Sushruta’s view of Arsha: An Interdisciplinary Framework for Managing Haemorrhoids as a Digestive Disease

Abstract

Abstract:

Haemorrhoids (Arsha) remain one of the most common anorectal disorders globally, with significant impact on quality of life despite modern advancements in diagnosis and treatment. Contemporary medicine explains haemorrhoids as pathological dilatations of the anal venous plexus, influenced by factors such as constipation, straining, and increased intra-abdominal pressure. In contrast, classical Ayurvedic literature—particularly the Sushruta Saṁhitā—presents Arsha as a systemic disease rooted in impaired Agni (digestive fire) and Doṣha imbalance. This research critically examines Sushruta’s conceptualization of Arsha, correlating it with modern understanding to develop an interdisciplinary framework for comprehensive management. The study analyses Ayurvedic etiological factors (Nidāna), highlighting the roles of Āhārāja, Vihārāja, and secondary diseases, and emphasizing the central involvement of Mandāgni in pathogenesis. Sushruta’s four-fold therapeutic approach—Bheshaja, Kṣhāra, Agni, and Śhastra Karma—is evaluated alongside contemporary practices such as conservative therapy, sclerotherapy, thermal coagulation, and haemorrhoidectomy, revealing remarkable parallels in indications and methodology. Findings suggest that Ayurvedic principles, particularly those targeting digestive health and lifestyle regulation, complement modern interventions and offer a holistic strategy for preventing recurrence and improving outcomes. This integrative analysis reinforces the continued relevance of Sushruta’s teachings and supports the incorporation of Ayurvedic concepts into modern anorectal care.

Keywords: Agni; Arsha; Haemorrhoids; Interdisciplinary Framework ; Sushruta Samhita