A PATHOPHYSIOLOGICAL CORRELATION BETWEEN ARSHA SAMPRAPTI AND PORTAL CIRCULATION: AN INTEGRATIVE REVIEW

Arsha, described in Ayurveda as a Tridoshaja Vyadhi, shares clinical and pathological similarity with hemorrhoids in modern medicine. Classical texts attribute its origin to Agnimandya (impaired digestive fire), Apana Vayu vitiation, Srotodushti (channel pathology), and involvement of Dushyas such as Rakta, Mamsa, and Meda. Modern literature describes hemorrhoids as pathological enlargements of the normal anal cushions arising due to venous congestion, mucosal sliding, and portal hemodynamic alterations. The aim of this integrative review is to systematically correlate the classical Ayurvedic Samprapti of Arsha with the physiology of the portal venous system and the known mechanisms of hemorrhoidal disease. Methods include a comprehensive narrative review of Ayurvedic classical texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hrudaya), modern physiology, surgical literature, and indexed PubMed sources. Correlation analysis revealed significant parallels between Ama, Srotorodha, and Vata-Pitta Dushti with modern endothelial inflammation, venous congestion, and mucosal prolapse. The internal hemorrhoidal plexus drains into the portal system via the superior rectal vein, establishing a direct hemodynamic link that mirrors Apana Vayu–Srotas dysfunction in Arsha Samprapti. Conclusion: Arsha Samprapti aligns closely with modern portal venous physiology and provides a holistic, integrative pathophysiological framework supporting contemporary clinical understanding and management of hemorrhoidal disease.