Prodromal symptoms of piles:
- Generalized weakness
- Fullness of the flanks
- Thinning of the body
- Copious eructations
- Weakness of the lower limbs
- Passage of small amount of faeces
Types of Piles:
- Vaataj Piles
- Pittaj piles
- Kaphaj Piles
- Tridoshaj and Sahaj Piles
- Raktaj Piles
- Aetiological factors in Vaataj Piles:
- Excessive intake of astringent, bitter, dry, cold and light food and drinks.
- Decrease in the quantity and frequency of meals.
- Excessive sexual intercourse.
- Strenous physical excercises.
- Prolonged exposure to cold winds or the sun.
Clinical Features of Vaataj Piles:
- There is severe pain in the head, the sides, the scapular regions, the waist, the thighs and the groins etc.
- Constipation and constricting pain in the cardiac region.
- Anorexia, cough and dyspnoea
- Poor digestive power.
- Tinnitus and giddiness
- There is blackish discoloration in the nails, skin, faeces, urine, eyes and face of the patient
- Aetiological Factors in Pittaj Piles:
- Excessive intake of pungent, sour, salty and hot food and drinks.
- Strenous Physical Excercises
- Prolonged exposure to heat or the sun.
- Residing in warm countries and hot climate.
Clinical Features of Pittaj Piles:
- Burning Sensation in pile masses
- Fever, sweating, thirst and fainting.
- Anorexia and confusion.
- Aetiological factors in Kaphaj Piles:
- Excessive intake of sweet, fatty and cold food.
- Excessive intake of heavy meals.
- Lack of physical exercise
- Day sleeping
- Sedentary habits like lying down or sitting
- Exposure to easterly winds
- Residing in cold countries and cold seasons
Clinical features of kaphaj piles:
- Swelling in the inguinal region accompanied with a stretching sensation in the anal, vesicle and umbilical regions.
- The condition may be associated with dyspnoea, cough, nausea, anorexia, chronic rhinitis, dysuria, heaviness in the head and fever with rigor.
- Impaired digestive power.
- The skin and nails of the patient becomes pale.
- Dwandaj Arsh: Piles due to the combination of any of the two doshas are called dwandaj arsh. The aetiological factors and clinical features of two doshas are present.
- Tridoshaj and hereditary (sahaj) Piles: All the aetiological factors and clinical features are present in tridoshaj and hereditary piles.
- Raktaj arsh: The anal piles, due to rakta predominance present features similar to those of pittaj arsh. On account of excessive bleeding, the patient assumes a pale appearance and suffers from various diseases due to heavy blood loss. His complexion becomes dull and there is a loss of energy.
Prognosis of Piles: In the aetiopathogenesis of the anal piles, all the five varieties of vaata, pitta and kapha get vitiated involving all the three anal folds; therefore, piles are troublesome and give rise to numerous diseases, hence very difficult to treat.