Arsha (Piles)

Arsha presents as mamsa ankuras (fleshy masses) at the anal orifice, impeding guda marga due to increased Apana Vata, frequently accompanied by Pitta or Kapha, resulting from chronic constipation, excessive lifting, or an unsuitable diet. There are seven varieties of piles: Vataja (dry, harsh, painful blackish piles); Pittaja (soft, bleeding, scorching red/yellow masses); Kaphaja (white, slimy, heavy with discharge); Raktaja; Sannipataja; and Agantuja.

Vataja causes discomfort that seems like it's stabbing you (toda), gas, and back pain; Pittaja causes fever, thirst, fainting, and hot watery blood in faeces; and Kaphaja causes swelling, nausea, and sluggish digestion. Prodromal indications consist of anal irritation and inadequate evacuation; the grades increase from bleeding (1st) to prolapsed, irreducible masses (4th), corresponding to contemporary internal/external haemorrhoids.

Pathogenesis entails the dilation of rectal veins by doshas, resulting in granthi-like formations inside mamsa and medas dhatus; the risk escalates after the age of 50 due to sedentary lifestyles. Management is more complicated as the disease becomes worse. For 1–2, Kshara karma (caustic application) is used; for severe cases, ligation or Shastra chikitsa is used. Shamana utilises Arshoghna medications like Khadiradi vati and Triphala guggulu.

Pathya includes foods high in fibre and buttermilk; however, you should stay away from spicy and heavy dishes. Most people can be cured with early intervention; however, advanced Sannipataja cannot.