Management of Piles (अर्श) with #Ayurveda

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Next topic for discussion: Management of Piles (अर्श) with #Ayurveda

Vd. Dhruti Kagrana: ARSHA (Piles) is defined as "arivat pranan shrinoti iti arshah"

A disease which tortures one's vital Force ( prana) as enemy is called as Arsha.

Dr. Rachana Mumbai: Here I would like to mention one differential diagnosis called amoebic proctitis which is mentioned by patient as initial stage of piles

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But even though u give treatment of piles patient has no relief

Dr. Shahil H Bhavsar: Piles are raktaj and mansaj dushti caused by vayu and pitta.

Vd. Dhruti Kagrana: Improper diet & lifestyle habits disturbed Agni. Inability to digest food material with proper pace and time leading to accumulation or stagnation of half digested food material  (Ama) in the form of stool inside, or expelling it before time in watery or semisolid form, which disturbs doshas at anorectal region.

2168: Should be simple to treat. Modern diet indeed. Classical treatment would in include yava as the main grain. Anyone that doesn't start with that i think will have little success

Vd. Dhruti Kagrana:

Causes of Piles(Arsha):

Incompatible food

Eating before previous food is digested

Exessive Sexual intercourse

Exessive  Squatting position

Exessive  Riding

Suppression of natural urges

AS per Shushruta aacharya Hemorrhoids situated in external and middle fold should be treated while those situated in internal fold should be taken up after declaring them incurable

Vd. Dhruti Kagrana: According to Shushruta Aacharya

Four types of Treatment in Arsha:

1. Bhaishja (Medicine)

2. Kshara Karma

3. Agnikarma

4. Shastrakarma (Surgery)

Those newly arisen, with little dosa, symptoms and complication are treatable with drugs.

- Soft, extensive, deep and raised piles are to be treated with caustic alkali.

- Those which are rough, fixed, large & hard are treated by cauterization.

- Those with thin roots, elevated and sodden are treated with sharp instrument.

                                                                                     (su.chi.6/3)

According to Dosha

Vata & kapha – cauterization&application of caustic alkali.

Pitta & rakta – mild caustic alkali (su.chi.6/5)

Ayulink Ayurveda: This is very common symptoms / problem in sedentary life style or people have habit of sitting on a single place for long time ...or riding a vehicle daily for long distance.

Late night work, sitting on one place for long, riding on horse or vehicle, are life style oriented causes for piles

Dr. Aksht Sapare: Also people working in standing position for a long time. suffer from piles along with varicose veins.

Vd. Vipul Patil: In my practice In raktaarsha  Rx tab arshodhani 2-0-2, In non bleeding arsh Rx tab arshkuthar 2-0-2 And along with this Tab Triphala guggul, Tab kankayan vati, Tab suranvatak, Takraristam ( arsh adhikar), In daah( burning anal region), Tab laghusutsekhar, Tab Chandrakala ras Along with laxative Erandbhrustharitaki bed time, Panchasakar For pain relief Patha + dhamasa churan

In non bleeding pile  Use kshartail for local application ,it's gradually decrease size of arsh Many time in history

Most common hetu:- Simbidhanya (pules), Daal, Matha,matar ,udad daal sevan

Patra sak : Palak ,methi, very common So advice to avoid this Along with Backery food,guru ahar, spicy should avoid

Dr Jayesh Patel: During consulting some key points is important

Like

1) bleeding per anus before or after or along with stool

2) type of bleeding - dropwise or  bloody diarrhea, or squeeting etc

3) defecation with pain or without

4) during defecation burning or not

5) during defecation protrusion is there or not....if yes then reduce manually or spontaneous

6) Family history is also important in piles......(sahaj arsha)

7) itching

Some times pt have fissure in ano & told to us "I have piles"

So differential diagnosis is very important....

After that u can go for P/R or proctoscopy.....

If there is 1& 2 degree piles there is only c/o bleeding without pain. During anal haematoma (Raktaj Arsh)  pain is sever.....

During treatment so many doctors uses laxative......but main thing is that if  stool is bulk form  then sphincter mechanism is going on good side....so please give pt bulk agent like isabgul..

Dr. Savad Kerala: My prescription for bleeding piles 1.Dusparshakadi kashayam 2.Shigari gulam (contains apamarga)

 Non bleeding piles 1.Chiravilwadi kashayam 2. Kankayana vati

Dr. Arvind Shahane: I have got good results in bleeding Pilex with Tab v pil (Vaibhavi pharmacy) Contain as below

Ayucafe 032019 05: Sir wt abt fissures? Wt we should advice for fissures?

Ayulink Ayurveda: Normally I would go for hot water tub bath in the beginning for piles and fissure both conditions. Application of ghee, or any lubricant or cream base is good in fissure

Ayucafe 032019 05: No need to give any medicine orally? Some of my pt I advice tab HiLo twice day. Vata is main cause for fissure and sneha dravya  can pacify vata locally very comfortably. Okay...internally no need to give medication

Ayulink Ayurveda: For fissure : I generally don't advise for oral medicine. But sometimes for patient satisfaction you need to suggest medicine. May be abhayarishta can be one option

Hot water tub bath + local Sneha applications (3-4 times a day) mostly gives response in 3-4 days

Ayucafe 032019 05: Okay sir...wt abt tab hilo?

Ayulink Ayurveda: Constipation must not be there. This is primary condition. You can suggest any medication for constipation if needed

Vd. Vipul Patil: Reference from jawar chikitsa. We can use here also

Ayucafe 032019 05: OK sir ...ys constipation is main reason. We can give erand tail for only. Local  application also

Dr. Jayesh Patel: Give 30-40ml jatyadi ghreet.......as matra basti.....good results. Sitz bath with panchvalkal decoction gives excellent results

Vd. Pritam Bharat Veer: In Arsh i. Do deepaan pachan with hingwasthak. Anuloman - i preferr castor oil mostly Suran vatak Arshoghni Also Patha mishrn . Takra paan  Application Arshohita ointment  Sitz bath. I use one formula named Arsh gola which gave me ultimate results these days. I also give Abhayaristha 4 tsp at bed time.

Zarana Doshi: We have results in bleeding piles with this treatment ...Naturopathy and Diet. Stop eating green n red chilies. Stop eating Dry and Stale food. Avoid Nonveg . Avoid pulses at night. Soak Niranjan fal daily at night and it will blossam fully in the morning in water....this fruit gives miraculous results in bleeding piles and constipation both. (Ayurvedic Herb , Easy to follow.) Maximise usage of Lauki , Parval , Galka , Fresh Anjeer .Increase water intake with proper timings and art of drinking water...Slowly with chewing and adding saliva before gulping water.  Other common laws of Nature to follow ....early to rise and early to bed , do not stay hungry for more then 4 to 5 hours , let drop all work which gives stress and struggle.

Vd. Pritam Bharat Veer: What you all do for Apunarbhav chikitsa?

Ayulink Ayurveda: Very good question. My opinion: changes in life style and diet to avoid constipation - avoid dryness of stool and avoid dryness of intestine

Dr. Yogin Patel: This is prolapse piles so in this condition without operation we can get results

Vd. Sachin Kadlag: After treatment if complete cure is achieved one can go for Apunarbhava chiktsa by means of Rasayana chiktsa only. In case of arsha , being mansa pradoshaja vyadhi in area of Purishavaha srotasa , Rutu Haritaki Rasayan should  be advised for one year or throughout the life for Apunarbhava  as Haritaki acts on both mansa dhatu and Purishavaha srotasa . Hariatki is paachaan , anulomana and at the same time one of the great Rasayan. In all cases for cure as well as Apunarbhava nidaana parivarjana  and pathya sevan is always important.

2168: And what is your approach? As many patients are used to the foods they grew up with, so are vaidyas. Who uses yava as a main grain? Who stops eating dosa, roti, paratha etc. and follows classical food preparation like peya and vilepika? Maybe treatment is possible without such but it is faster and easier following the true best methods. Too as we all should know, such conditions are not isolated and other conditions do or will manifest. One is not just treating one condition but trying to restore equalibrium to the whole mind and body. Without such, other disease will later follow.

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Compiled by - Dr. Dhruti Kagrana