It is also known as piles, these are swellings
that can occur in the anus and lower rectum (back passage).
There is a network of small veins (blood vessels) within the inside
lining of the anus and lower rectum. These veins sometimes become wider
and engorged with more blood than usual. These engorged veins and the
overlying tissue may then form into one or more small swellings called
haemorrhoids. Initially, they are located just inside the anus
(internal haemorrhoids) but can sometimes protrude (external
haemorrhoids). Haemorrhoids are not dangerous (unless you leave it to bleed).
Causes:
1. Sitting for long periods of time can start the hemorrhoidic process.
2. Increased straining during bowel movements caused by constipation or
diarrhea may lead
to hemorrhoids. It is thus a common
condition due to constipation caused by water
retention in women experiencing
premenstrual syndrome or menstruation.
3. Hypertension, particularly portal hypertension, can also cause
hemorrhoids because of the
connections between the portal vein and
the vena cava which occur in the rectal wall-
known as portocaval anastomoses.
4. Obesity can be a factor by increasing rectal vein pressure. Poor
muscle tone or poor
posture can result in too much pressure
on the rectal veins.
5. Pregnancy may lead to hypertension and increase strain during bowel
movements, so
hemorrhoids are often associated with
pregnancy.
6. Cigarette smoking during bowel movements, may worsen hemorrhoid, may
lead to severe
internal bleeding of veins inside rectum
area. Both can cause diarrhea. Note that caffeine
ingestion increases blood pressure
transiently, but is not thought to cause chronic
hypertension.
Symptoms:
Internal Haemorrhoids-
Haemorrhoids may be present for many years but remain undetected until
symptoms appear. They can cause anal bleeding and itching and also pain
and discomfort.
Normally, the bleeding is limited to small stains of fresh blood on the
toilet paper, but more severe bleeding can sometimes be present when
stools are passed.
A lump may also be felt in the anus and large haemorrhoids give a
sensation that the bowel hasn't emptied completely.
In addition, excessive straining, rubbing, or cleaning around the anus
may cause irritation with bleeding and/or itching, which may produce a
vicious circle of symptoms. Draining anal mucus, produced by the
dentate line may also cause itching.
Grade of haemorrhoids-
1.Grade 1- are common, develop on the inside lining of the back
passage, and cannot be seen or felt from outside the anus.
2.Grade 2- are larger, and are sometimes pushed out (prolapse) from the
anus when you go to the toilet. However, afterwards, they return inside.
3.Grade 3- one or more small lumps hanging from anus can be felt. It
will be able to push them back inside using finger.
4.Grade 4- can become quite large, and permanently protrude (hang down)
form the anus. They cannot be pushed back inside.
Investigation:
After visual examination of the anus and surrounding area for external
or prolapsed hemorrhoids, a doctor may conduct a digital examination.
In addition to probing for hemorrhoidal bulges, a doctor may also look
for indications of rectal tumor or polyp, enlarged prostate and
abscesses.
Visual confirmation of hemorrhoids can be done by doing an anoscopy,
using a medical device called an anoscope. This device is basically a
hollow tube with a light attached at one end that allows the doctor to
see the internal hemorrhoids, as well as polyps in the rectum.
If warranted, more detailed examinations, such as sigmoidoscopy and
colonoscopy can be performed. In sigmoidoscopy, the last 60 cm of the
colon and rectum are examined whereas in colonoscopy the entire large
bowel (colon) is examined.
Treatment:
1.Avoid constipation and straining in toilet-
a.Drink plenty of water atleast 3to 4 litres in a day that will help in
soften the feces.
b.Fibrous food must be added in the diet such as fruits, vegetables,
cereals etc.
c.Avoid painkiller that contain codeine as they cause constipation.
d.Toileting- when urge is present to pass stool it should not be
suppressed as suppression causes hardening of stools.
2. Use of ointments and cream for the passage of stool.
3. Surgery in cases of grade 4 piles.
4. homoeopathy- Homeopathic medicines are very effective in management
of piles and the symptoms associated with it such as pain, bleeding,
itching, etc. The point to be emphasized is that the relief of symptoms
is obtained with absolute gentleness and without invasion or surgery of
any kind. Moreover, the condition has high relapse rate following
surgical treatment, since surgery does not target the root causes like
genetic tendencies, habitual constipation, etc. Homeopathic medicines
work at the root level and can modify these genetic tendencies thus
reducing chances of relapse and recurrence of the condition
significantly. Grade 1 and 2 of internal piles can be significantly
helped with homeopathy. Grade 3 piles can find some relief of symptoms
with homeopathy but may not be completely cured. Grade 4 piles can get
symptomatic relief with medicines.
Preventing the return of piles
Having got rid of piles there is a lot can be done to help prevent
their recurrence. Stick to a high fibre diet and drink lots of liquid -
every day
Do not rely on convenience foods/ fast foods.
When bowels are open, don't strain. The correct diet should ensure
quick and comfortable passage of stools.
Drink plenty of water and exercise in moderation.