Piles (Hemorrhoids)

1. What Are Piles?

Piles (hemorrhoids) are swollen veins or vascular cushions in the rectum or anus. They can be internal (inside the rectum) or external (outside, around the anal opening).

Modern View: Due to increased pressure in rectal veins, these vascular cushions enlarge, causing pain or bleeding.

Ayurvedic View (Arśa): Aggravated Vata and Pitta doshas, combined with weak digestive fire (Mandagni), cause constipation and lead to swelling of the anal veins.

2. Causes of Piles

Modern Causes:

Straining during bowel movements.

Chronic constipation or diarrhea.

Pregnancy and childbirth.

Prolonged sitting or standing.

Obesity and lack of exercise.

Ayurvedic Causes:

Excessive spicy, oily, or dry foods.

Irregular eating habits and low fiber.

Suppression of natural urges (especially urge to pass stools).

Excessive alcohol and dehydration.

3. Pathophysiology

Modern Pathophysiology:

Repeated strain on rectal veins → weakening of vein walls → swelling, bleeding, and prolapse.

Ayurvedic Pathophysiology:

Aggravated Vata dries the colon and causes hard stools.

Pitta leads to inflammation and burning.

Kapha may cause swelling and mucus.

Impaired Agni (digestive fire) and blocked srotas (channels) result in piles (Arśa).

4. Symptoms

Bleeding while passing stools.

Pain, burning, or itching around anus.

Feeling of incomplete evacuation.

Swelling or lumps around anus.

Mucus discharge in stools.

5. Stages of Piles

1. Grade I: Bleeding but no prolapse.

2. Grade II: Prolapse that retracts by itself.

3. Grade III: Prolapse requiring manual pushing.

4. Grade IV: Irreducible prolapse with severe symptoms.

6. Ayurvedic Treatment

Internal Medicines: Triphala churna, Abhayarishta, Kutajarishta, Avipattikar churna.

external Applications: Jatyadi taila, herbal ointments.

Kshara Sutra: A para-surgical treatment that uses medicated threads to shrink and cut off piles.

Basti (Enemas): For balancing Vata and improving bowel health.

Dietary Advice: Include ghee, fiber-rich food, and plenty of warm water.

7. Modern Treatments

Conservative: Sitz bath, pain relief ointments, stool softeners.

Minimally Invasive: Rubber band ligation, infrared coagulation.

Surgical: Hemorrhoidectomy, laser surgery, Doppler-guided artery ligation.

8. Diet Chart for Piles

A healthy, fiber-rich diet prevents constipation and reduces symptoms.

Morning:

warm water with 1 tsp ghee or 1 tsp soaked flaxseed.

Seasonal fruits (papaya, figs, banana).

Breakfast:

Idli, dosa, or vegetable upma with coconut chutney.

Oats porridge or whole-grain toast.

Mid-Morning Snack:

Buttermilk with a pinch of roasted cumin.

Tender coconut water.

Lunch:

Brown rice or millets (foxtail/little millet).

Vegetable sambar, dal, or leafy greens.

A bowl of curd.

Evening:

Herbal tea (coriander or cumin water).

Roasted gram or fruits

Dinner:

Soft chapati with vegetable curry.

Moong dal khichdi with ghee.

Before Bed:

1 tsp Triphala churna with warm water or milk (if prescribed).

Avoid: Deep-fried foods, excess chili, processed snacks, alcohol, red meat, and white bread.

9. Home Remedies

Triphala Powder: 1 tsp with warm water at bedtime improves digestion.

Aloe Vera Gel: Apply externally to reduce burning and swelling.

Sitz Bath: Warm water bath with a pinch of turmeric and neem leaves for 10–15 minutes.

Dry Figs: Soak 2–3 figs overnight and eat in the morning to ease constipation.

Ghee & Milk: 1 tsp ghee in warm milk helps soften stools.

10. Diseases/Complications Caused by Piles

Anemia: Due to chronic bleeding.

Thrombosis: Clot formation in external piles.

Fissures or fistulas: Chronic irritation can lead to other anal diseases.

Infections: From poor hygiene or untreated wounds.

11. Research & Innovations

Kshara Sutra: Proven to reduce recurrence compared to open surgery.

Laser Hemorrhoidoplasty: Painless and fast recovery.

HAL-RAR (Doppler-guided): Targets feeding arteries, reducing recurrence.

Ayurveda & Fiber Research: Studies confirm high-fiber diet and Triphala improve outcomes.

12. FAQs

Q1: Can piles be cured completely?

A: Yes, early piles respond well to Ayurveda and lifestyle changes. Advanced cases may need procedures.

Q2: Is piles dangerous?

A: It’s not life-threatening but untreated bleeding piles can cause anemia.

Q3: Can I prevent piles?

A: Absolutely! Regular water intake, high-fiber diet, and not straining are key.

Q4: Is Kshara Sutra better than surgery?

A: Kshara Sutra is less invasive, cost-effective, and has fewer complications.

Professional Disclaimer

This blog is intended for educational and awareness purposes only. It does not replace a professional medical diagnosis or treatment. Please consult a qualified physician or Ayurvedic doctor for personalized advice.

Author & Ayurvedic Consultant: Dr. Subha R. (BAMS, Ayurveda Physician)

Clinic: Dr. R.V. Pathy Ayurveda Clinic, Periyakulam

 | Email: subharajan10@gmail.com