HOLISTIC AYURVEDIC PERSPECTIVES IN THE PREVENTION AND TREATMENT OF ANORECTAL DISORDERS

Abstract

Anorectal disorders, referred to in classical Ayurvedic literature as Gudagata Vikara, constitute a clinically diverse group of conditions affecting the ano-rectal canal that carry substantial morbidity across all demographic groups worldwide. The principal entities include Arsha (haemorrhoids), Bhagandara (fistula-in-ano), Parikartika (fissure-in-ano), Gudabhramsha (rectal prolapse), Gudapaka (perianal abscess), and Shataponaka (complex fistulae). The global prevalence of these disorders has escalated with the widespread adoption of sedentary lifestyles, fibre-depleted diets, unregulated psychosocial stress, and diminishing physical activity levels. Ayurveda provides a scientifically coherent aetiological model centred on Tridosha imbalance chiefly vitiation of Apana Vata and Pitta Dosha with consequent impairment of Jatharagni (digestive fire) and Ama (metabolic residue) formation as integral pathogenic steps. Classical treatises including Sushruta Samhita, Charaka Samhita, Ashtanga Hridayam, and Sharangadhara Samhita document comprehensive preventive guidelines through Nidana Parivarjana (avoidance of causative factors) and graduated therapeutic approaches encompassing pharmacological management, Kshara Karma (chemical ablation), Agnikarma (thermal cauterisation), Ksharasutra (medicated thread therapy), and Shastra Karma (surgical excision). A growing body of clinical and pharmacological evidence validates several of these interventions, most notably Ksharasutra for fistula-in-ano and Kshara Karma for haemorrhoids. This review consolidates classical Ayurvedic scholarship with current biomedical evidence, offering a comprehensive and integrative framework for prevention and management of anorectal disorders.