Piles also known as Haemorrhoids are swollen or inflamed veins in the anal canal and lower part of rectum. Haemorrhoids generally result due to increased pressure on these veins.
Haemorrhoids are generally accompanied with pain and bleeding.
Various causative factors which lead to increased pressure in the veins lead to piles. The vein stretch under pressure and may bulge or swell.
The factors are as follows:
Piles have been categorized in two types:-
1. External piles – Present as a swelling or a bulge outside the anal region.
2. Internal Piles – These are present inside the anal region or in the lower part of rectum.
Piles have also been classified into four grades:-
Grade 1 – Piles are small swellings on the inside lining of the anus. They cannot be seen or felt from outside the anus.
Grade 2 – Piles are prolapsed during defecation and retract back inside again.
Grade 3 – Piles prolapsed out from the anus. They can be felt as small soft lumps. However, they can be pushed back inside the anus with a finger.
Grade 4 – Piles bigger in size and permanently prolapsed out from the anus, and cannot be pushed back inside.
The symptoms usually depend on the type or location of Haemorrhoids.
External Haemorrhoids when irritated can cause itching and bleeding. When blood accumulates and form a clot or thrombus, then it may result in severe pain and swelling. A skin tag may even remain after healing.
Internal Haemorrhoids lie inside the rectum, when hard stools passes through the rectum it damages the delicate surface of Haemorrhoid and cause it to bleed leading to bright red bleeding during or after stools. It may be seen on toilet paper or as dripping in the toilet seat. Pile mass if protrudes through the anus or becomes thrombosed may lead to pain and irritation.
External Haemorrhoids produce less bleeding than internal ones and are more sensitive and painful.
In Ayurvedic science, this disease has been described as “Arsha” . According to Acharyas, it is difficult to treat . The Seat of this disease is “Gudavali” (anal region). It is called as “Arsha” because it gives pain and endangers life like an enemy.
Acharya charak has described two types of “Arsha”
Acharya Sushruta has described six types of Arsha according to the dominance of Dosha involved:-
Acharyas have again described two types of Arsha –
The intake of etiological factors causes Mandagni (Low digestive fire) which leads to collection of Ama (toxins) in the body which in turn causes aggravation of three Doshas leading to impaired functioning of digestive gut. The aggravated Doshas get accumulated in the Guda (lower rectum and anus) and thereby causes aggravation of Rakta (Hemorrhoidal plexus of veins), this create swellings or outgrowths of Haemorrhoids.
The sign or symptoms which occur prior to the full development of symptoms of disease in body are called as Purvarupa.
Premonitory symptoms of Arsha are Indigestion, Flatulence, Weakness, Constipation, Excessive belching, Pain in thighs, altered bowel habits, Pallor, Abdominal distension, drying of mouth or increased thirst, low volume of stool or sense of incomplete evacuation of bowel.
These include Pain in anal region with burning sensation and/or Bleeding, Constipation, Diarrhoea, Flatulence and Bloating of abdomen.
The main line of treatment for Arsha is Deepan Pachana along with Srotoshodhana. In case of bleeding piles Raktshodhak and Raktstambhak treatment should also be given.
Acharya Sushruta mentioned four line of treatment for Arsha:-
Avoiding constipation is very important for successful management of Piles.
Kshar Karma (Chemical cauterization) plays an important role in Ayurvedic treatment of Piles. Direct application of Kshar in internal piles help in their complete removal without any wound formation. It provides a quick management method for their treatment.
In external piles or 3rd and 4th Grade Piles, ksharsutra (a medicated thread on which various herbal pastes are applied) is tied on the root of pile which lead to gradual drying and shedding off of Haemorrhoid without any scar or wound formation. It is extremely hygienic and without any side effects.
1. Single herbs - Haritki (Terminalia chebula), Mahanimba (Melia azedarach), kareer(Capparis decidua), Suran ( Amorphophallus campanulatus), Chawpatiya (Marsilea minuta), Amalki (Emblica officinalis).
2. Churna (Herbal combinations) - Samsharkar churna, Vyoshadi churna, Vijay churna, Jaatiphaladi vati, Kankayan vati, Pranda Gutika, Suran Modaka, Baahushaal Guda, Avipattikar churna, Panchsakar churna.
3. Ras Aushadhis (Herbo Mineral preparations) – Arshakuthar Rasa, Nityodit Rasa, Chakrakhyo Rasa, Ashtaang Rasa.
4. Asava/Arishta (Alcholic Preparations) – Abhayarishta, Takrarishta, Phalarishta, Kankarishta, Drakshasava, Chandanasava.
5. Taila (oil preparations) – Kasisadi Taila, Jatyadi taila.
6. For Bleeding Piles – Nagkesar churna, Bol Badhha Rasa, Kutaja Ghana Vati, Bol Parpati, Swetchandanadi churna, Chopchinyadi churna, Shankh Bhasma.
1. Eat lot of fiber rich food like fruits, green leafy vegetables, whole wheat flour, whole grains, oat meal, barley, lentils, soyabeans etc. and drink 8-10 glasses of water daily. Take freshly prepared food only.
2. Avoid intake of heavy, oily, spicy, dry, cold, fermented and preserved food.
3. Avoid tea, coffee, carbonated drinks, alcohol, instead take fresh juice, soups, buttermilk, milk etc.
4. Local Fomentation of piles helps in reducing their size. Local Fomentation can be done with Barley seeds in a pottali or submerging the Hip region in warm tub of water (Hot sitz bath) is very useful.
5. In case of bleeding or itching piles, Hot sitz bath for 10 min thrice a day with 1teaspoon purified Alum water is very useful.
6. Intake of small piece of jaggery with 1 piece of harad (Hareetki – Terminalia chebula) 5-10 min before meals help in improving digestive capacity of the body and digests Aam (toxins) from the body. This will help in regression of piles or any other digestive problem.
7. Drink daily 1 - 2 glasses of buttermilk mixed with roasted cumin seeds and rock salt.
8. Take 1 teaspoon triphala powder twice a day with buttermilk regularly to reduce swelling and pain in piles.
9. prepare a paste of curcumin powder with equal quantity of long pepper powder along with cow’s milk or urine. Apply this paste on external piles, this will help in reducing itching, pain and size of haemorrhoids.
10. Kshar Karma (Chemical cauterization) plays an important role in Ayurvedic treatment of Piles. Direct application of Kshar in internal piles help in their complete removal without any wound formation. It provides a quick management method for their treatment. In external piles or 3rd and 4th Grade Piles, ksharsutra (a medicated thread on which various herbal pastes are applied) is tied on the root of pile which lead to gradual drying and shedding off of Haemorrhoid without any scar or wound formation. It is extremely hygienic and without any side effects.
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