Know more
about Hemorrhoids / Piles.
Hemorrhoids
or Piles as is generally known is a very common disease. About 70% of the
population have at some time in their lives suffered from piles or have had
experienced some symptoms related to it.
We will
first try to understand what Piles / Hemorrhoids are. Piles or Hemorrhoids are
actually, distended veins in the anal canal. Veins tend to stretch under
pressure. When veins in the lower part of the rectum or anus stretch, swell or
descend in to the anal canal, i.e. when they prolapse or protrude in to the
canal they are considered as Piles/Hemorrhoids.
The set of
veins inside the rectum when distended result in internal hemorrhoids and the
set of veins under the skin around the anus when distended result in External
Piles.
Some other
factors also contribute to the prolepses of the veins. They are long standing
constipation, leading to straining while passing stool, pregnancy, weakening of
the muscles supporting the veins due to ageing etc. One may also have a
hereditary tendency to develop piles.
If you
have any of the following symptoms you are probably suffering from Hemorrhoids-
Piles.
1. Bleeding
from the anus :
after
defecation (passing stool)
during
defecation
during and
after defecation
usually
without pain but in some conditions with pain.
2.
Constipation
3. Itching
4.
Protrusion of a mass from the anal canal (can be felt digitally).
Causes
As described earlier, hemorrhoids develop because of
increasing pressure in the veins of the lower part of the rectum and anus. This
increasing pressure can be due to various reasons like -
Pregnancy
Straining during chilled birth
Obesity
Lifting heavy weights over a long period
Sitting or standing for a long time
Chronic constipation accompanied with straining to evacuate
the bowels
Repeated diarrhea and dysentery
A habit of suppressing the urge to defecate
There may also be an inherited tendency to develop
Hemorrhoids / Piles.
Hemmorrhoids ( Piles )
Free piles diagnostic camp on world piles day (20th November
2013).
Know more about Hemorrhoids / Piles.
Hemorrhoids or Piles as is generally known is a very common
disease. About 70% of the population have at some time in their lives suffered
from piles or have had experienced some symptoms related to it.
We will first try to understand what Piles / Hemorrhoids
are. Piles or Hemorrhoids are actually, distended veins in the anal canal.
Veins tend to stretch under pressure. When veins in the lower part of the
rectum or anus stretch, swell or descend in to the anal canal, i.e. when they
prolapse or protrude in to the canal they are considered as Piles/Hemorrhoids.
The set of veins inside the rectum when distended result in
internal hemorrhoids and the set of veins under the skin around the anus when
distended result in External Piles.
Some other factors also contribute to the prolepses of the
veins. They are long standing constipation, leading to straining while passing
stool, pregnancy, weakening of the muscles supporting the veins due to ageing
etc. One may also have a hereditary tendency to develop piles.
If you have any of the following symptoms you are probably
suffering from Hemorrhoids- Piles.
1. Bleeding from the anus :
after defecation (passing stool)
during defecation
during and after defecation
usually without pain but in some conditions with pain.
2. Constipation
3. Itching
4. Protrusion of a mass from the anal canal (can be felt
digitally).
Causes
As described earlier, hemorrhoids develop because of
increasing pressure in the veins of the lower part of the rectum and anus. This
increasing pressure can be due to various reasons like -
Pregnancy
Straining during chilled birth
Obesity
Lifting heavy weights over a long period
Sitting or standing for a long time
Chronic constipation accompanied with straining to evacuate
the bowels
Repeated diarrhea and dysentery
A habit of suppressing the urge to defecate
There may also be an inherited tendency to develop
Hemorrhoids / Piles.
Types of Hemorrhoids / Piles
Hemorrhoids / Piles can be classified in two ways
I. As per their site of development
1. Internal hemorrhoids / piles
2. External hemorrhoids / piles
II. As per the stages of the diseases
1. First degree hemorrhoids
2. Second degree hemorrhoids
3. Third degree hemorrhoids
4. Fourth degree hemorrhoids
First degree Hemorrhoids: Is the condition when the
mass (The structure with the veins) projects slightly into the anal canal, but
only when the veins are congested i.e. during defecation / passing stool.
In this stage the patient will have no mass protruding from
the anus.
Second degree Hemorrhoids: The mass protrudes out of
the anus, but only during defecation. The hemorrhoidal mass returns into the
anal canal spontaneously after passing stool as soon as the accompanied
straining stops.
Third degree hemorrhoids: The hemorrhoidal mass
protrudes from the anus during defecation or on exerting force and remains
protruded until forced back into the anus digitally ( with fingers) .
Fourth degree hemorrhoids: The hemorrhoidal mass
(Piles) remains protruded (out of the anus) at all times and can not be forced
into the anal canal with the help of the fingers.
Treatments
1. Oral medicines, like laxatives, stool softeners
etc and local anti inflammatory creams and warm water sits bath can help to
reduce the symptoms. However second, third and fourth degree piles can not be
cured with just oral treatment.
2. Barran band ligation: One or two special kind of
rubber bands are tied around the base (slipped to the base with the help of a
special instrument,) of the internal hemorrhoids. The pressure exerted by the
rubber band stops the circulation in the tied off pile mass. Gradually, within
seven to ten days, the pile mass falls off. This is comparatively a simple
procedure and is usually painless. It is performed under anesthesia or even
without anesthesia. This treatment is indicated in most cases of second and
third degree hemorrhoids.
3. Sclero therapy: A chemical solution is injected
around the veins of the hemorrhoids. This treatment is indicated in first to
second degree piles. Sclero therapy is not preferred by most surgeons now.
4. Crayo surgery: The affected part is freezed by
nitrous oxide or carbandioxide gas. This cuts off the circulation and destroys
the pile mass. This is indicated in first to third degree hemorrhoids. This
method is now not preferred by most surgeons.
5. Cauterization: The pile mass is shrunk with the
help of bursts of electric current. Indicated in second to third degree piles.
This method is not now practice by most surgeons
6. Infrared photo coagulation: Infra red rays are
given to an internal hemorrhoid which cuts off the circulation in it. Some heat
may be experienced during the procedure. The pile mass falls off within a few
days. There may be some bleeding. Indicated in second to third degree piles.
7. Laser therapy: The hemorrhoid mass is vaporized by
a laser beam. Using laser beams for surgery is beneficial since it minimizes
pain and bleeding. Indicated in second to fourth degree piles.
8. Conventional surgery: (Open and closed hemorrhoidectomy)
An operation is performed under suitable anesthesia, the vein in the pile mass
is tied / legated and the mass is cut off with a surgical knife or scissors.
The wound caused is closed or kept open. The surgery requires 24 to 48 hours
hospitalization. Indicated in 3rd to 4th degree piles
9. Kshar Patan (Ksharkarma): Ksharpatan is a non
surgical procedure of Ayurveda used to effectively treat hemorrhoids. A
medicine (chemical) derived from a combination of various herbs is applied to
the pile mass with the help of a special slit proctoscope. It is a type of
chemical cauterization. This method is highly effective, cost effective and can
be performed on OPD level.
The patient may require more that one sitting. The
Ksharpatan method of treating piles has been described in detail in the ancient
Shusrut Samhita. The details of preparation of the herbal combination used can
also be got from the Shusrut Samhita. This method of treating piles-
hemorrhoids was forgotten for years, but thanks to the research in the field of
Ayurveda Surgery, it has made a comeback.
This simple procedure is so effective and safe that it is
now slowly becoming popular in India like the Kshar-sutra legation method of
treating Ano-rectal fistulae.
This method is indicated in 2ndo 3rd degree Piles-
Hemorrhoids
Prevention
To prevent hemorrhoids or Hemorrhoidal flare-ups:
Eat high-fiber foods.
Why is fibre important?
Stools (sometimes called faeces or motions) are usually soft
and easy to pass if you eat enough fibre, and drink enough fluid. A diet with
plenty of fibre will help to:
Prevent constipation.
Prevent diverticulosis (a common bowel condition).
Prevent hemorrhoids (piles) and anal fissure (a painful
condition of the anus).
Reduce weight. Fiber is filling but not fattening as it has
no calories and is not digested.
Possibly reduce the risk of developing bowel cancer.
30 grams of fiber per day is recommended. However, the
average person in the UK eats only about 20 grams of fiber each day
High fiber foods include the following
Whole meal or whole-wheat bread and biscuits.
Whole meal flour used for baking and cooking.
Fruit, vegetables, and nuts.
Whole-grain breakfast cereals such as All Bran, Bran Flakes,
Weetabix, Shredded Wheat, muesli, etc.
Brown rice, and whole meal spaghetti and other whole meal
pasta.
A simple thing like changing your regular breakfast cereal
can make a big difference
Fiber supplements
You may need to take extra fibre supplements if you have
constipation or other bowel problems. Several are available. You can buy them
at pharmacies or health food shops.
Unprocessed bran is the most common (and cheapest) fibre
supplement. If you take bran, it is best to build up the amount gradually.
Start with 2 teaspoons a day, and double the amount every 5 days until you
reach about about 1-3 tablespoons per day. You can sprinkle bran on breakfast
cereals, or mix it with fruit juices, milk, stews, soups, crumbles, pastries,
scones, etc.
Some people find bran unpalatable, and you may want to try
other fibre supplements such as ispaghula husk or methylcellulose. Ispaghula
husk is also gluten-free.
Have lots to drink when you eat a high fibre diet or fibre
supplements. Drink at least 2 litres (about 8-10 cups) per day. You may find that
if you eat more fibre, you may have some bloating and wind at first. This is
often temporary. As your bowel becomes used to extra fibre, the bloating or
wind tends to settle over a few weeks.
Eat more fruits, vegetables and grains. Doing so softens the
stool and increases its bulk, which will help lessen the straining that can
cause hemorrhoids.
Drink plenty of liquids.
How much water and other fluids should you drink daily ? The
National Research Council (NRC) uses a sliding scale of 1 milliliter (ml) of
water for every calorie burned. This scale is not for women who are pregnant or
breast-feeding, infants, children and older adults who are unhealthy. The NRC
says the average man — who burns about 2,900 calories daily — needs 2,900 ml,
or about 12 cups, of water each day. The average woman — who burns 2,200
calories daily — needs about 2,200 ml, or about 9 cups, of water each day. For
your own calculations: One measuring cup (8 fluid ounces) of water equals 236
ml. But these cups don't have to be filled with water. Solid food contains
water. In an average diet, food provides about 3 to 4 cups of water each day.
Men, because they generally are bigger and have more lean muscle tissue, on
average need more water each day than women do.
Try fiber supplements
Over-the-counter products such as Metamucil and Citrucel can
help keep stools soft and regular. Check with your doctor about using stool softeners.
If you use fiber supplements, be sure to drink at least 8 to 10 glasses of
water or other fluids every day. Otherwise, fiber supplements can cause
constipation or make constipation worse. Add fiber to your diet slowly to avoid
problems with gas.
Exercise
• Stay active to reduce pressure on veins, which can occur
with long periods of standing or sitting, and to help prevent constipation.
Exercise can also help you lose excess weight.
• Avoid long periods of standing or sitting. If you must sit
for long periods, don't use an inflatable doughnut cushion to pad your chair.
It can increase the pressure on the veins in the anus.
Don't Strain
• Straining and holding your breath when trying to pass a
stool creates greater pressure in the veins in the lower rectum.
• Go as soon as you feel the urge. If you wait to pass a
bowel movement and the urge goes away, your stool could become dry and be
harder to pass.
Self - Care
You can temporarily relieve the mild pain, swelling and
inflammation of most Hemorrhoidal flare-ups with the following self-care
measures :
Apply an over-the-counter hemorrhoid cream or suppository
containing hydrocortisone, or use pads containing witch hazel or a topical
numbing agent.
Keep the anal area clean. Bathe (preferably) or shower daily
to cleanse the skin around your anus gently with warm water. Soap isn't
necessary and may aggravate the problem. Gently drying the area with a hair
dryer after bathing can minimize moisture, which can cause irritation.
Soak in a warm bath several times daily.
Apply ice packs or cold compresses on the anus for 10
minutes up to four times a day.
If a hemorrhoid has prolapsed, gently push the hemorrhoid
back into the anal canal.
Use a sitz bath with warm water. A sitz bath fits over the
toilet. You can get one at a medical supply store or some pharmacies.
Use moist towelettes or wet toilet paper after a bowel
movement instead of dry toilet paper.
These self-care measures may relieve the symptoms, but they
won't make the hemorrhoid disappear. See your doctor if you don't get relief in
a few days.
