Piles, also known as hemorrhoids, is a collection of tissues that are swollen and inflamed that grows in the anal region. Piles may vary in size and can be found inside (internal hemorrhoids) or outside (external hemorrhoids) the anus.
The prevalence of piles is estimated to be 50-85% around the world and in India, 75% of the population is estimated to suffer from piles.
Piles develop when the tissues protecting the anal region get inflamed and the anal passage becomes thin, stretched and irritated when passing bowel movement.
The causes of piles include:
Genetics predisposition to piles
Lifting heavy weights
Lack of fiber diet and less fluid intake
Straining during bowel movement
Previous bowel surgery
Some of the common symptoms of piles are:
Intense itching around the anus
Painful or itchy swelling or lump near the anus
Painful bowel movements
Bleeding from your anus during or after bowel movements
Irritation and pain around the anus
Leakage of stool
Excessive bleeding in stool leading to anemia
Infection in and around anal region
There are 4 grades of piles or hemorrhoids:
There are small inflammations, usually inside the lining of the anus. They are generally not visible.
In this grade, the piles are larger than in grade I, but also remain inside the anus. They may get pushed out during the passing of stool..
This stage of piles are also known as prolapsed hemorrhoids, and appear outside the anus. You may feel them protruding out from the rectum, but they can be easily re-inserted.
These cannot be pushed back in and need immediate treatment. They are large and remain outside the anus.
Consult a doctor when you see you have the symptoms as mentioned above. He will perform a physical examination of the anal region. In case of external piles, the doctor may be able to see them. To check for internal piles, the doctor performs certain tests of the anal canal and rectum.
- The doctor inserts a gloved and lubricated finger into the rectum to check for any unusual growths.
The doctor examines the lower portion of the colon and rectum using anoscope or sigmoidoscope.
Ayurveda aims to balance the doshas - pitta, vata and kapha. It is always recommended to consult a doctor before going for Ayurvedic medicines (Bhaishajya chikitsa) or surgical treatment (Sastra chikitsa). Ayurveda medicines for piles includes:
Kshar Sutra Therapy is another Ayurvedic technique where kshar sutra is put at the roots of piles tissues and are tied together. The blood supply to the piles is cut off which allows the piles to shed off in a few days. Before you decide to opt for the treatment, it is important to consider the risks and benefits of the procedure and have a discussion with the doctor.
However, there is an increased risk of piles recurrence and rectal prolapse, in which part of the rectum pushes out of the anus. This process cannot treat external piles.
: Dietary changes can help regulate stool and keep you away from constipation. It involves eating more fiber such as fruits, vegetables, bran-based cereals and more liquid intake.
: Obesity is also a reason for piles. Reducing those extra pounds can reduce the severity of piles. The exercises include:
Pelvic floor exercises
Medication includes creams, ointments and painkillers to soothe swelling and burning in the anal region. Using witch hazel or numbing agents as topical treatments can also help in reducing the swelling.
Laxatives can help loosen stools and reduce straining during a bowel movement.
After every bowel movement, soak your anal parts in warm water or take a warm water bath for 10-15 minutes, two to three times a day.
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The complications of piles include:
Bleeding during bowel movement
Severe pain while passing stool
Gangrene (Dead tissue caused by an infection or lack of blood flow)
To keep piles at bay, it is important to keep stools soft so that they are easy to pass. Therefore, to reduce symptoms of piles, here are some preventive measures:
Eat high-fiber food
Drink plenty of water or increase liquid intake
Do not strain during bowel movement
Talk to doctor about fiber supplements to soften stool
Do not ignore the sudden urge to visit the washroom
Avoid sedentary lifestyle