What is Piles ,Symptoms, Causes, Diagnosis & Treatment:
Now, if we have to understand the digestive process, we should see what happens to the food we eat. The food we eat will go through the mouth into the food pipe, medically called the esophagus. So, from the mouth, the food travels along the food pipe and reaches the stomach. Once the digestive process is completed in the stomach, the food gets passed into the intestine. The small intestine and the large intestine are the two different types of intestines, as everyone is aware.
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| Which treatment is best for piles? |
For digestion, food first passes through the small intestine. The cecum is the point of connection between the small and large intestines. The cecum is present on the right side of the lower abdomen. There is a small organ present near the cecum, called the appendix. It looks like a small tissue near the cecum. We will see separately what will happen if the appendix inflames.
From the cecum, the food moves upwards; it is called the ascending colon. What else is present on the right side? Your liver. The intestine takes a turn near the liver, which is called hepatic flexure. Hepatic means liver, and flexure means the place where it turns. From there, the intestine travels horizontally, and that part is called the transverse colon. The transverse colon travels straight in our body's midline and turns downward on the left side, where the spleen is present. Hence, it is called splenic flexure. As it turns and moves downward on the left side, it is called the descending colon. From there, the last part, the sigmoid colon, is present, which ends with the rectum.
Now, as the urine is getting collected in the urinary bladder, the remains or stool, which is produced after the absorption of all the nutrients from the food, the waste products, is called feces in medical terms. The last part where the stool gets collected is called the rectum. The opening of the rectum is called an anal canal or anus.
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| Anal canal |
Now we know so much about anatomy. So, let us now know more about what is present inside the intestine, which helps in absorbing the nutrients from the food.
Lumen. What is lumen? Lumen is like small holes. It is present all over the intestine, and its covering is called the mucosa. All of the nutrients in the food we eat are absorbed by these two.
What causes piles and when do they occur?
Now, let's explore how this stable process can be affected. Before delving into haemorrhoids, it's important to note the anal canal. The anal canal is the outer part of the rectum, visible as the anus.
Now let's look at what the anal canal contains.
The anal canal consists of two parts: internal and external. There is a structure called a vascular cushion above and below the anal opening.
What is a vascular cushion?
All our body parts contain blood vessels, including arteries and veins, which are also present in the vascular cushion. When piles develop, the internal vascular cushion becomes swollen and enlarges. There is a possibility that it can prolapse outside the body, resembling a tongue.
Externally, if we develop piles or haemorrhoids, they will be seen as a boil-like or grape-like structure. Therefore, when we strain to pass stool, the vascular cushion becomes inflamed and protrudes outside as piles.
Causes of piles or haemorrhoids.
The primary reason is constipation.
How does the food we eat reach the rectum?
Our intestines perform an involuntary movement called peristalsis, a wave-like motion that pushes food remains or waste out of the body as stool. This peristalsis movement is crucial for smooth stool passage.
When does this movement get affected, hindering stool passage from the rectum to the anal canal?
Mainly due to constipation.
Why do we experience constipation?
First, insufficient intake of water.
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| Fibre rich foods |
Second, a diet low in fiber-rich foods, such as fruits, vegetables, or nuts, with a preference for low-fiber foods like starches and fats, along with inadequate hydration.
This can lead to constipation.
Not only insufficient fiber intake but also excessive consumption of junk or processed foods or soda can dehydrate the body, contributing to constipation.
Constipation can also result from other things like carrying too much weight, carrying too much weight on your upper body during pregnancy, or having irregular bowel movements.
These small factors may harden the stool, requiring more pressure to pass. This pressure can compress and irritate the vascular cushions, which can result in haemorrhoids.
If left untreated, internal haemorrhoids may prolapse internally, while external ones can bleed.
What happens during haemorrhoids?
As mentioned earlier, there are internal and external haemorrhoids.
External haemorrhoids appear swollen and can be seen outside the body.
Internal haemorrhoids occur when straining during constipation causes the blood vessels inside to become swollen.
The first degree of haemorrhoids occurs when the tissue prolapses inside and is not visible externally.
This is referred to as internal haemorrhoid degree one.
A second-degree internal haemorrhoid occurs when, during constipation, the tissue prolapses out along with the stool, retracting back inside after passing stool.
Third-degree internal haemorrhoids happen when the tissue is pulled out along with the stool during constipation and needs to be pushed back inside manually.
In the fourth degree, the tissue is pulled out with the stool and cannot be pushed back in, remaining outside the body.
This is known as the fourth degree of internal haemorrhoids.
Now let us discuss the symptoms of haemorrhoids:
Symptoms may include:
- Pain during constipation and while passing stool
- Presence of lumps or boils near the anal canal
- Skin irritation or itchiness around the anal area
- Painless bleeding during bowel movements
If you observe fresh blood in the toilet after passing stool, it is recommended to seek medical advice as it could be due to haemorrhoids.
Additionally, there is a condition known as thrombosed haemorrhoids. This occurs when blood clots form inside the haemorrhoids, leading to intense pain. While not life-threatening, thrombosed haemorrhoids can cause significant discomfort, especially when sitting.
After seeing the doctor for hemorrhoids and completing all the necessary tests, what treatment options does the doctor offer?
Surgery is not the only solution. Initially, we can opt for home remedies or medications, known as conservative management, before considering surgical intervention.
Let's delve further into these two treatment approaches.
I will tell you what your doctor would advise you to follow at home:
First, make lifestyle changes:
- Aim to drink a minimum of two to three liters of water per day.
- Include plenty of fruits and vegetables in your daily diet.
- Avoid sodas, junk food, and processed foods that can lead to dehydration.
Your doctor may prescribe stool softeners in the form of powders or syrups.
Lastly, a warm bath, known as a sitz bath, can be beneficial. This involves sitting in a basin of warm water with a solution provided by your doctor. You can do this two to three times a day.
Additionally, your doctor might prescribe anesthetic jelly for immediate pain relief. If conservative methods do not alleviate recurring hemorrhoids or pain, your doctor may recommend surgical intervention.
There are various surgical methods available. In the past, rubber band ligation was commonly used. This procedure involves tying a rubber band around the hemorrhoid to cut off its blood supply, followed by removal of the swollen tissue.
Modern techniques like laser treatment are now used for their painlessness, shorter hospital stays, and faster recovery times. Laser treatment involves cutting off the blood supply to the hemorrhoid using a laser beam, causing it to shrink and fall off.
Surgical therapy is typically recommended for patients in the third or fourth stage of hemorrhoids, those with large external hemorrhoids, or individuals who have not responded to medical management.
Here is a list of dos and don'ts for patients dealing with piles or hemorrhoids:
Dos:
- Stay hydrated and consume plenty of fruits and vegetables.
- Use wet toilet paper to wipe your anus.
- Consult your doctor for pain relief options like paracetamol.
- Take warm sitz baths to relieve pain and itching.
- Use ice packs to alleviate discomfort.
- If tissue prolapses, gently push it back in with clean hands.
- Make lifestyle changes, follow a proper diet, and exercise for at least 30 to 45 minutes daily.
- Increase water intake and reduce caffeine and alcohol consumption to prevent constipation.
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| Don'ts |
Don'ts:
- Avoid rough wiping of the anus.
- Do not ignore the urge to pass stool; controlling it can lead to hardened stool.
- Avoid straining to pass stool.
- Refrain from taking painkillers or medications containing codeine, as they can cause constipation.
Consult your doctor immediately if you experience difficulty passing stool. Early intervention is key for simpler treatment.
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