Decoding Arsha Through Ayurvedic Concepts: Clinical Interpretation and Treatment Modalities

Abstract

Arsha, described extensively in Ayurvedic classics, is a common anorectal disorder broadly comparable to haemorrhoids in contemporary medicine and is considered a Mahagada owing to its chronic, recurrent nature. This review decodes the concept of Arsha through classical Ayurvedic principles, correlating its etiology, pathogenesis, and clinical presentation with modern understanding. According to Ayurveda, Arsha originates from derangement of Tridosha, predominantly Vata, along with impairment of Agni and vitiation of Rakta and Mamsa dhatu, leading to fleshy growths in the Guda pradesha (anal region). Clinical classification is based on Dosha predominance, bleeding type (Raktaja Arsha), and non-bleeding type, with symptoms such as pain, bleeding, prolapse, and itching. Diagnosis integrates Dashavidha Pariksha with local examination. Management is comprehensive, combining curative and preventive care through Bheshaja Chikitsa (internal medications), Kshara Karma (chemical cauterization), Agni Karma (thermal cauterization), and Shastra Karma (surgical intervention), selected according to disease stage. Dietary and lifestyle modification (Pathya-Apathya) plays a key role in preventing recurrence. This review highlights the relevance of Ayurvedic principles in understanding Arsha and supports an individualized, minimally invasive, holistic approach that offers effective alternatives and adjuncts to modern therapeutic strategies.