Haemorrhoids

Haemorrhoids, also known as piles, are swollen and inflamed veins in the rectum and anus that cause discomfort and bleeding. They can be classified into internal and external haemorrhoids based on their location.

According to Ayurveda, hemorrhoids are known as "Arsha", a condition arising from an imbalance in the doshas (Vata, Pitta, Kapha).

Types of Haemorrhoids

Internal Haemorrhoids:

• Located inside the rectum.
• Usually painless but may cause bleeding.

External Haemorrhoids:

• Located under the skin around the anus.
• Can cause pain, swelling, itching, and sometimes bleeding.

Prolapsed Haemorrhoids:

• Internal haemorrhoids that start swelling from the rectum and protrude outside the anus.

Thrombosed Haemorrhoids:

• External haemorrhoids with a blood clot inside, causing severe pain and swelling.

Etiological causative factors of Haemorrhoids

• Vata aggravation: Dryness and constipation lead to hard stools and strain
• Pitta imbalance: May cause burning and bleeding.
• Kapha imbalance: Leads to swelling and heaviness.
• Common factors: improper diet (heavy, spicy, oily food), lifestyle factors (lack of physical activity), suppression of natural urges, and stress.
• Chronic constipation or diarrhoea: Straining during bowel movements can put pressure on the veins.
• Prolonged sitting: Sitting for extended periods, especially on the toilet.
• Low-fibre diet: This leads to constipation and straining.
• Pregnancy: Increased pressure on the pelvic veins.
• Aging: The tissues supporting the veins in the rectum and anus can weaken with age.

Symptoms and Signs of Haemorrhoids

• Internal hemorrhoids: Bright red blood in stool, itching, discomfort.
• External hemorrhoids: Pain, swelling, itching, and irritation around the anus.
• Thrombosed hemorrhoids: Severe pain, swelling, and a hard lump near the anus.
• Vata-type Arsha: Dry, hard stools, pain, and bloating.
• Pitta-type Arsha: Burning sensation, bleeding, inflammation.
• Kapha-type Arsha: Swelling, heaviness, mucous discharge.

Management of Haemorrhoids or Piles (Arsha)

Conservative treatment: 

• This includes giving some herbal preparations in the form of tablets, powder, decoction to balance the doshas, Stop the bleeding if any, Relieve constipation and improve digestion.
• Regular Sitz bath with some herbal decoctions.
• Local Application of herbal oils / ghee, ointments to relieve pain or burning sensation.
• Sometimes some Panchakarma or detoxification treatment might be necessary.

Kshar – Sutra treatment: 

• This is an Ayurvedic treatment procedures which involves using a specially prepared medicated thread (Kshar Sutra) to treat both internal and external haemorrhoids without surgery.
• The Kshar Sutra is coated with herbal medicines like alkaline compounds, which have healing and tissue-cutting properties.
• The medicated thread is tied around the base of the haemorrhoid.
• Over time, the thread cuts off the blood supply to the haemorrhoid, causing it to shrink and eventually fall off.
• The thread also promotes healing of the surrounding tissue and reduces infection.
• This treatment is minimally invasive, usually painless with local anaesthesia, effective in both internal and external piles, and recovery is quicker than surgery.

Surgery: 

• If the above two modes of treatment don’t work then even Ayurveda recommends surgery (Haemorrhoidectomy).

Diet and lifestyle recommendations:

• Eat a high-fiber diet to avoid constipation.
• Eating Suran or elephant’s foot vegetable is recommended.
• Avoid dry, uncooked food, spicy food.
• Intake of clear butter milk is advised
• Stay hydrated. Drink plenty of water.
• Exercise regularly to promote good digestion.
• Avoid sitting for long periods, especially on the toilet.
• Take regular Sitz baths

Herbs beneficial in Haemorrhoids

Triphala:

It’s a combination of three herbs – Haritaki + Amalaki + Bibhitaki. It is to be taken as a powder or capsule. It acts as a mild laxative and detoxifies the body.

(Mesua ferrea):

It reduces bleeding, inflammation, and pain in haemorrhoids when consumed in powdered form, often mixed with other herbs and with butter.

Patha (Cissampelos pareira):

It pacifies all the 3 doshas and balances them, it is a good digestive and helps relieve pain in the anal region when given in combination of Dhamasa.

Dhamasa (Fagonia arabica):

It alleviates the increased Vata and Pitta Doshas and helps relieve pain of piles when given as mentioned above.