Arsha vyadhi is defined as Sprouts of muscles, of different shapes appearing in Guda (rectum) which causes obstruction of Guda marga and are very difficult to treat. It is a disease which occur due to physiological deviation precipitating in anatomical changes in Guda. For understanding this disease, thorough knowledge of pathology is must and hence the same is explained here.

Arsha Vyadhi Hetu:
 
Samanya Hetu or Nidan of Arsha vyadhi are as follows

1) Virrudhasan - Consuming pathya and apathya at the same time.
2) Adhyashan - Having meal prior to digestion of previous meal.
3) Stree prasang - Excessive indulgence in matting.
4) Utkatasan - Sitting with ankle below the anal region for long period.
5) Prustha yaan - Excessive travelling on hard seat (like animal back).
6) Vega vidharan - Forceful inhibition of natural urges of body.
7) Mandagni - The main reason being inefficient digestive system.

All the Acharyas have mentioned the same cause for Arsha in more or less different words. Charaka and Vagbhata have described Amagarbha brhansha, Garbha vriddhi, Visham prasuti, and Bastikarma vibrhama and Bastinetra asamyak pranidhan as gynaecological and iatrogenic causes of arsha.

Categorization of Hetu:

These hetu can be categorized on the basis of their pathogenesis as -

1. Causes of Sahaja Arsha:

The main causes of this type of Arsha are –

a) Maternal and Paternal wrong diet and regimen.
b) Sinful acts of the past life.

2. Conditions Localized to the Guda:

a) Improper application of Basti Netra.
b) Sitting and travelling for a long period on an uneven seat as vehicle riding.
c) Application of cold water.
d) Retention of natural urges like flatus, etc.
e) Forceful expulsion of the urges.
f) Improper application of Basti Karma.
g) Frequent injury of anal region.

3. Category according to secondary diseases:

Atisara, pandu, ama, jwara, grahani, gulma, shopha, these diseases play an important role in the manifestation of the disease arsha.

4. According to general causes:

This again divided into as:

i.  Aharaja
ii. Viharaja

a) Aharaja nidana:

From the study of the literature it becomes evident that Acharya Charaka has elaborately described regarding the Ahara as an etiological factor in the production of the disease Arsha, while Acharya Sushruta has mentioned Adhyashana and Viruddhashana.

b) Viharajanya nidana:

Ativyavaya, divaswapa, ativyayama, shayyasukha, avyayama, vishama asana.
These factors cause apan vayu vaigunya leading to Arsha vyadhi.

5. According to Excitatory Causes:

a) Retention of urine
b) Forceful expulsion of urine
c) Miscarriage in women
d) Disturbance of growing uterus
e) Difficult labour