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Hemorrhoids – An Ayurvedic Perspective

Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum. In Ayurveda, hemorrhoids are mentioned under the name ‘Arsas’. The name comes from the Sanskrit root word ‘Ari’ which means ‘enemy’.
Hemorrhoids protrude on straining to eliminate stools, coughing, sneezing, sitting for a long time etc. Arsas are considered a Mahaoga in Ayurveda, which means a long standing disease that cannot be cured completely and that can lead to many other associated diseases.
Worldwide the prevalence of hemorrhoids in the general population is estimated to be 44%. After the age of 50 it is estimated that about half of the population suffer from this disease.

Causative factors of Hemorrhoids

Swelling in the rectal veins causes hemorrhoids (Also referred to as Piles.) Several factors may cause this swelling including chronic constipation or diarrhoea, straining during bowel movements, sitting on the toilet for long periods, lack of fibre in your diet, weakening of connective tissue in the rectum and anus that occurs with advanced age, pregnancy (gravid uterus applies pressure on the rectum which causes venous engorgement) etc. Your genes play an important role in the development of piles.
According to Ayurveda, the basic cause of Arsas is ‘Agnimandya’ (reduced digestive power) and Malabandha (constipation). When people suffering from constipation ride on rough roads, sit on an uneven surface or even squat for a long time, there are chances of them developing hemorrhoids. Chronic use of very cold water for cleaning, suppressing impending natural urges (like urine, flatus and faeces) or forcefully doing them, causes the vitiation of Apana Vatha (Vatha which is situated below umbilicus) which in turn causes Arsas.

Internal and External Hemorrhoids

Hemorrhoids are broadly classified to internal and external hemorrhoids. Internal hemorrhoids are situated deep inside the rectum and will not be visible outside. They are painless, but cause rectal bleeding. External hemorrhoids are under the skin around the anus and are therefore visible.
According to the stages of development, hemorrhoids are classified into:-
a) First degree – Protrude inside the rectum, not outside the anal verge
b) Second degree – Come out of the anal verge during defecation, but reduce spontaneously after the act.
c) Third degree – Prolapse out of the anal verge and require manual reduction
d) Fourth degree – Constantly prolapsed out and cannot be reduced.

Symptoms of Hemorrhoids

The most common symptom of internal hemorrhoids is fresh bleeding just after defecation often described as a splash in the pan. Internal hemorrhoids are usually painless.
Anal discomfort, perianal itching, incomplete feeling of bowel voidance, mucous discharge etc. are associated with external hemorrhoids, which appear as a lump protruding outside the anus.
Blood clots may form in external hemorrhoids. A blood clot in a vein is known as a thrombus. Thrombosed external hemorrhoids cause bleeding and a painful hard lump outside the anus which may require surgical management.

Diagnosis of Hemorrhoids

A visual examination of the anus may be enough to diagnose hemorrhoids. Symptoms of hemorrhoids are similar to the symptoms of other anorectal problems such as fissures , abscess, warts, polyps etc. We strongly advise consulting a doctor to rule out other abnormalities.

Management of hemorrhoids

a. Food and lifestyle
Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve symptoms. Eating a high-fibre diet can make the stool softer and easier to pass, reducing the pressure on hemorrhoids caused by straining. Good sources of dietary fibres are vegetables and whole grains.

Use of buttermilk mixed with turmeric, onion and curry leaves is advisable. The use of Vanasoorana (a variety of Elephant foot yam Botanical Name:- Amorphophallus Dubius) is found to be very effective.
Drinking 3-4 litres of water per-day decreases the progressive development of hemorrhoids to later stages. Sitting in a tub of warm water (sitz bath) for 15 minutes 3 – 4 times a day reduces the swelling of hemorrhoids.
Proper exercise and weight management are very important factors in managing hemorrhoids.
b. Ayurvedic medicines
Ayurveda advises different medicines for bleeding and non-bleeding piles. Dusparsakadi Kashayam, Chirivilwadi Kashayam, Abhayarishtam, Duralabharishtam, Danthyarishtam, Pootheekasavam, Vanasooranadi lehyam, Manibhadram Lehyam are some medications which are to be taken as per the advice of physicians. Application of Jathyadi Oil around and a little inside the anus before and after defecation softens the pile mass and thus helps easy voidance.

Aswini Mudra in the management of hemorrhoids

Aswini Mudra is a practice in Yoga. The practice is so called because the anal contraction resembles the movement a horse makes with its sphincter immediately after evacuation of bowels. The term ‘Aswa’ means horse. This Mudra involves the contraction and relaxation of anal sphincter, perineum and the entire pelvic region. Practicing Aswini Mudra helps regain the tone of anal sphincters, relieves constipation and prevents further development of piles.


Hemorrhoids are not dangerous or life threatening. Long term sedentary work leads to stagnation of blood in the rectal veins. Leading an active life, increasing daily dietary intake of fibres to prevent constipation and proper medication will prevent further complications caused due to hemorrhoids.