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Piles: Types, Causes & Treatments

Piles
Dr. Monika Bhanushali
Dr. Monika Bhanushali
August12/ 2016


Piles are known as Haemorrhoids in medical terminology. Haemorrhoids are the swellings of the blood vessels in the anal canal. These blood vessels are primarily veins. These veins are located in the lowest part of the anal canal, close to the opening of the anus. Haemorrhoids are one of the most common ailment of anal canal.

The haemorrhoidal veins are normally present in every individual. They are cushion like and help in controlling the stool motions. They have a very rich blood supply. Due to this vascular supply, they tend to engorge and prolapse which gives rise to the pathological symptoms of Haemorrhoids.

Although many people complain of the condition, there is usually a lag in seeking out medical treatment due to embarrassment and shame. Hence the exact number of people affected every year is far more than the number actually reported.

Causes:

The exact cause is not known. Although following conditions may result in haemorrhoids.

  1. Constipation
  2. Low fibre diet
  3. Lack of exercise
  4. Standing or sitting for a long time
  5. Obesity
  6. Pregnancy
  7. Increased intraabdominal pressure by coughing, Sneezing, prolonged straining
  8. aging

There are two type of haemorrhoids:

  1. Internal haemorrhoids: they are far up the anal canal. They cannot be felt on touching. They have less number of pain nerves.
  2. External haemorrhoids: they lie within the anus. They can be felt by touching. They have higher number of pain nerves.

The patient presents with following symptoms:

  1. Bleeding in stools
  2. Severe pain at the time of stool motion
  3. Swelling in the anal area
  4. Itching in the skin around anus
  5. A bulb like swelling felt on touching
  6. Mucous discharge

Diagnosis:

  1. The haemorrhoids are diagnosed by physical examination. A doctor visually inspects the area surrounding the anus.
  2. Rectal examination: a rectal exam may be done to rule out other possible conditions like anal tumour, prostate enlargement, polyps or abscess. The area is first numbed by using local anaesthetic jelly.
  3. Visual anoscopy: it is done to visualise the internal haemorrhoids.

Treatment:

  1. Conservative:

  • Fibre rich food intake e.g. cabbage, cucumber, carrot, oats, fruits etc.
  • Increased intake of oral fluid like water, fruit juices etc.
  • Pain killers for the pain
  • Sitz bath: it is a special type of bath where the person has to sit in warm water. The warmth makes the affected area clean and improves blood circulation in that area.
  • Treatment of associated conditions such as constipation and straining while defecating by giving a bulking agent such as isabghula, and sabja. Treating cold and cough in order to avoid the rise in intra- abdominal pressure.
  1. Procedures:

If the haemorrhoids are not responding to only conservative treatment or the grade is more, they have to be treated by minor surgical methods such as,

  • Rubber band ligation
  • Sclerotherapy
  • Cauterization
  1. Surgical:

Surgery has to be done if conservative and simple procedures are not successful. They are as follows:

  • Excisional haemorrhoidectomy
  • Haemorrhoidal dearterialisation
  • Stapled haemorrhoidectomy

It is a manageable condition and with proper treatment and life style modifications, a person can lead a normal life like any other individual

Dr. Monika Bhanushali
Dr. Monika Bhanushali

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