"I am scared to go to the toilet because of the pain."

Grades of Piles: Ayurvedic Perspective

Grade	Modern Symptoms	Ayurvedic Prognosis (Sadhya/Asadhya)
Grade 1	No prolapse, only bleeding	Easily Curable (Sukha Sadhya) with diet/herbs
Grade 2	Prolapses but goes back in spontaneously	Curable (Sadhya) with strict regimen
Grade 3	Prolapses, needs manual push back	Difficult to Treat (Krichra Sadhya) - needs Kshara Sutra
Grade 4	Chronically prolapsed	Needs Surgery/Kshara Sutra immediately

Home Procedure: The Ayurvedic Sitz Bath (Avagaha Sweda)

This is the most effective home remedy for pain relief and shrinking piles.

Prevention: Never Get Piles Again

Treating piles is easy; preventing recurrence is the challenge.

• Never Suppress Urges: 'Vegadharana' (suppressing natural urges) is a root cause. Go when you need to go.
• Don't Strain: If it doesn't come out in 2 minutes, get up. Straining creates pressure veins can't handle.
• Lubricate: Drink 1 tsp of Ghee in warm water every night to keep stools soft and slippery.

The Squatting Science

Humans were designed to squat. Modern western toilets create a "kink" in the rectum that blocks elimination, forcing you to strain.

Pregnancy & Piles: A Safe Guide

Up to 50% of pregnant women get piles due to the pressure of the uterus on the pelvic veins.
Is it permanent? Usually no. It resolves after delivery.
Safe Remedies:

• Sitz Bath: Completely safe during pregnancy (make sure water is not too hot).
• Coconut Oil: Apply locally for soothing relief.
• Ghee: Take 1 tsp ghee internally to keep bowels soft (safe for baby too).
• Side Sleeping: Sleep on left side to reduce pressure on the vena cava.

Traveling with Piles

Travel (especialy flying) increases Vata and dehydration, triggering constipation and piles flare-ups.
Travel Kit:
1. Triphala tablets (take 2 at night).
2. Soaked raisins (eat 10 every morning).
3. Sitz bath portable tub (collapsible ones available online).
4. Don't eat airplane food (usually dry/processed); carry home-cooked warm food or fruits.

Hack: Use a "Squatty Potty" or a simple footstool to elevate your knees above your hips. This straightens the anorectal angle and allows gravity to do the work.

The Kshara Sutra Therapy: Better Than Surgery?

For chronic piles/fistula, Ayurveda offers Kshara Sutra (Medicated Alkaline Thread).
Procedure: A thread coated in herbal alkalis is tied around the pile mass. It cuts off blood supply and chemically cauterizes the tissue. Use "Anesthetic" paste locally.
Advantages: No hospitalization (day care), <1% recurrence rate (vs 20-30% in modern surgery), no loss of sphincter control.

Yogic Management: Ashwini Mudra

Technique: In a seated pose, rhythmically contract and relax the anal sphincter muscles (like a horse).
Benefits: Improves blood circulation to the rectum, strengthens anal muscles, prevents venous congestion (the cause of hemorrhoids). Do 50 reps morning and evening.

Emotional Roots: Holding On

The large intestine is the organ of "letting go." Constipation and piles are often physical manifestations of an inability to let go—of money, past memories, grief, or control.
Affirmation: "I release what no longer serves me. I flow with life." Repeat this while on the toilet. It consciously relaxes the pelvic floor muscles.

Post-Surgery Care

If you've already had surgery, recurrence is common if you don't change your lifestyle.
Protocol:
1. Continue Sitz Baths for 3 weeks post-op.
2. Take Triphala indefinitely.
3. Apply Jatyadi Oil to the surgical scar to prevent stricture (narrowing of the anal canal).

Scientific Backing

1. Triphala Sitz Bath: Clinical studies show significant reduction in pain, bleeding, and pile mass size with Triphala decoction sitz baths.
2. Kshara Sutra: The Indian Council of Medical Research (ICMR) validated it as a safe, cost-effective alternative to surgery with higher success rates for Fistula-in-Ano.

Diet Chart for Piles

Meal	Recommended	Avoid
Breakfast	Oatmeal, Papaya, Stewed Prunes	Toast, Dry Cereal, Coffee
Lunch	Buttermilk (Takra), Yam (Suran), Rice	Spicy Curry, Fried Food
Dinner	Vegetable Soup, Moong Dal	Meat, Pizza, Alcohol

Conclusion: Softness is Strength

Healing piles requires keeping the body soft and hydrated. Through Ghee, fiber, and stress reduction, you can shrink piles naturally and reclaim your comfort.

Bonus Chapter: Pelvic Floor Yoga (Mula Bandha)

Piles happen when the Apana Vayu (Downwards Wind) is blocked.
Ashwini Mudra (Horse Gesture):
Contract your anal sphincter muscles for 5 seconds. Release. Repeat 20 times.
This simple exercise pumps blood out of the hemorrhoidal veins, reducing swelling instantly. Do it sitting at your desk or while driving. No one will know!

Frequently Asked Questions

Hemorrhoids(Arsha) are essentially varicose veins of the rectum.They swell, bleed, and cause immense suffering. Surgeons cut them, but they often grow back.Why ? Because the ** Constipation ** (the root cause) was never fixed.

Ayurvedic View: Arsha(The Enemy)

Ayurveda calls Piles "Arsha," which means "That which torments like an enemy." It happens when ** Apana Vayu ** (Downward Wind) gets blocked and exerts pressure on the rectal veins.

• Bleeding Piles(Raktarsha): Pitta dominant. Bright red blood, burning sensation.
• Dry Piles(Shushkarsha): Vata dominant. Painful, hard masses, no bleeding but severe constipation.

The Wonder Treatment: Kshara Sutra

For stubborn piles and fistula, Ayurveda offers ** Kshara Sutra ** (Medicated Alkaline Thread). Does it require a hospital stay ? No. It acts by cutting and healing the tract simultaneously.The recurrence rate is less than 1 %, compared to 20 - 30 % in modern surgery.

Home Remedies for Immediate Relief

1. The "Takra"(Buttermilk) Therapy

"He who drinks Takra never gets Arsha." Buttermilk is the specific antidote for piles.It improves digestion and binds the stool without causing hardness.

2. Sitz Bath(Avagaha Sweda)

Sit in a tub of warm water mixed with ** Triphala Kashayam ** or just Epsom salt for 15 minutes.This relaxes the sphincter muscles and instantly reduces pain.

3. Radish Juice(Mooli)

White Radish is excellent for piles.Grate it, squeeze the juice, add a pinch of salt, and drink 1 / 4 cup.It shrinks the pile mass.

Top 3 Foods to Avoid(Constipators)

Specific Herb: Yam(Suran)

Elephant Foot Yam(Suran) is called "Arshoghna"(Destroyer of Piles).Eat it as a vegetable(cooked well with tamarind / lemon to remove itchiness). It acts as a natural medicine for piles.

Final Words

Understanding the 4 Grades of Hemorrhoids

Hemorrhoids (Arsha) are classified by severity:

Grade	Symptoms	Treatment Approach
Grade 1	Internal, bleeding but no prolapse	Diet + Herbs (fully reversible)
Grade 2	Prolapse during straining, retracts on its own	Ayurvedic treatment + lifestyle changes
Grade 3	Prolapse, needs manual push back	Kshara Sutra therapy or surgery
Grade 4	Chronically prolapsed, thrombosed	Surgery usually required

Kshara Sutra: The Ancient Ayurvedic Surgery

For Grade 2-3 piles, Kshara Sutra is a minimally invasive Ayurvedic procedure where a medicated thread is tied around the hemorrhoid, cutting off blood supply. It shrinks and falls off within 7-10 days.
Advantages over modern surgery: No cutting, less pain, faster recovery, lower recurrence rate.

Top Herbs for Hemorrhoids

• Abhayarishta: Liquid formulation that softens stools and heals bleeding piles. Dosage: 20ml twice daily after meals.
• Triphala Guggulu: Reduces inflammation, improves bowel regularity. Dosage: 2 tablets twice daily.
• Kankayan Vati: Stops bleeding, reduces pile mass. Dosage: 2 tablets twice daily.
• Arshoghni Vati: Specific for internal bleeding piles. Dosage: 2 tablets before bed.

The Sitz Bath Protocol

A warm water sitz bath reduces pain and inflammation:

Prevention: The Squat Position Saves Your Veins

Western toilets force you to sit, creating a kink in the rectum that requires straining. This straining increases pressure on rectal veins, causing hemorrhoids.
Solution: Use a footstool to elevate feet while sitting on toilet (mimics squatting). This straightens the anal canal, allowing effortless evacuation.

Diet for Hemorrhoid Prevention

Clinical Case Study: From Bleeding to Remission

When Surgery is Necessary

Ayurveda can treat Grade 1-2 piles conservatively. For Grade 3-4 or complications (thrombosis, severe prolapse), modern surgery or Kshara Sutra is needed.

Scientific Backing

1. Kshara Sutra Efficacy: Studies show 85-90% success rate with minimal recurrence compared to conventional hemorrhoidectomy.
2. Fiber for Hemorrhoids: Clinical trials confirm high-fiber diet reduces bleeding and pain in hemorrhoid patients.

Final Wisdom: Hemorrhoids are preventable and treatable. The root cause is always the same: chronic constipation + straining. Fix your bowel habits with the protocols outlined here, and piles will shrink naturally. Don't wait until surgery is the only option. Three months of dedicated Ayurvedic treatment can save you from the knife.

Piles is not a disease of the rectum; it is a disease of lifestyle.Sitting for hours and eating dry food causes it.Get up, hydrate, and use the wisdom of Ayurveda to shrink the enemy.

Sit comfortably again,

Dr.Arti Singh, BAMS