Changes

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.     

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, shodhan chikitsa, soothing therapy, sitz bath, fumigation, asava, arishta, churna, vati

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

=== Introduction ===

=== Introduction ===