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Hemorrhoids are extremely common problem.  Its prevalence rate is highest among all Anorectal disorders. Hemorrhoids are actually a symptomatic anal cushion.(1) Newer concepts of the Pathophysiology of hemorrhoids have been defined during the past 30 to 40 years, yet it hasn’t updated at under graduate and post graduate education level.(2) Most common Modern classification, used in prospect to treatment is according to its degree of prolapse, i.e. grade I to IV. Many times in regards to practice, this conventional classification doesn’t provide sufficient details about the exact extent of the disease. So there was a need of making classification more precise. All the acharyas of Ayurved has mentioned about Arsh. A brief review of that also will included in this article. In this review article we have tried to show some focus regarding Anal Cushion theory for Pathophysiology of hemorrhoids. Attempt has been also made to review the newer guidelines for Hemorrhoids classification. This article is intended for the use of all the practitioners and academicians and students.

HEMORRHOIDS - PATHOPHYSIOLOGY AND CLASSIFICATION – AN ANALYTICAL APPROACH WITH SPECIAL REFERENCE TO ARSHAS