Piles – An Ayurvedic Perspective

Ayurvedic Treatment for Piles

Our busy lifestyle influences our health in a big way. Several health problems result due to unhealthy lifestyle. Today we will talk about one such health problem which is known as Piles.

Piles is gradually becoming a common disease among people. Its causes are long sitting hours, intake of junk food, insufficient exercises, insufficient intake of fiber containing food. Piles is also known as hemorrhoide. In this disease, our anal canal, which has plenty of blood vessels, develops swelling. When these blood vessels rupture, it causes bleeding through anus.

To discuss the topic of Piles in more detail, today we have with us our Ayurvedic health expert, Dr. Parmeshwar Arora. Welcome to our show Dr. Arora.

Q. First of all I would like you to tell our viewers about what exactly Piles is?

If we consider the anatomy of anal canal, it is about 3.8 cm long. It has vascular tissues which comprises of arteries (which carry fresh blood to anal canal) and veins (which carry impure blood back for purification). Any kind of venous dialatation in these vascular tissues (which we commonly call as massa i.e. wart in english) is termed as Piles. Depending on their position these are further classified as Primary piles, Secondary piles, External piles and Internal piles. Apart from this, depending upon the symptoms we classify them into Bleeding piles and Non-bleeding piles. So, to conclude Piles are basically masses of vascular tissue in the anal canal.

Q. You just told us about various types of Piles like Primary, Secondary, External, Internal, Bleeding and Non-bleeding piles. Please tell us about them in a little more detail.

As I told you, total length of anal canal is about 3.8 cm. Pectinate line divides the anal canal into two parts. The upper portion has a lining of mucus membrane and the lower portion has a lining of skin. The Piles occurring above the pectinate line are termed as Internal piles. Here I would like to tell you that the rectal venous plexus (or hemorrhoidal plexus) which surrounds the rectum, has a radial arrangement of superior and inferior rectal veins. If we compare this arrangement with the position of needles in a clock then 3 o’clock, 7 o’clock and 11 o’clock are those positions where these veins are automatically dilated (this is natural). This means that somehow there is always a possibility that if you do long standings or you are a victim of constipation or you have to pass stool with stress then these are the positions which are likely to get affected first (i.e. the initial impact is on the venous dilatations present at positions of 3 o’clock, 7 o’clock and 11 o’clock). The Piles occurring at these positions are referred to as Primary piles and the Piles occurring at positions other than this are referred to as Secondary piles.

Similarly if we talk about the anal canal then this too gets the blood supply through rectal arteries and the blood from here is drained through external rectal veins. The Piles occurring at the position of inferior hemorrhidal plexus is called as External piles. In case of External piles, though the hemorrhage occurs here too but due to skin covering there is no outside bleeding. Thus the External piles are Non-bleeding piles. But when we talk about Internal piles, these are the ones which occur above the pectinate line. This part of the anal canal has a lining of mucus membrane so when hard stool passes through it or pressure is exerted to pass stool then the mucus membrane gets ruptured and bleeding happens. Generally speaking, Internal piles are bleeding piles and External piles are Non-bleeding piles. Also as generally seen, while Internal piles involves no pain, there is pain in case of External piles. But since arteries and veins are connected (arterio-venous anastomosis), mixed features are also seen and this condition can be referred to as Mixed piles. In case of Mixed piles there is simultaneous bleeding and pain.

Q. While discussing about various causes of Piles, you said that though constipation is the major cause but sometimes wrong eating habits can also lead to Piles. How ?

Mandagni i.e. weak digestive power can be attributed to wrong eating habits and unhealthy lifestyle which involves stressful living conditions and busy routine. Both these result into vata dosha i.e. disturbed (prakopit) vayu (air) which weakens our digestive power (agni). For example consumption of non-fresh food items ( or stale food), consumption of ruksha aahar (i.e. dry things), too much of fasting or living under lot of mental stress results into prakopit vayu (air) or disturbed vata which in turn causes mandagni i.e. poor digestion. Also, if you are a victim of mandagni and you continue to consume spicy or sour food items (they have a property of heat) then this results into aggravated pitta dosh and leads to pittaj arsha. Similarly if you already have mandagni and you consume things which aggravate kapha dosha, e.g. too much of sweets, milk or curd etc. then it leads to kaphaj arsha.

Here, there is a need is to understand Shastra which has everything described so minutely and precisely. We need to understand its theories properly and accordingly follow the methods of treatment. If we do that then I am sure it is going to help us a lot. Somehow I believe that the time would come when we would stop referring to this condition as Piles and instead we would become accustomed to the term Arsha. Today, as I observe, gradually people are getting inclined towards Ayurvedic treatments. Even people like us who are Aurvedic scholars are trying to study Shastra more extensively. It is clearly written into it that if it is vatik arsha, then there shall be shoola i.e. pain, if it is paitik arsha then there shall be bleeding and if it is kaphaj arsha then there shall be itching. Some patients of piles who visit us don’t complain about any pain or bleeding but their only complaint is about itching in the anal region. According to Shastra, this symptom directly points towards kaphaj arsha. I am just trying to tell you that see how elaborate the Shastra is. Sometimes we happen to overlook certain things but then it’s all there in the Shastra. It is obvious that once we have known that a particular case involves increased kapha dosha then we can easily decide the treatment plan. In other words, if we have established the case on the basis of doshas then it is definitely going to help us a lot in the treatment. So, mandagni and the dosha involved are important factors in deciding the name of piles.

Q. Arsha is a very painful condition in which the patient suffers from constipation. Besides this, his day to day routine gets disturbed immensely. So please tell us about how can a person come out of the problem of vatik, paitik or kaphaj arsha?

According to Shastra, the condition of Piles directly indicates towards weak agni bal i.e. digestive power. As the digestive power deteriorates there is increased severity of this disease and adversely as there is improvement in agni i.e. digestive power the disease recedes. So, while treating this disease the prime objective should be to strengthen or maintain the agni. Not only in the treatment of Piles but in the treatment of two more diseases namely atisaar (i.e. diarrhea) and sangrahni (Irritable Bowel Syndrome or IBS), our sole intension should be to increase the agni bal. This effort helps in resolving the problems.

If a patient of piles wants to come out of his painful condition and he wants to avoid a hemorrhoidectomy i.e. surgery then I would advise him five principles. 1) If you think that certain food items are causing problem or are acting as a trigger then you will have to abstain from them completely. Even if a medicine provides you relief, the relief will only be temporary because if you restart consuming similar things or alcohol or spicy food then after three days of violation the piles would resurface automatically. According to Shastra, once somebody becomes a patient of Piles and he carries this disease over a period of one year then it becomes almost incurable. One can get relief with medicines but the relief would only last till you follow the precautions. As soon as the precautions are violated, the problem of piles would automatically recur. So, you will have to stay away from the triggers. 2) Vata Anuloman i.e. Dispelling intestinal gas. In case of Piles, vayu is said to be the main culprit so we need to work upon vayu anuloman i.e. vayu’s adhogati which means downward expulsion of vayu (i.e. air). For this you can take abhayarisht or abhaya churna. It is very simple medicine. If you consume abhaya churna at bedtime, it will help in vata anuloman. 3) Agni Sandeepan i.e. increasing agni (improving digestion). For this, you can take chitrakadi vati as 2 tablets each in morning and evening. This will immensely improve your agni bal I.e. digestive power. 4) I would like to name one herb called suran (i.e. elephant foot yam) here. Also known as jimikand, suran (i.e. elephant foot yam) is said to be an enemy of piles. A medicine prepared from suran called suran vataka, if taken empty stomach as 1gm (or as two capsules each) in morning and evening provides good relief from the condition of piles. 5) Besides this, mattha or whey is known to benefit a lot in case of Piles. But then it depends upon the particular dosha involved. Mattha (i.e. whey), Dahi (i.e. curd), chhachha (i.e. buttermilk) or takra, though all of them seem to be similar, they all carry different properties. If you are suffering from vaitik piles i.e. the piles has developed due to vata dosha then you have to consume ghol. Ghol is prepared by churning curd.