Piles – “The disease that causes both physical and mental distress”

Anus is an organ that is considered as ugly, unhealthy and most of the people are shy to discuss and show their problems to the doctor. Even some doctors hesitate to do proper examination of the anus and rectum to rule out the underlying diseases.

Disease in and around the anus are quite common and is seen in 1-2% of the population. They cause not only physical but also mental agony. All the diseases in and around the anus are usually called as Piles. But they are mainly three different diseases namely:

· Fistula

· Fissure and

· Piles

that commonly occurs in the anal region. Let us learn more about piles in this article.

Piles or “Hemorrhoids” as it is called in medical words is a “bunch of distended and tortuous blood vessels causing a bulge/swelling in the anal canal”. They are common in all age groups from mid-teens onwards and particularly common in pregnant women.

Types of Piles: There are two types of Piles namely:

· Internal piles- the bulge extends internally into the rectum. It cannot be seen or felt easily.

· External piles- In this type, the bulge protrudes out of the anus and is easily seen and felt.

Stages of the disease: There are four stages of the disease which include:

· First-degree piles are small swellings on the inside lining of the anal canal. They cannot be seen or felt from outside the anus.

· Second-degree piles are larger and stick out from the anus when you go to the toilet, but return afterwards.

· Third-degree piles are similar, but hang out from the anus and only return inside when pushed back with a finger.

· Fourth-degree piles permanently hang down from the anus and you cannot push them back inside.

FIG 1: Shows types of Piles

Symptoms: Common symptoms include:

• Bleeding from the anus.
• Itchiness around anal area.
• Pain and discomfort after have opened the bowels.

Complications: Plies can give rise to complications which include:

• Strangulation - when a pile that sticks out of the body swells considerably and the blood flowing into it cannot return to the body.
• Blood clotting- if the blood in the swollen pile clots.
• Gangrene (tissue death) - if there is a lack of blood supply to a pile.
• Infection

Causes: The exact way piles form is controversial but may be linked to excess pressure in the anus and lower rectum.

An increased risk of getting piles:

• Strain to empty the bowels when constipated.
• Pregnancy - as the weight of the fetus on the abdomen and the increased blood. flow.
• Have a family history of piles.
• Have varicose veins

Diagnosis: Doctor may carry out a rectal examination. Sometimes a proctoscopy that allows the internal view of the rectum is necessary.

Treatment: To encourage piles to clear up, it's important to avoid constipation.

Eating plenty of fiber-rich foods such as fruit, vegetables and wholegrain cereals (eg brown rice, whole meal bread and drinking plenty of fluids, especially water, should keep bowel movements soft.

Non-surgical treatments: In non surgical treatments banding, sclerotherapy, cryosurgery and light coagulation can be done

Surgical treatments: Removal of the bulge can be done to cure piles.

Prevention: A good intake of dietary fiber, plenty of fluids, especially water, and regular exercise can keep the bowel movements soft and regular, making piles less likely. Yoga can help to prevent piles. Also yoga is helpful in treating early stages of the disease. It can also prevent further of the disease.

Conclusion: Treatment of piles of quacks must be avoided. Most of the times the patient treated with quacks land up in complication like infection, fissure and fistula formation. It is ideal to contact the qualified doctor as soon as the disease is noticed and get proper treatment at an early stage.