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Guda in Samskrit refers to the anus and rectum. These are the end parts of the large intestines involved in the process of defecation. It is the excretory organ. In Ayurveda Guda is included under the bahirmukha [[Strotas (स्रोतसम्)|strotasa]] (external orifices) and also as the chief organ of the purishavaha [[Strotas (स्रोतसम्)|strotasa]] i.e. system dealing with transport of feces. Despite being a part of cleansing system guda has got some special importance in terms of the energy channels. As per yogashastra, Muladhara [[Chakras (चक्राणि)|chakra]] (Root chakra) is situated at this site while as per Ayurveda, it is a vital point ([[Marma (मर्म)|marma]]). Therefore this end part of the gut has immense importance when it comes to health and life.  

Guda (गुदम्) in Samskrit refers to the anus and rectum. These are the end parts of the large intestines involved in the process of defecation. It is the excretory organ. In Ayurveda Guda is included under the bahirmukha [[Strotas (स्रोतसम्)|strotasa]] (बहिर्मुखस्त्रोतसम् । external orifices) and also as the chief organ of the purishavaha [[Strotas (स्रोतसम्)|strotasa]] (पुरीषवह स्त्रोतसम्) i.e. system dealing with transport of feces. Despite being a part of cleansing system guda has got some special importance in terms of the energy channels. As per yogashastra (योगशास्त्रम्), Muladhara [[Chakras (चक्राणि)|chakra]] (मूलाधार चक्रम्)Root chakra) is situated at this site while as per Ayurveda, it is a vital point ([[Marma (मर्म)|मर्म । marma]]). Therefore this end part of the gut has immense importance when it comes to health and life.  

== Introduction ==

== परिचयः ॥ Introduction ==

Guda refers to the anus and rectume. It is known to be the marma (vital point) and specifically a sadhyopranahara marma (a type of marma or vital point which if injured will cause death or serious deformities).<ref>Sushruta Samhita (Sharirasthana Adhyaya 6 Sutra 9)</ref> It is stated as ''bahyastrotas'' (a type of channel) or an external opening channel in the shareera.<ref>Sushruta Samhita (Sharirasthanam Adhyaya 5 Sutra 10)</ref> Guda is also one among the dashapranayatana (ten seats of prana).<ref name=":0">Charaka Samhita (Sharirasthanam Adhyaya 7 Sutra 9,10)</ref>

Guda refers to the anus and rectume. It is known to be the marma (vital point) and specifically a sadhyopranahara marma (a type of marma or vital point which if injured will cause death or serious deformities).<ref>Sushruta Samhita (Sharirasthana Adhyaya 6 Sutra 9)</ref> It is stated as ''bahyastrotas'' (a type of channel) or an external opening channel in the shareera.<ref>Sushruta Samhita (Sharirasthanam Adhyaya 5 Sutra 10)</ref> Guda is also one among the dashapranayatana (ten seats of prana).<ref name=":0">Charaka Samhita (Sharirasthanam Adhyaya 7 Sutra 9,10)</ref>

According to charaka acharya Guda is one the 15 koshtangas, which precisely means a part or an entity of koshta (inner core-part of the body corelated with gut and connected organs).<ref name=":0" />

According to charaka acharya Guda is one the 15 koshtangas, which precisely means a part or an entity of koshta (inner core-part of the body corelated with gut and connected organs).<ref name=":0" />

== Etymology ==

== निरुक्तिः ॥ Etymology ==

The term Guda is made up of and derived from 2 parts as below,

The term Guda is made up of and derived from 2 parts as below,

Therefore, that which excretes mala or stool is termed as guda.

Therefore, that which excretes mala or stool is termed as guda.

Guda is also termed as an organ which is controlled by apana vata (a type of vata dosha responsible for excretion of stools among other functions) and is a channel through which along with the fecal matter, the accumulated bowel gas is also expelled out.  

Guda is also termed as an organ which is controlled by apana vata (अपान वातः a type of vata dosha responsible for excretion of stools among other functions) and is a channel through which along with the fecal matter, the accumulated bowel gas is also expelled out.  

== Anatomy | ''rachana'' ==

== गुदशारीरम् ॥ Anatomy ==

Structure, development and function of Guda have been studied in detail in Ayurveda.  

Structure, development and function of Guda have been studied in detail in Ayurveda.  

In the process of embryogenesis i.e. development of fetus in womb, guda is said to be originated from matruja bhava which means it has its roots in maternal factors.<ref>Sushruta Samhita (Sharirasthana Adhyaya 3 sutra 31)</ref>

In the process of embryogenesis i.e. development of fetus in womb, guda is said to be originated from matruja bhava (मातृज भावः) which means it has its roots in maternal factors.<ref>Sushruta Samhita (Sharirasthana Adhyaya 3 sutra 31)</ref>

Acharya Sushruta explained the location of the guda as in the gudasthivivara which is corelated with the pelvic cavity and near the paurusha (prostate) and bastishira which is the neck of the bladder. <ref>Sushruta Samhita (Nidanasthanam Adhyaya 3 Sutra 19-20)</ref>

Acharya Sushruta explained the location of the guda as in the gudasthivivara which is corelated with the pelvic cavity and near the paurusha (prostate) and bastishira which is the neck of the bladder. <ref>Sushruta Samhita (Nidanasthanam Adhyaya 3 Sutra 19-20)</ref>

The total length of guda is four and half anguli pramana (anguli pramana is the length equal to the transverse length of one’s own middle phalanx of middle finger).<ref name=":1">Sushruta Samhita (Nidanasthanam Adhyaya 2 Sutra 5-8)</ref>

The total length of guda is four and half anguli pramana (अंगुली प्रमाणम् । anguli pramana is the length equal to the transverse length of one’s own middle phalanx of middle finger).<ref name=":1">Sushruta Samhita (Nidanasthanam Adhyaya 2 Sutra 5-8)</ref>

Internally guda has three valis (Folds) which are corelated with folds, which are pravahani, visarjini and samvarini. These are situated one over the other with a distance of one and half angula.

Internally guda has three valis (वली । Folds) which are corelated with folds, which are pravahani (प्रवाहिणी), visarjini (विसर्जिनी) and samvarini(संवरणी). These are situated one over the other with a distance of one and half angula (अंगुली).

Acharya sushruta states the colour of guda resembles gajataalu means the palate of an elephant which is reddish black in colour.<ref name=":1" />

Acharya sushruta states the colour of guda resembles gajataalu (गजतालु) means the palate of an elephant which is reddish black in colour.<ref name=":1" />

Guda is mamsa (muscle) dominant marma.<ref>Sushruta Samhita (Sharirasthanam Adhyaya 9 Sutra 12)</ref>  

Guda is mamsa (मांस । muscle) dominant marma(मर्म).<ref>Sushruta Samhita (Sharirasthanam Adhyaya 9 Sutra 12)</ref>

Since it is one among the bahirmukha srotas, It is the root of purishavaha strotas (precisely a channel concerning with excretory pathway ).<ref>Sushruta Samhita (Sharirasthanam Adhyaya 9 Sutra 12)</ref>  

Since it is one among the bahirmukha srotas, It is the root of purishavaha strotas (precisely a channel concerning with excretory pathway ).<ref>Sushruta Samhita (Sharirasthanam Adhyaya 9 Sutra 12)</ref>  

There are 8 siras (corelated with veins) present in the central area of shroni ( pelvic region), which supply blood to guda and two dhamani (corelated with arteries) supplying blood to the guda in the downward direction.<ref>Sushruta Samhita (Sharirasthana Adhyaya 7 sutra 7), Sushruta Samhita (Sharirasthana Adhyaya 9 sutra 7)</ref>

There are 8 siras (सिराः। corelated with veins) present in the central area of shroni (श्रोणी । pelvic region), which supply blood to guda and two dhamani (धमनी । corelated with arteries) supplying blood to the guda in the downward direction.<ref>Sushruta Samhita (Sharirasthana Adhyaya 7 sutra 7), Sushruta Samhita (Sharirasthana Adhyaya 9 sutra 7)</ref>

== Diseases pertaining to Guda | ''gudagata vikaras'' ==

== गुदगताः विकाराः ॥ Diseases pertaining to Guda ==

There are certain medical conditions that primarily affect guda or develop in guda. Arsha (Hemorrhoids/piles), Bhagandara (Fistula-in-ano), Parikartika (Fissure -in-ano) are the diseases primarily affect and develop in Guda. Other diseases like atisara (diarrhea), pravahika (Dysentery), Grahani (conditions like IBS or Ulcerative colitis etc) also affect guda as a organ to certain level and might lead to some signs and symptoms in this region. The diseases that primarily affect guda are described in brief here,

There are certain medical conditions that primarily affect guda or develop in guda. Arsha (Hemorrhoids/piles), Bhagandara (Fistula-in-ano), Parikartika (Fissure -in-ano) are the diseases primarily affect and develop in Guda. Other diseases like atisara (diarrhea), pravahika (Dysentery), Grahani (conditions like IBS or Ulcerative colitis etc) also affect guda as a organ to certain level and might lead to some signs and symptoms in this region. The diseases that primarily affect guda are described in brief here,

=== Arsha ===

=== अर्श ॥ Arsha ===

Arsha is corelated with haemorrhoids. When these are found in guda region they are known as gudarsha (hemorrhoids in ano) or piles described in western medicine.  When in guda, Arshas are located in the guda valis (the three folds present in the guda region).<ref>Charaka Samhita (Chikitsasthanam Adhyaya 14 Sutra 6)</ref>  

Arsha is corelated with haemorrhoids. When these are found in guda region they are known as gudarsha (hemorrhoids in ano) or piles described in western medicine.  When in guda, Arshas are located in the guda valis (the three folds present in the guda region).<ref>Charaka Samhita (Chikitsasthanam Adhyaya 14 Sutra 6)</ref>  

==== Location ====

==== स्थानम् ॥ Location ====

Alike Guda region, arshas can also be found in mukha (oral cavity), talu (palate), nasa (nose), karna (ears) etc

Alike Guda region, arshas can also be found in mukha (oral cavity), talu (palate), nasa (nose), karna (ears) etc

==== Types ====

==== भेदाः ॥ Types ====

Fundamentally arshas are of two types,<ref>Charaka Samhita (Chikitsasthanam Adhyaya 14 Sutra 5-25)</ref>  

Fundamentally arshas are of two types,<ref>Charaka Samhita (Chikitsasthanam Adhyaya 14 Sutra 5-25)</ref>  

1.     Sahaja (congenital)

1.     Sahaja (सहजानि । congenital)

2.     Kalaja (acquired)

2.     Kalaja (कालजानि । acquired)

Arshas are classified again, on the basis of dominance of a single dosha.

Arshas are classified again, on the basis of dominance of a single dosha.

4.     Tridoshaja arshas(due to aggravation of all the three doshas at the same time)

4.     Tridoshaja arshas(due to aggravation of all the three doshas at the same time)

==== Signs and symptoms ====

==== रुपाणि ॥ Signs and symptoms ====

Clinical features of Gudarshas are described in brief below,

Clinical features of Gudarshas are described in brief below,

* Kalaja arshas – Due to gudarshas, [[Agni in Ayurveda (आयुर्वेदे अग्निः)|agni]] is affected it becomes weak and that ultimately affects overall metabolism. Disturbed metabolism leads to emaciation, weakness, loss of energy, discharge through anus, difficulty in defecation and many other symptoms like coughing, breathlessness, vomiting, swelling, sneezing etc. Therefore gudarshas located in anal region have the potential to cause signs and symptoms across all body systems and have wide rage of signs and symptoms.  

* Kalaja arshas – Due to gudarshas, [[Agni in Ayurveda (आयुर्वेदे अग्निः)|agni]] is affected it becomes weak and that ultimately affects overall metabolism. Disturbed metabolism leads to emaciation, weakness, loss of energy, discharge through anus, difficulty in defecation and many other symptoms like coughing, breathlessness, vomiting, swelling, sneezing etc. Therefore gudarshas located in anal region have the potential to cause signs and symptoms across all body systems and have wide rage of signs and symptoms.  

==== General management ====

==== चिकित्सा ॥ General management ====

Gudarshas treatment has been discussed in detail in Ayurveda.<ref>Charaka Samhita (Chikitsasthanam Adhyaya 14 Sutra 33-143)</ref> The different types of treatments applied here are discussed in brief here,

Gudarshas treatment has been discussed in detail in Ayurveda.<ref>Charaka Samhita (Chikitsasthanam Adhyaya 14 Sutra 33-143)</ref> The different types of treatments applied here are discussed in brief here,

* Kshar karma (application of alkali) and agni karma (thermal cauterization)

* Kshar karma (application of alkali) and agni karma (thermal cauterization)

=== Bhagandara ===

=== भगंदरः ॥ Bhagandara ===

Bhagandara in guda region is a condition which can be corelated with Fistula-in-ano.  

Bhagandara in guda region is a condition which can be corelated with Fistula-in-ano.  

Bhagandara is a painful draining track or canal with one opening present in and around guda, vasti(urinary bladder), bhaga(genital region).<ref name=":2">Sushruta Samhita (Nidanasthana Adhyaya 4 Sutra 1-9)</ref>

Bhagandara is a painful draining track or canal with one opening present in and around guda, vasti(urinary bladder), bhaga(genital region).<ref name=":2">Sushruta Samhita (Nidanasthana Adhyaya 4 Sutra 1-9)</ref>

==== Types ====

==== भेदाः ॥ Types ====

There are five types of bhagandara<ref name=":2" />

There are five types of bhagandara<ref name=":2" />

# Agantuja or unmargini bhagandara

# Agantuja or unmargini bhagandara

==== Premonitory symptom ====

==== पूर्वरूपाणि ॥ Premonitory symptom ====

Certain signs and symptoms that manifest before actual Bhagandara is developed are known as Purvarupas or premonitory symptoms of Bhaganadara and they are as below,<blockquote>‘तेषां पूर्वरूपं गुदकण्डूदाहशोफागुदायामश्चेति सर्वेषां सामान्यम्’ (sush.nida.4.4 gaydas vyakha)<ref name=":2" /></blockquote>Meaning: Itching, burning sensation, edema in the guda or anal region are the general premonitory symptoms of bhagandara.

Certain signs and symptoms that manifest before actual Bhagandara is developed are known as Purvarupas or premonitory symptoms of Bhaganadara and they are as below,<blockquote>‘तेषां पूर्वरूपं गुदकण्डूदाहशोफागुदायामश्चेति सर्वेषां सामान्यम्’ (sush.nida.4.4 gaydas vyakha)<ref name=":2" /></blockquote>Meaning: Itching, burning sensation, edema in the guda or anal region are the general premonitory symptoms of bhagandara.

==== Symptoms ====

==== रूपाणि ॥ Symptoms ====

Symptoms or clinical features of Bhagandara according to dosha dominant types are listed in short below,

Symptoms or clinical features of Bhagandara according to dosha dominant types are listed in short below,

# Agantuja or unmargini bhagandara – external injury leads to agantuja bhagandara, which if neglected can cause pain and build of microrganisms.

# Agantuja or unmargini bhagandara – external injury leads to agantuja bhagandara, which if neglected can cause pain and build of microrganisms.

==== General management ====

==== चिकित्सा ॥ General management ====

[[Raktamokshana (रक्तमोक्षणम्)|Raktamokshana]](bloodletting), agnikarma(thermal cautery),kshara karma(alkali application) etc are certain general management protocols in the successful treatment of bhagandara.<ref>Sushruta Samhita (Chikitsasthana Adhyaya 8)</ref>  

[[Raktamokshana (रक्तमोक्षणम्)|Raktamokshana]](bloodletting), agnikarma(thermal cautery),kshara karma(alkali application) etc are certain general management protocols in the successful treatment of bhagandara.<ref>Sushruta Samhita (Chikitsasthana Adhyaya 8)</ref>  

=== Parikartika ===

=== परिकर्तिका ॥ Parikartika ===

Parikartana means cutting. Thus parikartika refers to the cuts in the guda or anal region that are popularly known as anal fissures. Also, when there is cutting and piercing type of pain in the guda region region it is known as parikartika. It is a vata dosha dominant disorder of the guda, which affects dhatus like tvak (skin), [[Mansa Dhatu (मांस धातु)|mamsa]](muscle) and [[Rakta Dhatu (रक्त धातु)|rakta]](blood). (sush.nida.1.25-26) ?

Parikartana means cutting. Thus parikartika refers to the cuts in the guda or anal region that are popularly known as anal fissures. Also, when there is cutting and piercing type of pain in the guda region region it is known as parikartika. It is a vata dosha dominant disorder of the guda, which affects dhatus like tvak (skin), [[Mansa Dhatu (मांस धातु)|mamsa]](muscle) and [[Rakta Dhatu (रक्त धातु)|rakta]](blood). (sush.nida.1.25-26) ?

==== Symptoms ====

==== रुपाणि ॥ Symptoms ====

Common signs and symptoms of parikartika are,<ref>Sushruta Samhita (Uttaratantra Adhyaya 40 Sutra 103)</ref> <ref>Charaka Samhita (Siddhisthanam Adhyaya 6 Sutra 61)</ref>

Common signs and symptoms of parikartika are,<ref>Sushruta Samhita (Uttaratantra Adhyaya 40 Sutra 103)</ref> <ref>Charaka Samhita (Siddhisthanam Adhyaya 6 Sutra 61)</ref>

* Blood filled mucous discharge

* Blood filled mucous discharge

* Discomfort in anal region

* Discomfort in anal region

Parikartika is found as a symptom in various disorders and as an ill effect of certain inappropriately done [[Panchakarmas (पञ्चकर्माणि)|panchakarma]] methods.

Parikartika is found as a symptom in various disorders and as an ill effect of certain inappropriately done [[Panchakarmas (पञ्चकर्माणि)|panchakarma]] methods.

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