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{{#seo:

|title=Arsha Chikitsa

|title=Arsha Chikitsa

|type=article

|type=article

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<big>'''[[Chikitsa Sthana]] Chapter 14. Management of Arsha (Hemorrhoids)</big>'''

<big>'''[[Chikitsa Sthana]] Chapter 14. Management of Arsha (Hemorrhoids)</big>'''

{{Infobox

{{Infobox

|data7  = Goyal M.

|data7  = Goyal M.

|label8 = Editors

|label8 = Editors

|data8  = Singh G., Goyal M., Deole Y.S., Basisht G.

|data8  = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]

|label9 = Year of publication  

|label9 = Year of publication  

|data9 =  2020

|data9 =  2020

}}

}}

<big>'''Abstract </big>'''

<big>'''Abstract </big>'''

<div style="text-align:justify;">

<p style='text-align:justify;'>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).  

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).  

 

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. </p>

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.  

'''Keywords''': ''Arsha, anuvasana basti, [[raktamokshana]],'' hemorrhoids, ''[[shodhana]] chikitsa'', soothing therapy, sitz bath, fumigation, ''asava, arishta, churna, vati, pichcha basti'' </div>

'''Keywords''': ''Arsha, anuvasana basti, [[raktamokshana]],'' hemorrhoids, ''[[shodhana]] chikitsa'', soothing therapy, sitz bath, fumigation, ''asava, arishta, churna, vati, pichcha basti''  

*In pathophysiology of ''arsha'', ''apana vayu'' gets obstructed by the hemorrhoid-mass and moves upwards leading to aggravation of ''samana vayu, vyana vayu, prana vayu, udana vayu, [[pitta]]'' and ''[[kapha dosha]]''. When all these five types of ''[[vata]], [[pitta]]'' and ''[[kapha]]'' get aggravated the individual suffers from morbidities of hemorrhoids.

*In pathophysiology of ''arsha'', ''apana vayu'' gets obstructed by the hemorrhoid-mass and moves upwards leading to aggravation of ''samana vayu, vyana vayu, prana vayu, udana vayu, [[pitta]]'' and ''[[kapha dosha]]''. When all these five types of ''[[vata]], [[pitta]]'' and ''[[kapha]]'' get aggravated the individual suffers from morbidities of hemorrhoids.

*The causes of ''[[vata]]ja arsha'' include habitual intake of astringent, pungent, bitter, ununctuous, cold and light food; habitual intake of ''pramitashana'' (food measured in extremely small quantities), intake of less quantity of food, intake of excess alcoholic drinks and indulgence in sexual acts; fasting, living in cold country and cold season, excess physical exercise, grief and exposure to sun and wind.

*The causes of ''[[vata]]ja arsha'' include habitual intake of astringent, pungent, bitter, ununctuous, cold and light food; habitual intake of ''pramitashana'' (food measured in extremely small quantities), intake of less quantity of food, intake of excess alcoholic drinks and indulgence in sexual acts; fasting, living in cold country and cold season, excess physical exercise, grief and exposure to sun and wind.

*The causes of ''[[[pitta]]ja arsha'' include intake of pungent, hot, salty and alkaline food; excess exercise and exposure to the heat of fire and Sun; living in a place and season which are not cold, intake of alcohol and envy; Intake of drinks, food and drugs having ''vidahi'' (causing burning sensation), sharp and hot properties.

*The causes of ''[[pitta]]ja arsha'' include intake of pungent, hot, salty and alkaline food; excess exercise and exposure to the heat of fire and Sun; living in a place and season which are not cold, intake of alcohol and envy; Intake of drinks, food and drugs having ''vidahi'' (causing burning sensation), sharp and hot properties.

*The causes of ''[[kapha]]ja arsha'' (hemorrhoids) include sweet, unctuous, cold, salty, sour and heavy food; lack of exercise, sleeping during day time, excess sleeping and sitting; direct exposure to wind, living in cold place and exposure to cold season and mental inactivity.

*The causes of ''[[kapha]]ja arsha'' (hemorrhoids) include sweet, unctuous, cold, salty, sour and heavy food; lack of exercise, sleeping during day time, excess sleeping and sitting; direct exposure to wind, living in cold place and exposure to cold season and mental inactivity.

*Hemorrhoids always include aggravation of all the three ''[[dosha]]s''. Predominance of one or all the ''[[dosha]]s'' determine the type of hemorrhoids.

*Hemorrhoids always include aggravation of all the three ''[[dosha]]s''. Predominance of one or all the ''[[dosha]]s'' determine the type of hemorrhoids.

#Chopade KM, Khatri SR, Raut SY, Lakhapati AM. To evaluate the efficacy of Kshiri - Vruksh Patra (Vata, Udumbara & Peepal) in management of Arsha. e-Journal Rasamruta. 2013; 5(14):1-5.

#Chopade KM, Khatri SR, Raut SY, Lakhapati AM. To evaluate the efficacy of Kshiri - Vruksh Patra (Vata, Udumbara & Peepal) in management of Arsha. e-Journal Rasamruta. 2013; 5(14):1-5.

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