Piles also known as hemorrhoids are normal part of the anal canal and have important role for in continence of stools unless there is some abnormality associated with them. Piles are inflamed and swollen veins of the anal canal along with supportive tissue and elastic fiber as they are part of the anal sphincter. The size of the piles may vary.
Hemorrhoids or piles (swollen veins in the anus and lower rectum) may result from straining while passing stool or during pregnancy also due to increased pressure in these veins.
TYPES OF PILES:
There are two anal sphincters viz. internal and external. Hemorrhoids may be located inside the rectum known as internal piles or may develop under the skin around the anus known as external hemorrhoids. Occasionally a clot may form in the external hemorrhoids known as thrombosed piles.
INTERNAL PILES: internal piles (around internal anal sphincter) are usually painless but usually bleed when they are irritated (by passage of hard stool). they can be of four grades
Grades of internal piles:
GRADE I - In grade I piles, there is just swelling of veins but no protrusion or prolapse of veins. Thus there is prominence of veins only.
GRADE II - In grade II piles, the veins prolapse or protrude only on bearing down which reduce spontaneously on removal of pressure
GRADE III - In grade III piles, the veins are protruded on bearing down but don't reduce on their own and has to be pushed back manually.
GRADE IV - In grade IV piles, the prolapsed veins can't be reduced even manually.
EXTERNAL PILES: external piles are swelling of veins present outside the anus which may be painful sometimes and don't bleed usually. Common symptoms are irritation and itching.
RISK FACTORS FOR DEVELOPING PILES ARE:
- Chronic constipation
- Chronic diarrhoea
- During pregnancy
- Heavy weight lifting
- Prolonged straining for
- Inactive lifestyle
- Low fiber diet
- Family history of piles
SYMPTOMS & CAUSES
- Swelling around anus which is hard and possibly painful
- Pain and discomfort in anal region.
- Painless bleeding per rectum while passing stool
- Itching, burning or irritation in anus CAUSES
- Straining while passing stool
- Sitting for long in toilet
- Chronic diarrhea or constipation
- Low fiber diet
- Constant heavy weight lifting
- Family history of hemorrhoids
DIAGNOSIS & TREATMENT
Visual examination along with symptoms is enough for diagnosis by the doctor.
- Anti-hemorrhoidal cream
- Sitz bath
- Advice on taking high fiber diet.
- To relieve pain advice on hot fomentation is given.
- Advice on plenty of liquid.
- Patient is advised to avoid straining.
There are many homeopathic medicines which can help not only in relieving pain but also in decreasing the swelling of the veins but should always be taken after consulting a homoeopath based on the symptomatic presentation. Few medicines helpful in treatment of hemorrhoids are
- Aesculus hippocastanum
- Muriatic acid
- Nitric acid
DO's And DON'Ts
- Eat high fiber foods: add fruits, vegetables and whole grain to the diet. This will help the stool in being bulky and soft and avoid straining. Approximately 30-40 grams of fiber should be taken everyday. Foods in high dietary fibers are: whole wheat, brown rice, oat meals, pears, carrots, bran.
- Plenty of fluids: ample amount of liquid would keep the stool soft.
- Exercise: being active would help avoiding constipation and pressure in the veins. Weight would also be normal on being active thus preventing increase of pressure in the veins.
- Use toilet as soon as urge is felt: this would help preventing stool becoming hard and dry thus preventing hemorrhoids and straining required to pass stool.
- No straining: straining to pass stool would cause great pressure in the veins and would cause hemorrhoids
- Avoid sitting for long: sitting for long also increase pressure in veins