Arshas (Hemorrhoids), Ayurvedic Types, Causes And Symptoms

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa B.A.M.S
Definition of Arshas
The disease in which the mamsa ankuras (fleshy masses) which occur at the opening of guda marga (anus), obstructs the pathway and troubles the person like an enemy is called Arshas. 

Pathogenesis of Arshas
The vitiated doshas (vata, pitta and kapha) contaminate the twak (skin), mamsa (muscle) and meda (fat) tissues and cause mamsa ankuras (fleshy masses) at the anal opening. These masses are called Arshas.

Types of Arshas
Arshas is of 6 types, they are:

  • Vataja Arshas (caused by vitiated vata)
  • Pittaja Arshas (caused by vitiated pitta)
  • Kaphaja Arshas (caused by vitiated kapha)
  • Sannipataja Arshas (caused by simultaneous vitiation of all the 3 doshas)
  • Raktaja Arshas (caused by vitiated blood, bleeding piles)
  • Sahaja Arshas (congenital haemorrhoids or hereditary)
  • Read related: Buttermilk Home Remedy For Hemorrhoids [Video]

Vataja Arshas
Causes of Vataja Arshas

  • Kashaya – excessive consumption of astringent foods
  • Katu – excessive consumption of pungent foods
  • Tikta – excessive consumption of bitter foods
  • Ruksha – excessive consumption of dry foods
  • Sheeta – excessive consumption of cold foods
  • Laghu – excessive consumption of light foods
  • Pramita ahara – taking food in deficit quantities (against the quantity needed) or eating after the time for food has elapsed
  • Alpa ahara – very less food
  • Teekshna Madhya – excessive consumption of strong alcohol
  • Maithuna – – excessive indulgence in sex
  • Langhana – fasting in excess
  • Sheeta desha – cold places
  • Sheeta kala – cold season
  • Vyaayama – excessive indulgence in physical exercises
  • Shoka – grief
  • Vata – excessive exposure to breeze
  • Atapa – excessive exposure to heat of the Sun
  • Read related: Easy Ayurvedic Home Remedy For Bleeding Hemorrhoids

Symptoms of Vataja Arshas –
Nature of arshas or pile mass:

  • Shushka – dry
  • Chimachimanvita – tingling sensation
  • Mlaana – pale
  • Shyava – blackish blue
  • Aruna – yellowish red
  • Stabdha – hard
  • Parusha / khara – rough on touch
  • Vakra – haphazard, crooked
  • Mithovi sadrusha – split and broken
  • Vishputita – cracks
  • Resembling the fruits of bimbi (ivy gourd), karkandu (jujube), kharjura (dates), karpasa phala (fruit of cotton, cotton seeds), siddartha (mustard) etc

Associated symptoms –

  • Shira shula – headache
  • Parshwa shula – pain in flanks
  • Amsa shula – pain in scapular region
  • Kati shula – low back pain
  • Uru shula – thigh pain
  • Vankshana shula – pain in groin
  • Kshavathu – sneeze
  • Udgaara – belchings,
  • Hrid graham – tightness in the chest
  • Arochaka – anorexia
  • Kasa – cough
  • Shwasa – shortness of breath
  • Agni vaishamya – metabolic errors
  • Karna nada – tinnitus
  • Bhrama – giddiness
  • Grathita, stokam, sashabdam pravahikam – loose stools or dysentery with pellet like stools, coming in less quantity along with sound, blood, froath, mucus and with delayed evacuation
  • Gulma – abdominal tumour
  • Pleeha – spleen enlargement etc

Pittaja Arshas
Causes of Pittaja Arshas:

  • Katu ahara – excessive consumption of pungent foods
  • Amla ahara – excessive consumption of sour foods
  • Lavana ahara – excessive consumption of salt or salty foods
  • Ushna ahara – excessive consumption of hot foods
  • Vyaayama – excessive exercise
  • Agni – excessive exposure to fire
  • Atapa – excessive exposure to heat of Sun
  • Ushna desha – living in hot areas / places
  • Krodha – anger
  • Madhyam – excessive consumption of alcohol
  • Asooyanam – jealousy
  • Vidahia ahara, pana, bheshaja – excessive consumption of corrosive foods, drinks and medicines
  • Teekshna ahara, pana, bheshaja – excessive consumption of irritating foods, drinks and medicines
  • Ushna ahara, pana, bheshaja – excessive consumption of hot foods, drinks and medicines

Symptoms of Pittaja Arshas –
Appearance of arsha (pile mass):

  • Neela mukha – blue tipped
  • Rakta – red coloured
  • Peeta – yellow coloured
  • Asita – black coloured
  • Mrudu – soft on touch
  • Snigdha – unctuous
  • Tanu, visra, asru visraavini – dilute, foul smelling discharges
  • Shuka jihwa – shape resembling the tongue of parrot
  • Yakrut khanda – shape resembling the piece of Liver
  • Jalauka vaktra – resembling the mouth of leech

Associated symptoms:

  • Daha – burning sensation
  • Paka – suppuration
  • Jwara – fever
  • Sweda – excessive sweating
  • Trushna – thirst
  • Murcha – fainting
  • Arati – discomfort,
  • Moha – loss of consciousness, confusion
  • Ushna, drava neela ushna peeta rakta varcha – stools which are hot, watery, blue, yellow, or red coloured
  • Harit peeta haaridra twak nakhadayaha – green, yellow or turmeric discolouration of skin, nails, eyes etc.

Kaphaja Arshas
Causes of Kaphaja Arshas:

  • Madhura ahara – excessive consumption of sweet foods
  • Snigdha ahara – excessive consumption of unctuous or oily foods
  • Sheeta ahara – excessive consumption of cold foods
  • Lavana ahara – excessive consumption of salt or salty foods
  • Amla ahara – excessive consumption of sour foods
  • Guru ahara – excessive consumption of heavy to digest foods
  • Avyayama – lack of exercise, sedentary life habits
  • Diva swapna – sleeping in day time
  • Shayya sukha – comfortable bedding
  • Asana sukha – comfortable seating
  • Prag vata – excessive exposure to wind blowing from east direction
  • Sheeta desha – living in cold areas / places
  • Sheeta kala – excessive exposure to cold climate
  • Achintanam – lack of worries

Symptoms of Kaphaja Arshas:
Appearance of Arshas (pile mass):

  • Mahamula – deep rooted mass
  • Ghana – thick, heavy
  • Manda ruja – mild pain
  • Sitaa – white in colour
  • Utsanna – swollen
  • Snigdha – unctuous
  • Stabdha – hard
  • Vrutta – rounded
  • Guru – heavy
  • Sthira – stable
  • Pichchila – slimy
  • Stimita – feeling as if covered with wet cloth
  • Shlakshana – smooth
  • Kandu – itching
  • Sparshana priya – feels comfort on touching
  • Kareera samana – shape of Capparis deciduas
  • Panasasthi samana – shape of seed of jack fruit
  • Gostana samana – shape of udder of cow

Associated symptoms:

  • Vankshna anaha – heaviness in groin (hernia)
  • Payu avakarshana – pulling pain in anus
  • Vasti avakarshana – pulling pain in urinary bladder
  • Nabhi avakarshana – pulling pain in navel region
  • Kasa – cough
  • Shwasa – dyspnoea
  • Hrullasa – excessive salivation, nausea
  • Praseka – excessive watering in the mouth
  • Aruchi – tastelessness
  • Peenasa – cold, running or stuffy nose
  • Meha – urinary disorders
  • Shiro jadya – heaviness of head
  • Shishira jwara – fever with cold and chills
  • Klaibya – impotence
  • Agnimandya – sluggish digestion
  • Chardi – vomiting
  • Vasaabha sa kapha pureesha – stools appearing like muscle fat and mixed with phlegm
  • Pravahika – dysentery
  • Na sravanti – no discharges
  • Na bhidyanti – will not open up easily
  • Pandu snigdha twak adi – pallor of skin, nails, eye etc

Tridoshaja Arshas
Causes – all the causes which aggravate the doshas individually taken together
Symptoms – mixture of symptoms mentioned in arshas caused by vitiation of individual doshas

Treatment – Treatments said for arshas caused by vitiation of individual doshas shall be clubbed together skilfully to combat Tridoshaja Arshas. Tretment depends on the predominance of dosha in the combined vitiation.

Raktaja Arshas
Causes – vitiation of rakta or blood by morbid doshas or by itself
Charaka has included Raktaja Arshas in Pittaja Arshas and has not counted it separately.

Symptoms of Raktaja Arshas:
Appearance of Arshas (pile mass) –
Similar to the appearance of pile mass in Pittaja Arshas
Vata praroha sannibha – Similar to the colour and structure of shoots of Vata tree (Banyan tree)
Gunja sannibha – colour and appearance as that of Gunja seed or Abrus precatorius
Vidruma / Pravala sannibha – colour and appearance as that of Pravala (coral)

Associated symptoms:

  • Dushtam ushnam raktam – bleeding of contaminated and hot (to touch) blood, due to the pile masses continuously subjected to errosion by hard stools
  • Rakta ati pravrutti – excess bleeding
  • Bhekabhaha – The person appears like a frog in rainy season due to excessive bleeding
  • Peedaa – pain and discomfort
  • Shonita sankshaya sambhava dukha vyadhi – painful and annoying diseases caused due to excessive blood loss
  • Heena varna – loss of body colour
  • Heena bala – loss of strength and vigour
  • Heena utsaha – loss of enthusiasm
  • Hata oja – lack lustre
  • Kalusha indriyaha – disturbed sensorium

Sahaja Arshas
Causes – This type of arshas or haemorrhoids is hereditary, acquired from one of the parents. These people will have a tendency to get piles right from their birth.

Symptoms of Sahaja Arshas:
The symptoms indicate not only that of the manifested piles but also those signs and symptoms seen from childhood or early adolescence which indicate the inherited tendency to develop piles.

  • Krisha, Vivarna, Kshama, Deena – thin (emaciated), discoloured, weak, helpless right from the birth
  • Prachura vibaddhaha – severe constipation with obstruction of stools, flatus and urine
  • Sharkara, ashmari – develops gravel and stones in urinary tract
  • Aniyata malabaddhata – unpredictable bowel changes
  • Sama mala – unformed stools occasionally which comes in different colours, white, pale, green, yellow, red, reddish yellow, loose, sticky, smell of dead body, foul smell
  • Shula – cutting pain in the navel region, butts, groin and urinary bladder
  • Shotha – swelling in hands, legs, face and around eye sockets
  • Tikta amla udgaara – sour and bitter belching
  • Durbala – weak
  • Durbala agni – weak digestion
  • Alpa shukra – less semen
  • Krodhana – anger
  • Suffers from – pravahika (dysentery), romancha (horripulation), prameha (urinary disorders), vishtambha (constant constipation), antra kujana (constant presence of gurgling sounds in the abdomen), udavarta (upward movement of vayu), hrudaya upalepa (feeling of coating over the heart), indriya upalepa (feeling of coating over the sense organs), kasa (cough), shwasa (dyspnoea), tamaka shwasa (asthma), trushna (thirst), hrullasa (belching, nausea), vamana (vomiting), arochaka (tastlessness), peenasa (cold),kshawathu (excessive sneezing), timira (darkness before eyes), shira shula (headache), swara kshaya (loss of voice), karna roga (ear diseases), asthi shula (bone pains), sandhi shula (joint pains), jwara (fever), angamarda (body pains), parshwa shula (pain in flanks), udara shula (colic), prushta shula (back pain), trika shula (sacral pain), alasya (lazyness),
  • Dukha upachaarasheela – will develop health upsets and diseases which are very difficult to manage
    Click to Consult Dr Raghuram YS MD (Ayu)

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