidence indicates that lifestyle modification, dietary correction, and bowel habit regulation remain the cornerstone of Arsha management. Ayurvedic para-surgical procedures such as Kshara Karma and Kshara Sutra demonstrate favorable outcomes in selected patients with low recurrence rates, minimal complications, and satisfactory healing. Herbal formulations possessing anti-inflammatory, wound-healing, venotonic, antioxidant, and mild laxative properties contribute significantly to symptom relief. Emerging clinical evidence supports the integration of Ayurvedic interventions with modern diagnostic protocols for individualized patient care.
Conclusion
An integrative approach combining classical Ayurvedic principles, para-surgical techniques, dietary regulation, and modern clinical assessment offers promising outcomes in the management of Arsha. Nevertheless, larger multicentric randomized controlled trials with standardized outcome measures are required to strengthen the evidence base and facilitate wider clinical acceptance.
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