Arsha (Haemorrhoids): An Ayurvedic Perspective and Contemporary Management—a Narrative Review

Haemorrhoids are among the most frequently encountered anorectal disorders and represent an important cause of lower gastrointestinal bleeding. In addition to producing local symptoms, they may adversely affect a patient's quality of life. In Ayurveda, Acharya Sushruta included Arsha among the Ashtamahagada, highlighting its clinical significance and the difficulty sometimes associated with its management. Classical Ayurvedic texts provide extensive descriptions of the causative factors, classification, clinical manifestations, pathogenesis, prognosis, and therapeutic approaches to Arsha. Despite considerable developments in contemporary medicine, effective prevention and long-term management of haemorrhoids remain challenging because of recurrence and treatment-related complications. The present review discusses Arsha from both Ayurvedic and contemporary perspectives, with particular emphasis on its aetiological factors, classification, clinical features, and available treatment modalities. Ayurvedic approaches including Bhesaja Chikitsa, Kshara Karma, Agni Karma, and Shastra Karma, along with dietary and lifestyle measures, are reviewed in relation to contemporary therapeutic practices. An integrated understanding of the two approaches may contribute to improved strategies for prevention and management of haemorrhoidal disease.