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== ([[Chikitsa Sthana]] Chapter 14, Chapter on Treatment of Hemorrhoids) ==
 
== ([[Chikitsa Sthana]] Chapter 14, Chapter on Treatment of Hemorrhoids) ==
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Abstract:
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=== Abstract ===
This chapter of Chikitsa sthana exclusively deals with the treatment of guda arsha (piles/hemorrhoids). Congenital and acquired types, their causes, clinical features of dosha dominance and management are elaborated. The usual treatment of hemorrhoids is surgical, but if proper treatment is received it can be best managed with medicinal treatment. The disease arsha is mentioned in the Ashtomahagada (group of eight diseases that are difficult to cure).
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            Recurrence rate of hemorrhoids is high, even after surgical intervention. Sushruta has mentioned that any disease, if can be cured with the medicine is not required to be treated with shodhana and shastrakarma (surgical intervention). So, every attempt should be made to treat hemorrhoids with medicinal treatment, diet and lifestyle changes.  . Different medicinal formulations for conservative management and local applications, soothing therapy, sitz bath, fumigation, and sprinkling with the herbs are some of the modes of treatment prescribed to relieve the local inflammation, bleeding and maintain the peri-anal hygiene to control the disease. The principal of treatment is to avoid the nidana (causative factors), with diet being one of them. Digestive power of the person should be strong, which can be maintained with the consumption of different types of thin and thick gruels. Anuvasana basti is used for management of constipation, the root cause of arsha. Raktamokshana (bloodletting), in cases of vitiation of rakta, is advised. Finally, it is evident that treatment of hemorrhoids is multifocal and no single modality is effective including surgery.   
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Keywords: Arsha, anuvasana basti, raktamokshana, hemorrhoids, shodhan chikitsa, soothing therapy, sitz bath, fumigation, asava, arishta, churna, vati
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This chapter of [[Chikitsa Sthana]] exclusively deals with the treatment of ''guda arsha'' (piles/hemorrhoids). Congenital and acquired types, their causes, clinical features of ''dosha'' dominance and management are elaborated. The usual treatment of hemorrhoids is surgical, but if proper treatment is received it can be best managed with medicinal treatment. The disease ''arsha'' is mentioned in the ''Ashtomahagada'' (group of eight diseases that are difficult to cure).
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Recurrence rate of hemorrhoids is high, even after surgical intervention. Sushruta has mentioned that any disease, if can be cured with the medicine is not required to be treated with ''shodhana'' and ''shastrakarma'' (surgical intervention). So, every attempt should be made to treat hemorrhoids with medicinal treatment, diet and lifestyle changes. Different medicinal formulations for conservative management and local applications, soothing therapy, sitz bath, fumigation, and sprinkling with the herbs are some of the modes of treatment prescribed to relieve the local inflammation, bleeding and maintain the peri-anal hygiene to control the disease. The principal of treatment is to avoid the ''nidana'' (causative factors), with diet being one of them. Digestive power of the person should be strong, which can be maintained with the consumption of different types of thin and thick gruels. Anuvasana basti is used for management of constipation, the root cause of arsha. Raktamokshana (bloodletting), in cases of vitiation of rakta, is advised. Finally, it is evident that treatment of hemorrhoids is multifocal and no single modality is effective including surgery.   
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'''Keywords''': Arsha, anuvasana basti, raktamokshana, hemorrhoids, shodhan chikitsa, soothing therapy, sitz bath, fumigation, asava, arishta, churna, vati
    
Introduction:
 
Introduction: