Abstract

AN INTEGRATIVE REVIEW ON ARSHA: AYURVEDIC APPROACH AS WELL AS CONTEMPORARY UNDERSTANDING

Dr. Harimohan Kushwaha*, Dr. Ramnarayan Morya, Dr. Anita singh, Dr. Ankit Gupta

Abstract

Arsha, often known as hemorrhoids, is a widespread anorectal condition defined through the enlargement and irritation of the anal blood vessels. Arsha is one of the most common anorectal disease described in Ayurvedic literature and is included among the Ashta Mahagada by Acharya Sushruta due to its chronicity, difficulty in management, and tendency to recur. The disease originates primarily from Mandagni leading to improper digestion, formation of Ama, and vitiation of Tridosha, especially Apana Vata. Factors such as excessive intake of Guru, Abhishyandi, Vidahi Ahara, irregular food habits, prolonged sitting, suppression of natural urges, constipation, lack of exercise, and psychological stress contribute significantly to the pathogenesis of Arsha. The vitiated Doshas localize in the Gudavali and vitiate Twak, Mamsa, Meda, and Rakta Dhatu, producing fleshy projections in the anal region known as Arsha. Ayurveda classifies Arsha into various types based on Dosha predominance, bleeding tendency, congenital origin, and prognosis. Clinically, patients present with symptoms such as Gudashoola (pain), Raktasrava (bleeding per rectum), Kandu (itching), Guda Shotha (swelling), prolapse, constipation, and discomfort during defecation. Modern science correlates Arsha with hemorrhoids resulting from engorgement of hemorrhoidal venous plexus. Ayurvedic management emphasizes Nidana Parivarjana, correction of Agni, purification of vitiated Doshas, and strengthening of anorectal tissues. Treatment modalities include Bhaishajya Chikitsa, Kshara Karma, Agnikarma, Kshara Sutra, and Shastra Karma depending upon the stage and severity of disease. Classical formulations such as Triphala, Arshoghni Vati, Abhayarishta, and Kutajadi preparations are widely used along with dietary regulation and lifestyle modifications. Among para-surgical procedures, Kshara Karma described by Sushruta has gained importance due to its minimal invasiveness, reduced recurrence, and cost-effectiveness. This review highlights the Ayurvedic concept, etiopathogenesis, classification, clinical manifestations, and holistic management of Arsha with special emphasis on classical Ayurvedic principles and their contemporary relevance in anorectal disorders.

Keywords: Anorectal, Arsha, Sushruta, Haemorrhoids, Ayurveda, Modern science.