Ayurveda Treatment for Piles and Fistula

Best Herbal Ayurveda Treatment



Hemorrhoids or piles are an inflamed mass of tissue that may contain blood vessels and soft tissue. In ayurveda the disease is considered as Maha-vyadhi and is compared to the patient who will get tortured without any mercy just like an enemy. In Ayurveda congenital type of the disease is also mentioned. It is one disease that is explained with utmost importance because this disease itself can cause many other diseases as per the classics.



Main causes include chronic constipation, straining while passing stools, people with chronic diarrhea, those who lift heavy weights, pregnancy (most of the cases it is reversed post-delivery) 

In ayurveda the disease is caused due to improper digestive fire, be it vishama, teekshna or manda agni. Its is maily due to ekarasabhyasam or intake of one or two predominant tastes rather than advised sarvarasabhyasa (means as per ayurveda it is advised to take all tastes sweet, sour, salt, spice, pungent and bitter in equal proportion). This happens when someone taking mainly spicy foods alone will have more chance to have vata/pitha predominant arshas.  According to Ayurveda some interesting other causes are also mentioned like extreme climate conditions – too hot / cold, inappropriate food habits — like overeating, continuous fasting, inactivity/sedentary lifestyle or overexertion like heavy exercises, lifting weights, excess sexual indulgence, excess grief/anger and inappropriate sleeping habits.


  1. Bleeding type
  2. Nonbleeding type
  3. Internal piles
  4. External pile

As per ayurveda classics agni once Arshas or piles blocks the Apana vayu it can cause the pratiloma gati of vayu which inturn causes gastric issues, headaches, lowbackpain, flatulence, heartburn, tinnitus, pain in flanks, and can also cause diseases like pandu, kamala udavartam etc .

Fistula is known as Bhagandara in Ayurveda. Fistula in ano is a tract or tunnel that opens from the rectum or anal canal to the skin. The tract can be partial or complete and usually associated with an abscess. There can also be multiple tracts and branches from single tract. It is classified based on its passage as shown in the picture

Pilonodal sinus is a hole or sinus tunnel with an abscess formed at the top of the anal cleft usually filled with hair/dirt/debris etc.


  • Digital rectal examination
  • Proctoscope
  • Colonoscopy in some cases
  • MR Fistulogram


Treatment options

  • Lifestyle changes
  • Dietary changes
  • Modern techniques
  • Banding
  • Sclerotherapy
  • Infrared coagulation
  • Hemorrhoidectomy
  • Hemorrhoid stapling
  • Fistulotomy
  • Fistulectomy
  • Fibrin glue


  • Grade 1 – mild nonvisible
  • Grade 2 – visible pile mass may get pushed out of anus but gets back inside after passing of stool
  • Grade 3 – pile mass protruding outside venus but can be inserted back to position
  • Grade 4 – Large protruded mass which cannot be inserted back

Grade 3 and 4 usually requires External procedures


  • Hard painful massPain, itching, in the anal region
  • Fresh flood appears in closet after passing stoolsEven after passing
  • motion, the person may feel his bowels are full


  • Bleeding causes anemia
  • Infection
  • Fistula
  • Strangulated hemorrhoid
  • Fecal incontinence

Ayurveda treatment options

Internal medications given to correct the bowel patterns in mild cases. Kshara karma or banding with kshara sutra is required in grade 3  and 4. Some times agnikarma and rakthamokshanam (blood letting) is also required for complete cure.

How ksharasutra helps in anorectal diseases?

  • It helps is cutting, curetting, draining and healing of the fistulous track.
  • It destroys and removes unhealthy tissue and promotes healing of the fistulous track due to its caustic action.
  • Controls infection by the microbicidal action.
  • Separation of debris and cleaning the wound.
  • Facilitate in drainage of pus in fistulous tract and help in healing.
  • Cutting through the tissues and laying the track open

Mechanism of action of Kshara Sutra

  • Chemical cauterization and mechanical strangulation of the blood vessel.
  • Local gangrene of the pile mass tissue.
  • Ischemic necrosis and debridement of unhealthy tissue.
  • Sloughing of the mass within 5-7 days.
  • Healing of the resulting wound takes 10-15 days.

Advantages of ayurveda treatments in anorectal diseases

  • Simple and safe para surgical procedure.
  • Cost-effective and ambulatory.
  • Minimal recurrence rate.
  • Systemic diseases are also undergoing this procedure.
  • No surgical complications like incontinence, stenosis, and stricture



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