In Ayurveda, anorectal disorders are elucidated through the lens of disturbed doshas, primarily Vata and Pitta, along with the influence of various factors like diet, lifestyle, and psychological aspects. Conditions such as hemorrhoids (Arsha), anal fissures (Parikartika), and fistulas (Bhagandara) fall under the spectrum of anorectal disorders.

According to Ayurvedic principles, an imbalance in Vata dosha, responsible for movement and dryness, can lead to dryness and constriction in the anal area, contributing to conditions like fissures and hemorrhoids. Additionally, aggravated Pitta dosha, associated with heat, may cause inflammation and irritation.

Dietary indiscretions, such as consuming spicy and fried foods, and a sedentary lifestyle are considered contributing factors. Emotional stress and irregular bowel habits further exacerbate these disorders.

If any individual follows irregular dietary and lifestyle regimen (apathya aahar and vihaar) it leads to imbalance in the doshas which further vitiates the digestive fire (agni) and also vitiation in the regulation of apana vayu (responsible for all movements in the intestinal channels) creating a sort of stagnation in the digesion process from going smoothly and this forms the basis ofanorectal diseases as the “mala” is not excreted properly.

In ayurveda science as well, for the treatment and healing of anorectal diseases, many protocols are listed and these also focus on the symptomatic approach because signs in many of such illnesses are very much troublesome interfering with basic day to day activities of patient’s life. And if we have to heal the disease from the root, then root cause is “mandagni” – imbalanced digestive fire. Hence through ayurveda protocols only its possible to achieve complete healing in anorectal diseases because root cause of vitiated digestive fire is addressed.

Ano-rectal diseases, as viewed in Ayurveda, fall under the category of “Guda Roga” or diseases related to the anal region. Ayurveda, the ancient system of holistic healing, provides a profound understanding of these conditions, emphasizing the balance of doshas, dhatus (tissues), and malas (wastes) for overall health. The most common ano-rectal diseases include hemorrhoids (Arsha), fissures (Parikartika), fistulas (Bhagandara), and pilonidal sinus (Nadi Vrana). According to Ayurveda, these conditions are primarily associated with the vitiation of the Vata dosha, often aggravated by factors such as improper diet, sedentary lifestyle, and chronic constipation.

Hemorrhoids, or Arsha, are characterized by the swelling of blood vessels in the anal region. Ayurveda attributes this condition to the imbalance of all three doshas, with Vata being the predominant factor. Dietary factors such as excessive intake of spicy, oily, and dry foods, as well as sedentary habits, are believed to contribute to the aggravation of Vata and the formation of hemorrhoids. Ayurvedic treatments for Arsha include dietary modifications, lifestyle changes, and the use of herbal formulations like Triphala and Arshoghni Vati to alleviate symptoms and promote healing.

Fissures, known as Parikartika in Ayurveda, involve painful tears or cracks in the lining of the anal canal. This condition is associated with an aggravated Vata dosha and is often triggered by constipation, passage of hard stools, and dietary factors that lead to dryness in the anal region. Ayurvedic interventions for Parikartika include dietary fiber supplementation, local application of soothing oils like Ghee, and the use of herbs like Haritaki to relieve constipation and promote healing.

Fistulas, termed as Bhagandara, represent abnormal channels or passages that connect the anal or rectal lumen with the external skin. Ayurveda considers Bhagandara as a complex condition involving the vitiation of all three doshas, with a predominant role of Pitta. Prolonged constipation, improper hygiene, and the formation of abscesses in the anal region are factors contributing to the development of fistulas. Ayurvedic treatments for Bhagandara include the use of herbal formulations like Triphala Guggulu and Kshara Sutra, a medicated thread, to encourage healing and closure of the fistulous tracts.

Pilonidal sinus, or Nadi Vrana, is a condition characterized by the formation of a sinus or cyst in the coccygeal region. Ayurveda attributes this condition to the vitiation of Vata and Kapha doshas, aggravated by factors such as poor hygiene and a sedentary lifestyle. The accumulation of hair follicles and debris in the coccygeal region leads to the formation of sinus tracts. Ayurvedic treatments for Nadi Vrana involve the application of herbal pastes, warm compresses, and the use of Kshara Sutra to promote drainage, healing, and prevent recurrence.

Ayurveda emphasizes a holistic approach to the management of ano-rectal diseases, incorporating dietary and lifestyle modifications, herbal interventions, and Panchakarma therapies. Maintaining regular bowel habits, following a balanced diet, and adopting a physically active lifestyle are essential components of preventive care. Ayurvedic treatments aim not only to alleviate symptoms but also to address the underlying imbalances, promoting long-term health and well-being. Individualized treatment plans, tailored to each person’s unique constitution and doshic imbalances, are crucial for the effective management of ano-rectal diseases in the Ayurvedic tradition.

Causes of anorectal diseases

In Ayurveda, the causes of ano-rectal diseases are understood through the lens of doshic imbalances, lifestyle factors, and the accumulation of toxins. Ano-rectal diseases, including hemorrhoids (Arsha), fissures (Parikartika), fistulas (Bhagandara), and pilonidal sinus (Nadi Vrana), are often attributed to specific factors that disrupt the equilibrium of Vata, Pitta, and Kapha doshas. Here is a detailed exploration of the causes of ano-rectal diseases in Ayurveda:

1. Vata Dosha Imbalance:

   • Description: Vata dosha is responsible for the movement and transportation of bodily substances. When Vata becomes aggravated, it can lead to dryness, constriction, and impaired movement in the anal region.
   • Contribution to Diseases: Conditions like fissures, characterized by painful cracks in the anal lining, are often associated with Vata imbalance. Constipation, a common precursor to ano-rectal diseases, is influenced by impaired Vata.

2. Pitta Dosha Imbalance:

   • Description: Pitta dosha governs heat, digestion, and transformation in the body. When Pitta is aggravated, it can lead to inflammation, heat, and increased metabolic processes.
   • Contribution to Diseases: Hemorrhoids, characterized by swelling and inflammation of blood vessels in the anal region, often result from the aggravation of Pitta. Inflammatory conditions, such as fissures with a burning sensation, are also linked to increased Pitta.

3. Kapha Dosha Imbalance:

   • Description: Kapha dosha is associated with stability, lubrication, and nourishment. When Kapha becomes aggravated, it can lead to excess mucus, heaviness, and stagnation.
   • Contribution to Diseases: Fistulas, characterized by abnormal channels connecting the anal or rectal lumen to the external skin, are often associated with Kapha imbalance. Conditions involving excess moisture, such as pilonidal sinus, may also be linked to Kapha vitiation.

4. Impaired Agni (Digestive Fire):

   • Description: Ayurveda emphasizes the role of strong Agni in maintaining digestive health. Impaired Agni can lead to the formation of toxins (ama) and hinder the proper digestion and elimination of waste.
   • Contribution to Diseases: Constipation, a common factor in ano-rectal diseases, is often related to weak Agni. The accumulation of undigested food and toxins contributes to the aggravation of doshas in the anal region.

5. Unhealthy Diet and Lifestyle:

   • Description: Poor dietary habits, including excessive consumption of spicy, dry, and processed foods, contribute to doshic imbalances. Sedentary lifestyle choices further exacerbate these imbalances.
   • Contribution to Diseases: Unhealthy diets and sedentary habits often lead to constipation, a significant factor in the development of ano-rectal diseases. Excessive intake of spicy foods can aggravate Pitta, contributing to conditions like hemorrhoids.

6. Chronic Constipation (Vibandha):

   • Description: Ayurveda emphasizes the importance of regular and healthy bowel movements. Chronic constipation can lead to the accumulation of toxins and increased pressure on the anal tissues.
   • Contribution to Diseases: Conditions such as hemorrhoids, fissures, and fistulas often have constipation as a common underlying cause. The strain during bowel movements contributes to the development and worsening of these conditions.

7. Poor Hygiene Practices:

   • Description: Inadequate hygiene in the anal region can lead to the accumulation of harmful microorganisms and contribute to the formation of abscesses or infections.
   • Contribution to Diseases: Fistulas and pilonidal sinus, involving the presence of abscesses and infection, can be influenced by poor hygiene practices. Maintaining cleanliness is essential to prevent and manage these conditions.

8. Excessive Straining During Bowel Movements:

   • Description: Straining during bowel movements due to factors like constipation or excessive force can lead to trauma in the anal region.
   • Contribution to Diseases: Conditions such as fissures and hemorrhoids may result from the undue pressure and trauma caused by excessive straining during bowel movements.

9. Genetic Predisposition:

   • Description: Ayurveda acknowledges individual variations in constitution (Prakriti) and genetic factors influencing susceptibility to certain conditions.
   • Contribution to Diseases: A familial tendency toward certain ano-rectal diseases may be observed, indicating a genetic predisposition that influences an individual’s susceptibility.

10. Excessive Alcohol and Spicy Food Consumption:

    • Description: Ayurveda recognizes the impact of dietary choices on doshic balance. Excessive consumption of alcohol and spicy foods can lead to the aggravation of doshas.
    • Contribution to Diseases: Conditions like hemorrhoids may be exacerbated by the consumption of alcohol and spicy foods, which contribute to the heat and inflammation associated with Pitta imbalance.

due to the factors listed above and many others as well which carries the tendency to vitiate the digestive fire, the digestive fire can be compromised leading to the development of anorectal disorders.

Illness specific herbs used in preparing ayurveda medications:

The primary medicinal herbs which are used as ingredients in the ayurveda formulation for the treatment protocol of Anorectal disorders are as follows:

• Til (Seasame indicum)
• Maricha (Piper nigrum)
• Sunthi (Zingiber officinale)
• Ajamoda (Carum roxburghianum)
• Jeeraka (Cumimum cyminum)
• Surana (Amorphophallus campanulatus)
• Dadima (Punica granatum)
• Kapitta (Feronia limonia)
• Amla (Emblica officinalis)
• Palandu (Alium sepa)
• Shigru (Moringa oleifera)
• Sunishannaka (Marselia minuta)
• Karela (Momordica charantia)
• Jivanti (Leptadenia reticulata)
• Patola (Trichosanthes dioica)
• Vastuka (Chenopodium album)
• Punarnava (Boerhavia diffusa)
• Mugdha (Phaseolus radiates)
• Kulatha (Macrotyloma uniflorum)
• Agnimanth (Premna mucronata)
• Guduchi (Tinospora cordifolia)
• Agaru (Aquilaria agallocha)
• Brahmi (Bacopa monnieri)
• shatpushpa (Anethum sowa)
• Vasa (Adhatoda vasaca)
• Tulasi (Ocimum sanctum)
• Chitrak (Plumbago zeylanica)

Ayurveda, the ancient system of holistic healing, relies extensively on medicinal plants to address various health imbalances. The use of herbs in Ayurveda is deeply rooted in the principles of balancing the doshas (Vata, Pitta, and Kapha) and supporting overall well-being. Here is a list of some commonly used medicinal plants in Ayurveda, along with their therapeutic properties:

1. Ashwagandha (Withania somnifera):

   • Properties: Adaptogenic, rejuvenating, anti-inflammatory.
   • Uses: Supports the nervous system, enhances vitality, and helps manage stress.

2. Turmeric (Curcuma longa):

   • Properties: Anti-inflammatory, antioxidant, antimicrobial.
   • Uses: Supports joint health, aids digestion, and is beneficial for skin conditions.

3. Triphala (Amla, Haritaki, Bibhitaki):

   • Properties: Antioxidant, digestive, detoxifying.
   • Uses: Promotes digestive health, detoxification, and overall well-being.

4. Neem (Azadirachta indica):

   • Properties: Antimicrobial, antiviral, blood purifier.
   • Uses: Supports skin health, purifies the blood, and aids in detoxification.

5. Brahmi (Bacopa monnieri):

   • Properties: Nervine tonic, cognitive enhancer, adaptogenic.
   • Uses: Supports cognitive function, reduces stress, and promotes mental clarity.

6. Tulsi (Ocimum sanctum):

   • Properties: Immunomodulatory, antimicrobial, adaptogenic.
   • Uses: Boosts immunity, supports respiratory health, and reduces stress.

7. Amla (Emblica officinalis):

   • Properties: Antioxidant, rejuvenating, immune-boosting.
   • Uses: Supports digestion, enhances immunity, and promotes healthy skin.

8. Ginger (Zingiber officinale):

   • Properties: Digestive, anti-inflammatory, warming.
   • Uses: Aids digestion, reduces inflammation, and supports respiratory health.

9. Haritaki (Terminalia chebula):

   • Properties: Rejuvenating, digestive, mild laxative.
   • Uses: Supports digestive health, detoxification, and overall wellness.

10. Bhringaraja (Eclipta alba):

    • Properties: Liver tonic, hair rejuvenator, anti-inflammatory.
    • Uses: Supports liver health, promotes hair growth, and reduces inflammation.

11. Guduchi (Tinospora cordifolia):

    • Properties: Immunomodulatory, antipyretic, anti-inflammatory.
    • Uses: Boosts immunity, reduces fever, and supports overall health.

12. Shatavari (Asparagus racemosus):

    • Properties: Rejuvenating, adaptogenic, female reproductive tonic.
    • Uses: Supports female reproductive health, reduces stress, and enhances vitality.

13. Trikatu (Black Pepper, Long Pepper, Ginger):

    • Properties: Digestive, thermogenic, anti-inflammatory.
    • Uses: Aids digestion, enhances metabolism, and reduces inflammation.

14. Vidanga (Embelia ribes):

    • Properties: Antiparasitic, digestive, carminative.
    • Uses: Supports digestive health, eliminates parasites, and aids in detoxification.

15. Musta (Cyperus rotundus):

    • Properties: Digestive, anti-inflammatory, diuretic.
    • Uses: Aids digestion, reduces inflammation, and supports urinary health.

16. Arjuna (Terminalia arjuna):

    • Properties: Cardiovascular tonic, anti-inflammatory.
    • Uses: Supports heart health, reduces inflammation, and aids in managing cholesterol levels.

17. Punarnava (Boerhavia diffusa):

    • Properties: Diuretic, anti-inflammatory, rejuvenating.
    • Uses: Supports kidney health, reduces inflammation, and aids in detoxification.

18. Yashtimadhu (Glycyrrhiza glabra):

    • Properties: Demulcent, anti-inflammatory, adaptogenic.
    • Uses: Soothes the mucous membranes, reduces inflammation, and supports adrenal health.

19. Manjishtha (Rubia cordifolia):

    • Properties: Blood purifier, anti-inflammatory, cooling.
    • Uses: Supports skin health, purifies the blood, and aids in detoxification.

20. Vacha (Acorus calamus):

    • Properties: Nervine tonic, digestive, anti-inflammatory.
    • Uses: Supports nervous system health, aids digestion, and reduces inflammation.

These medicinal plants form the foundation of Ayurvedic formulations and treatments, offering a natural and holistic approach to health and wellness. It’s essential to use these herbs under the guidance of a qualified Ayurvedic practitioner to ensure proper dosage and personalized treatment.

Over the counter ayurveda medications prescribed for Anorectal disorders:

• kankayana vati
• bahushula guda
• Abhyarishta
• Avipatikar churna
• Takrarishta
• Triphala guggulu
• Punarnava mandoor
• Ashkuthar rasa
• Bhallatak lehyam
• Chavyadi ghrita
• drakshasava
• Soorana modaka
• Nagardaya choorna
• amalki rasayanam
• Dashamuladya ghrita
• chitrakadi vati
• Kutajghan vati
• Kutajarshta
• Bilwadi lehyam
• sutshekhara rasa

Ayurveda offers a variety of herbal formulations and medications to address various ano-rectal disorders, including hemorrhoids (Arsha), fissures (Parikartika), fistulas (Bhagandara), and pilonidal sinus (Nadi Vrana). These medications are designed to alleviate symptoms, promote healing, and address the underlying doshic imbalances. Here is a list of Ayurvedic medications commonly used in the management of ano-rectal disorders:

1. Arshoghni Vati:

   • Description: Arshoghni Vati is a tablet formulation that combines herbs like Haritaki, Nimba (Neem), and Shuddha Kupilu (Purified Strychnos nux-vomica).
   • Uses: Specifically formulated for hemorrhoids, it helps reduce inflammation, control bleeding, and alleviate pain.

2. Triphala Guggulu:

   • Description: Triphala Guggulu combines Triphala with Guggulu (Commiphora wightii), forming a powerful resinous compound.
   • Uses: Effective in various ano-rectal disorders, it aids in detoxification, promotes healthy digestion, and reduces inflammation.

3. Kankayan Vati:

   • Description: Kankayan Vati is a tablet formulation containing ingredients like Kankayan (Sulfur compound) and Shuddha Parada (Purified Mercury).
   • Uses: Beneficial in managing fistulas and abscesses, it promotes healing and prevents recurrence.

4. Pilex Tablets/Ointment:

   • Description: Pilex is a proprietary formulation containing various herbs like Guggulu, Neem, and Haritaki, available in both tablet and ointment forms.
   • Uses: Effective in hemorrhoids, it reduces inflammation, soothes discomfort, and aids in the healing of anal fissures.

5. Vidangasava:

   • Description: Vidangasava is a liquid formulation containing Vidanga (Embelia ribes) and other herbs.
   • Uses: Useful in managing intestinal worms, which can be a contributing factor in certain ano-rectal disorders.

6. Triphala Churna:

   • Description: Triphala, a blend of Amla, Haritaki, and Bibhitaki, is available in powdered form.
   • Uses: Triphala Churna aids in promoting regular bowel movements, detoxification, and maintaining digestive health.

7. Kasisadi Taila:

   • Description: Kasisadi Taila is an oil-based formulation containing Kasisa (ferrous sulfate) and other herbs.
   • Uses: Topical application for managing hemorrhoids and promoting healing of anal fissures.

8. Jatyadi Ghrita:

   • Description: Jatyadi Ghrita is a medicated ghee containing Jati (Jasminum officinale), Neem, and other herbs.
   • Uses: Topical application for wound healing, especially beneficial in anal fissures.

9. Panchavalkala Kwath:

   • Description: Panchavalkala Kwath is a decoction containing five types of tree barks, including Ficus species.
   • Uses: Topical application aids in reducing inflammation, promoting healing, and managing infections.

10. Nagkesar Churna:

    • Description: Nagkesar (Mesua ferrea) is available in powdered form.
    • Uses: Beneficial in managing bleeding disorders, including bleeding associated with hemorrhoids.

11. Triphala Kwath:

    • Description: Triphala Kwath is a decoction prepared from Triphala.
    • Uses: Useful in promoting digestion, detoxification, and managing constipation, which is often associated with ano-rectal disorders.

12. Bilvadi Leha:

    • Description: Bilvadi Leha is a herbal jam containing Bilva (Aegle marmelos) and other ingredients.
    • Uses: Supports digestion, reduces inflammation, and aids in managing symptoms of ano-rectal disorders.

13. Baladi Yoga:

    • Description: Baladi Yoga is a combination of herbs, including Shuddha Tankana (Purified Borax).
    • Uses: Beneficial in managing anal fistulas, promoting healing, and preventing infection.

14. Kanakasava:

    • Description: Kanakasava is a liquid formulation containing Kanaka (Datura metel) and other herbs.
    • Uses: Beneficial in managing fistulas, promoting healing, and reducing inflammation.

15. Haritaki Churna:

    • Description: Haritaki (Terminalia chebula) is available in powdered form.
    • Uses: Supports digestion, regulates bowel movements, and aids in detoxification.

It’s crucial to note that the usage of these medications should be guided by a qualified Ayurvedic practitioner based on an individual’s specific condition, constitution (Prakriti), and doshic imbalances (Vikriti). Ayurvedic treatment for ano-rectal disorders often involves a holistic approach, including dietary and lifestyle recommendations, along with the appropriate use of herbal formulations to address both symptoms and the root cause of the disorder.