Piles (Haemorrhoids) are swollen and inflamed blood vessels (veins) in the rectum and anus. Piles are broadly classified as follows:

External: Piles that are outside the anal verge
Internal: Piles that occur inside the rectum

These include the following:
• Genetic predisposition (weak rectal veins, walls)
• Poor muscle tone in the rectal region
• Constipation
• Obesity
• Sedentary lifestyle
• Chronic cough
• Pregnancy
• Overuse of laxatives or enemas

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Symptoms vary depending upon the site of piles, duration of complaints and general health of the person.

External piles present as a swelling outside the anus with irritation and itching. These can be painful sometimes and usually do not bleed.

Internal piles are usually not painful but these bleed when they are irritated such as during the passage of hard stools. They can be classified into four grades:

• Grade 1 piles are small swellings on the inside lining of the anus. They cannot be seen or felt from outside the anus.
• Grade 2 piles are partly pushed out (prolapse) from the anus when you go to the toilet, but quickly 'retract back' inside again.
• Grade 3 piles hang out (prolapse) from the anus and are felt as one or more small, soft lumps that hang from the anus. However, they can be pushed back inside the anus with a finger.
• Grade 4 piles permanently hang down from within the anus, and cannot be pushed back inside. They can sometimes become quite large.
Some of the other symptoms generally associated with piles are:
• Protrusion of piles outside the anus; this usually occurs after defecation, prolonged standing or unusual physical exertion
• Bleeding from the anus: This can occur before, during or after stools. This will be bright red blood, not usually mixed with the stools, but often seen on the toilet paper
• Soreness, pain, itching in the anal region
• In case of profuse bleeding that is chronic, the patient may be anemic
• Sensation of something coming down, or a bulge or lump at the anus
• If the piles outside the anus develop a blood clot inside, (thrombosed piles) it leads to a particularly tender, hard lump
Ayurvedic treatment:
Ayurvedic medicines are very effective in management of piles and the symptoms associated with it such as pain, bleeding, itching, etc. The point to be emphasized is that the relief of symptoms is obtained with absolute gentleness and without invasion or surgery of any kind. Moreover, the condition has high relapse rate following surgical treatment, since surgery does not target the root causes like genetic tendencies, habitual constipation, etc. Ayurvedic medicines work at the root level and can modify these genetic tendencies thus reducing chances of relapse and recurrence of the condition significantly. Grade 1 and 2 of internal piles can be significantly helped with Ayurvedic Medicine. Grade 3 piles can find some relief of symptoms with Ayurvedic Medicine, but may not be completely cured. Grade 4 piles can get symptomatic relief with medicines.


1. Ayurvedic treatment [Chikitsa] does not mean suppressing the main symptoms and creating some new ones as side effects of the main treatment. It is to remove the root cause and give permanent relief.

2. There are four main classifications of management of disease in Ayurveda: shodan, or cleansing; shaman or palliation; rasayana, or rejuvenation; and satvajaya, or mental hygiene.

3. The treatment mainly comprises of powders, tablets, decoctions, medicated oils etc. prepared from natural herbs, plants and minerals. Because the medicines are from natural sources and not synthetic, they are accepted and assimilated in the body without creating any side effects and on the other hand, there may be some side benefits.