The doshas which vitiate the skin and mucosa, muscles and fatty tissues, produce fleshy sprouts of various shapes in the ano-rectal region called piles. Piles or hemorrhoids are known as Arsha Aogas in Ayurvedic texts.
Prodromal symptoms of piles:
Fullness of the flanks
Thinning of the body
Weakness of the lower limbs
Passage of small amount of faeces
Types of Piles:
Tridoshaj and Sahaj Piles
A) Aetiological factors in Vaataj Piles:
Excessive intake of astringent, bitter, dry, cold and light food and drinks.
Decrease in the quantity and frequency of meals.
Excessive sexual intercourse.
Strenous physical excercises.
Prolonged exposure to cold winds or the sun.
Clinical Features of Vaataj Piles:
There is severe pain in the head, the sides, the scapular regions, the waist, the thighs and the groins etc.
Constipation and constricting pain in the cardiac region.
Anorexia, cough and dyspnoea
Poor digestive power.
Tinnitus and giddiness
There is blackish discoloration in the nails, skin, faeces, urine, eyes and face of the patient.
B) Aetiological Factors in Pittaj Piles:
Excessive intake of pungent, sour, salty and hot food and drinks.
Strenous Physical Excercises
Prolonged exposure to heat or the sun.
Residing in warm countries and hot climate.
Clinical Features of Pittaj Piles:
Burning Sensation in pile masses
Fever, sweating, thirst and fainting.
Anorexia and confusion.
C) Aetiological factors in Kaphaj Piles:
Excessive intake of sweet, fatty and cold food.
Excessive intake of heavy meals.
Lack of physical exercise
Sedentary habits like lying down or sitting
Exposure to easterly winds
Residing in cold countries and cold seasons
Clinical features of kaphaj piles:
Swelling in the inguinal region accompanied with a stretching sensation in the anal, vesicle and umbilical regions.
The condition may be associated with dyspnoea, cough, nausea, anorexia, chronic rhinitis, dysuria, heaviness in the head and fever with rigor.
Impaired digestive power.
The skin and nails of the patient becomes pale.
D) Dwandaj Arsh: Piles due to the combination of any of the two doshas are called dwandaj arsh. The aetiological factors and clinical features of two doshas are present.
E) Tridoshaj and hereditary (sahaj) Piles: All the aetiological factors and clinical features are present in tridoshaj and hereditary piles.
F) Raktaj arsh: The anal piles, due to rakta predominance present features similar to those of pittaj arsh. On account of excessive bleeding, the patient assumes a pale appearance and suffers from various diseases due to heavy blood loss. His complexion becomes dull and there is a loss of energy.
In the aetiopathogenesis of the anal piles, all the five varieties of vaata, pitta and kapha get vitiated involving all the three anal folds; therefore, piles are troublesome and give rise to numerous diseases, hence very difficult to treat.