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Piles: painless treatment without surgery by ayurveda

Dr. Imlikumba, Health Naturally Clinic, Mercy Building: Kevijau colony, Dimapur: Nagaland, +91948332
Published on 10 Sep. 2017 6:53 PM IST
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Piles is a kind of disease which is most unkind towards mankind. Piles incidence increases with advancing age, at least 50% of people over the age of 50 years have some degree of haemorrhoidal symptoms. While Arsha is correlating with Piles maximum concepts are similar to each other. Piles are one of the most common ailments of the rectum, affecting as much as half the population. Suffering from piles is not only painful but embarrassing as well. Piles are swollen, inflamed veins and capillaries around the rectum. They may be classified as either internal or external. Many not only want to know how to heal piles but also how to heal piles fast and naturally. The role of ayurveda in the management of piles(arsha) is explained here. It has been proved by scientific studies that botanicals improve microcirculation, capillary flow, and to strength the surrounding connective tissues of anus and lower rectum. By looking into the history one can understand that great saints like Adishankara who revived the vedic literature and famous rulers like Napoleon suffered from this disease. Haemorrhoids or piles are dealt rationally under the concept of Arshas found in almost all ayurvedic literature which deals with diseases and its treatment. Since the time immoral efforts have been made all over the world to combat the condition through different modalities of treatment, but not all of them have been uniformly successful .
Causes:  The exact causes of symptomatic haemorrhoids/piles are unknown. A number of factors are believed to play important role including: Irregular bowel habits( constipation or diarrhea), Lack of exercise, Nutritional factor( a low-fiber diet), Increased intra-abdominal pressure (prolonged straining, an intra-abdominal mass, or pregnancy), genetics, absence of valves within the hemorrhoidal veins, Aging, Other factors that are believed to increase the risk include  Obesity  Prolonged sitting  Chronic cough  Pelvic floor dysfunction. Evidence for these associations, however, is poor. During pregnancy, pressure from the fetus on the abdomen and hormonal changes cause the hemorrhoidal vessels to enlarge. Delivery also leads to increased intra-abdominal pressures. Surgical treatment is rarely needed in those who are pregnant, as symptoms usually resolve post delivery.
A) On the basis of position- 
1. Internal 2. External 3. Interno-external 
B) On the basis of symptoms-
Grade I: No Prolapse. Just prominent blood vessels.
Grade II: Prolapse upon bearing down but spontaneously reduce.
Grade III: Prolepses upon bearing down and require manual reduction.
Grade IV: Prolapsed and cannot be manually reduced.
Sign & symptoms:  The symptoms of pathological hemorrhoids depend on the type present. Internal hemorrhoids usually present with painless rectal bleeding while external hemorrhoids may produce few symptoms or if thrombosed significant pain and swelling in the area of the anus. External If not thrombosed external hemorrhoids may cause little problem. However when thrombosed they may be very painful with this pain typically resolves over 2 to 3 days. The swelling may take a few weeks to disappear, and after healing a skin tag may remain. If they are large and causing issues with hygiene, they may produce irritation of the surrounding skin and thus causes itching around the anus. Internal hemorrhoids usually present with painless, bright red, rectal bleeding during or following a bowel movement. The blood typically covers the stool, a condition known as hematochezia, is on the toilet paper, or drips into the toilet bowl. The stool itself is usually of a normal color. Other symptoms may include mucous discharge, a perianal mass if they prolapse through the anus, itching, and fecal incontinence. Internal hemorrhoids are usually only painful if they become thrombosed or necrotic.
Complications: Anemia (due to blood loss during defecation), Thrombosed strangulated piles
Conservative management: 
Prevention of constipation- Laxative- Triphala churna, Panchasakar churna, Haritaki churna, Abhayaarista. 
Deepan pachan- Chitrakadi vati , Lavan baskar churna, Agnitundi vati.  Arshoghna-Sooranpak,Arshakuthar ras, Shigru guggulu.
Hot sitz bath- Tankan bhasma Sphatic bhasma, Triphala kwath Panchawalkal kwath.
Rakta stambhak(for stopping bleeding)-Bol baddha rasa, Bol parpati,Kukutandatwak bhasma Praval pisthi. 
Vran ropak(for healing wound) -Jatyadi tail, Nirgundi tail. 
Vednahar(for decreasing pain)-Madhuyastyadi tail, Triphala guggulu.
Procedure management:
Kashar sutra ligation: It is a procedure in which medicated herbal coated thread are applied onto internal and external piles mass within 5-7 days withered piles mass falls off. Cure rate-97%.
Chedan karma: A number of surgical excision techniques may be used if conservative management and simple procedures fails. All are associated with some degree of complications including bleeding, infection, anal strictures and urinary retention, due to the close proximity to the rectum to the nerves that supply the bladder. There may also be a small risk of fecal incontinence, particularly of liquid, with rates reported between 0-28 percent.
Agni karma: A number of cauterization methods have been shown to be effective for hemorrhoids, but are usually only used when other methods fail. This procedure can be done using electrocautery, infrared radiation, laser surgery, or cryosurgery. Infrared cauterization may be an option for grade 1 or 2 disease. In those with grade 3 or 4 disease re-occurrence rates are high 
Ksharkarma: Involves the applying of a sclerosing agent, such as apamarg kshar snuhi kshar, into the hemorrhoid. This causes the vein walls to collapse and the hemorrhoids to shrivel up. The success rate four years after treatment is ~70% 
Benefits of kshar sutra therapy: Simple safe and sure treatment, No complications ,No recurrence, Very economic, Very high success rate, No antibiotic required, Day care surgery, Useful in all age and cardiac patients.
Pathya( Benificial in Piles): Cow milk, Butter, Buttermilk, Wheat, Ghee, Rice, Green vegetable, Regular sleep, Exercise, Regular diet, Non suppression of natural urges etc.
Apathya (What to avoid in Piles):  Chilies, Fried Foods, Maida product, Non-Veg, Paneer, Constipating foods, Constant sitting, Excessive Pressure in defeacation.etc.
Conclusion: Ayurveda has immense potential to solve many challenging and unresolved problems of the medical world. A hemorrhoid is a common discomfort, that is getting worse by prolonging immediate treatment, which directly affect the economy. Kshara sutra ligation takes less time and, if the patient has any associated systemic disorder, then the procedure can still be performed with proper prophylactic measures. Kshara sutra ligation treatment is much more beneficial in comparison with hemorrhoidectomy at maximum point. The disease described as Arshas in Ayurvedic literature can be regarded as Piles described in modern medical science .Piles can affect any one, any time, any place, anywhere. Haemorrhoids have plagued humankind since time immemorial, yet many misunderstanding regarding Haemorrhoidal complaints and disease still exist. Arshas are classified on the basis of character, origin, location, shapes, doshas, whereas modern classification is on their anatomical point of origin for the convenience of treatment.The causative factors explained in Ayurveda and Modern are almost the same. The causes like constipation and straining, occupation and heredity are the same to Modern and Ayurvedic science. External factors cause obstruction in veins resulting in dilations of haemorrhoids is nothing but Congestion. The clinical features of Arshas for each variety can be identified as colour, shape of pile mass, nature of stools, bowel movements, generalized symptoms and complications. Arshas chikitsa may divided into preventive measures and curative measures. Again curative measures divided into medical, parasurgical and surgical. Even the treatments of palliative and surgical measures are the same. But Ayurveda has got better planning and avoids immediate surgery. Ayurveda maintains a unique order in the management of arsas with the employment of Aushadha chikitsa (Medical management) Kshara chikitsa (Alkaline management) Agni chikitsa (Thermal cauterization) and Shahstra chikitsa (Surgical management).Only 10% of piles cases require surgery rest 90% are cureable by ayurveda medicine.
NOTE: Ayurvedic medicines and treatments should be taken under Qualified Ayurvedic Doctor/Physician. The drugs described in this article are for general information/educational purpose only. Anyone should not use these without consulting a qualified Ayurveda doctor/physician.

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