A Comprehensive Review of Arsha (Haemorrhoids): An Integrative Perspective of Ayurvedic and Contemporary Medicine

Arsha is a common anorectal disorder extensively described in Ayurvedic classics and is considered one of the Ashtamahagada (eight difficult-to-manage diseases). It is commonly correlated with haemorrhoids, a condition characterized by symptomatic enlargement and distal displacement of anal vascular cushions. The prevalence of haemorrhoidal disease has increased globally due to sedentary lifestyles, unhealthy dietary practices, chronic constipation, and prolonged straining during defecation. Ayurveda attributes the development of Arsha to Mandagni (impaired digestive fire), formation of Ama, and vitiation of Doshas, particularly Vata Dosha. Classical texts describe detailed etiological factors, clinical manifestations, prognostic features, and therapeutic approaches. Contemporary management includes conservative measures, office-based procedures, and surgical interventions. This review explores the concept of Arsha from both Ayurvedic and modern viewpoints, highlighting similarities in pathogenesis and therapeutic principles while emphasizing the role of integrative management.