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Piles

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Most people do not have the correct conception about piles (also called hemorrhoids). It’s only when the pain becomes unbearable accompanied with loss of blood, a person seeks advice from family members or close friends. Visiting a doctor for appropriate treatment is probably the last option that people choose. In this article, we highlight the importance of seeking medical help for piles at the right time. We also discuss what exactly piles are and its causes, symptoms and treatment with inputs from our expert Dr Ajit Naniksingh Kukreja, laparoscopic GI & colorectal surgeon. 

Your anal wall and rectum is protected by smooth muscles and connective tissue. The smooth muscles are lined by blood vessels called hemorrhoids. But pathologically, the term ‘hemorrhoids’ is used for lumps of coagulated blood caused due to inflammation and swelling when pressure is exerted on these blood vessels. ‘Hemorrhoids occur more commonly in young and middle-aged adults than in older adults. The prevalence of hemorrhoids increases with age, with a peak in persons aged 45-65 years, though we have operated cases as young as 13 years and as old as 85 years’, says Dr Kukreja.

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Causes

Dr Kukreja says, ‘The exact reason of hemorrhoidal symptoms is poorly understood. But there are a lot of factors that contribute to piles other than constipation. The prevalence of piles is found in around 4% of the population in US, but it is mentioned in literature that half the population above fifty will have symptoms of piles some time in their life'. Here is detailed information on 5 causes of piles you should know.

Apart from this, the few contributing factors of piles that you should be aware of are -


  • Obesity

  • Pregnancy

  • Chronic cough

  • Pelvic floor dysfunction

  • Accumulation of fluid in the abdominal cavity (ascites)

  • Low fiber intake leading to the formation of hard stools and excessive straining. Here are  10 reasons you should eat fibre-rich foods.

  • Behavioral features such as prolonged time sitting on the toilet

  • Diarrhea and frequent bowel movements have the same effect as constipation

  •  Ageing causes natural changes in supportive tissue making them less supportive

  • Elevated sphincter pressure which impairs venous drainage


 

Treatment

In most cases, piles get cured on their own with the help of dietary and lifestyle changes without the need for any treatment. High fibre intake by including cereals, fibrous fruits and vegetables in the diet helps in making the stool softer and relieving strain due to constipation. Here are 6 health complications of constipation you should be aware of!

Additionally, there are a few over-the-counter (OTC) medications in the form of creams and gels which help to reduce swelling and inflammation in the anal region.

Surgical intervention may be required in extreme cases. ‘There have been maximum advances in management of hemorrhoids ranging from stappled hemorrhoidectomy, radiofrequency, Doppler guided hemorrhoidal artery ligation and lasers.’ mentions Dr Kukreja. Read everything about treatment for piles or hemorrhoids.

Does hemorrhoid surgery cause loss of bowel control?

In hemorrhoidectomy (hemorrhoid surgery), the extra tissue that causes bleeding is removed surgically. Hemorrhoid stapling is done when blood flow to the tissue of hemorrhoid is blocked. This procedure is less painful than hemorrhoidectomy.

It is a myth that haemorrhoid surgery causes loss of bowel control. This may rarely occur if the sphincter fibers (muscles that control opening of anal movement) are damaged during procedures by quacks, in most cases if detected early the sphincter can be repaired. In case the sphincter is damaged to irreparable stages the patient might need artificial anal sphincters’, highlights Dr Kukreja.

You may also like to read about 10 helpful tips to treat piles.

Complications

Dr Kukreja says ‘Many patients are too embarrassed to ever seek treatment. But people should definitely see a doctor if the pain becomes unbearable, if there is persistent bleeding through the anal opening, if the hemorrhoids are irreducible and if they obstruct the anal passage due to blood clot.’

Hemorrhoids can cause a lot of complications if they’re not treated at the right time. These include:


  • Excessive bleeding leading to anaemia

  • Infection

  • Anal fistula

  • Gangrene

  • Rarely incontinence


Read about Mool Bandh -- yoga asana to treat piles, fistulas and prolapse of the rectum.

Home Remedies

Apart from drinking more water and eating fibre-rich foods, there are some home remedies to help you in dealing with piles. These include -


 

The content has been verified by Dr Ajit Naniksingh Kukreja, laparoscopic GI & colorectal surgeon, practising in Ahmedabad.

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