Overview

Piles, medically referred to as haemorrhoids, represent swollen veins located in the lower anus and rectum. This swelling can result in localised inflammation of adjacent tissues.

Classification of Haemorrhoids

• Internal haemorrhoids are situated within the rectum and are typically not visible during an external examination.                                                                                                                       

• External haemorrhoids may protrude beyond the confines of the anus, a condition known as a prolapsed haemorrhoid.

Grading of Haemorrhoids 

Grade I - The haemorrhoids are asymptomatic and do not protrude from the anus.

Grade II - The haemorrhoids may prolapse from the anus but spontaneously return inside.

Grade III - The haemorrhoids prolapse can only be reinserted into the anus, back to the position, through manual intervention.

Grade IV -The haemorrhoids remain protruding outside the anus, and the patient finds it difficult to reposition them.

Causes

The veins surrounding the anus are prone to stretching and may become prominent or swollen due to increased pressure, resulting in the formation of haemorrhoids. This increased pressure in the lower rectum can arise from several factors, including:

• Straining during bowel movements.

•  Prolonged sitting, particularly on the toilet.

• Persistent diarrhoea or constipation.

• Obesity.

• Pregnancy.

• A diet low in fibre.

• Frequently lifting heavy objects.

Symptoms

• Internal haemorrhoids typically do not cause pain and are generally not detectable unless they prolapse. Symptoms may include the presence of bright red blood on toilet paper, within stool, or in the toilet bowl. In cases where an internal haemorrhoid prolapses, it may be possible to gently reposition it back inside the anus.

• External haemorrhoids are more noticeable due to their location outside the anus. Common signs and symptoms associated with external haemorrhoids include:

• Itching or irritation in the anal region

• Firm lumps near the anus that may be sore or tender to the touch

• Discomfort or pain in the anal area, particularly while sitting

Ayurvedic View

Arshas is a disease that affects the guda valli(cushions )of the anal canal. This disease is caused due to agni mandhya(low digestion), factors aggravating vata dosha, then this aggravated vata enters into pakwashaya( colon), along with kapha and pitta, causing dushti (vitiation )of twak(skin),mamsa(muscle tissue),meda(fat layer) of guda(anus) and results in mamsa ankura (fleshy mass) at the anal canal called as haemorrhoid. This mass can be non-bleeding or bleeding. Ayurveda's way of approach is correct agni(metabolism,  bringing dosha back to prakruta awastha, preventing reoccurrence and aggravation of this disease by adopting panchakarma treatment and other 4 modalities of ayurvedic treatment, also by guiding patients to follow a healthy diet and lifestyle.