Piles (Hemorrhoids): A Comparative Analysis of Ayurvedic and Modern Perspectives

Abstract

Piles, also known as hemorrhoids, are a common anorectal disorder characterized by swollen veins in the lower rectum and anus. While modern medicine focuses on symptomatic relief and surgical interventions, Ayurveda offers a holistic approach involving diet, lifestyle modifications, and herbal therapies. This article provides a comparative analysis of Ayurvedic and modern treatments for piles, highlighting their efficacy and limitations.

Introduction

Piles affect millions worldwide, with risk factors including chronic constipation, pregnancy, obesity, and sedentary lifestyles.¹ Modern medicine categorizes hemorrhoids into internal and external types, whereas Ayurveda classifies them under ‘Arsha’ based on dosha imbalances. This review aims to compare the pathophysiology, diagnosis, and treatment modalities in both systems.

Modern Medicine Perspective

Modern medicine identifies hemorrhoids as vascular structures aiding anal continence, which become symptomatic when swollen.² Diagnosis involves clinical examination and procedures like anoscopy and sigmoidoscopy. Treatment includes:

• Conservative Management: Dietary fiber intake, sitz baths, and topical agents (lidocaine, hydrocortisone).

• Minimally Invasive Procedures: Rubber band ligation, sclerotherapy, infrared coagulation.

• Surgical Interventions: Hemorrhoidectomy and stapled hemorrhoidopexy for severe cases.

Ayurvedic Perspective

In Ayurveda, piles (Arsha) are attributed to an imbalance in Vata, Pitta, and Kapha doshas, leading to impaired digestion and chronic constipation.³ Treatment modalities include:

• Herbal Remedies: Triphala, Haritaki, and Guggulu for bowel regulation and inflammation control.

• Kshara Sutra Therapy: A minimally invasive procedure using medicated thread ligation.⁴

• Kshara Karma Therapy: An advanced Ayurvedic procedure where a specialized alkaline paste (Kshara) is applied to the hemorrhoidal mass to induce controlled cauterization and shrinkage. This technique is particularly effective for non-bleeding and prolapsed hemorrhoids.

Diet and Lifestyle Modifications: High-fiber diets, yoga, and abhyanga (oil massage) to improve gut health and circulation.

Comparative Analysis

• Efficacy: While modern interventions provide quick relief, recurrence rates are high. Ayurvedic therapies focus on root causes, offering long-term benefits.

• Safety: Modern surgical treatments have risks like infection and incontinence, whereas Ayurvedic methods are generally safe with fewer side effects.⁵

• Accessibility: Conventional treatments are more widely available, but Ayurvedic therapies are gaining global recognition.

Conclusion

Both Ayurvedic and modern treatments for piles have their advantages. A multidisciplinary approach combining dietary changes, herbal remedies, and minimally invasive procedures can offer optimal patient outcomes. Further research is needed to integrate traditional and modern perspectives for holistic anorectal healthcare.

References

1.      Gupta V, Sharma S. Ayurvedic management of Arsha (Piles): A review. J Ayurveda Integr Med. 2022;13(4):123-129.

2.      Gaj F, Trecca A, et al. Hemorrhoidal disease: Modern treatment strategies. Int J Colorectal Dis. 2020;35(3):567-578.

3.      Misra A, Pandey S. Role of Kshara Sutra in the management of hemorrhoids. J Res Ayurvedic Sci. 2021;10(2):88-9.

4.      Brisinda G, Maria G, et al. Surgical management of hemorrhoids: An updated review. Ann Surg. 2019;270(4):645-65.

5.      Chopra A, Tiwari V. A comparative study of Ayurvedic and allopathic treatments for hemorrhoids. Indian J Surg. 2021;83(1):37-4.