Piles are technically called as haemorrhoids. Haemorrhoids are blood vessels located in rectum and anal region. They form an important part of human anatomy. Capillaries merge together to form vein-lets and vein-lets join together to form veins. Veins carry impure blood or de-oxygenated blood from various parts of body to the heart for purification. These blood vessels become a cause of major concern when they begun to swell. Piles causes is the result of swelling of these blood vessels.
- Different types of piles:
Piles can be divided into two categories- internal piles and external piles. Let us understand these two categories in detail.
- Internal piles: Internal piles form in the internal anal passage or in the upper part of anal canal. They occur at a distance of 2-3 cm inside above the opening of anus. It is the most commonly occurring type of piles.
Internal piles is further classified into four types depending upon their size and intensity.
- Grade 1: It is the initial stage of piles. They occur in the interior of anal canal and cannot be felt or seen externally. If piles is not treated in this stage, they advance to grade 2.
- Grade 2: Size of swelling enlarges and some part of it can be seen outside the anus when patient visits toilet. However, portion exposed outside the anus springs back to its original place after finishing toilet activity.
- Grade 3: Blood vessels enlarge further in size. Some part of haemorrhoids hangs down from the anus and can be pushed back inside. Piles in this stage start becoming painful and one must consult with doctor without any delay.
- Grade 4: It is the last of internal piles. Haemorrhoids are permanently pushed outside the anus and person may experience blood in their stools.
- External piles: As the name suggests, these type of piles occur in the exterior part of anus. It can be seen and felt from outside. You can see clumps of haemorrhoids around the anal region. External piles can be extremely painful since there is a huge network of nerves around the anus. External piles are also referred as perianal hematoma.
- Symptoms of piles:
Generally, piles can fade out on their own after a certain period of time. However, it is safe not to ignore early signs of piles. Timely treatment reduces damage to tissues and there are less complications involved. Few symptoms of piles have been enlisted below:
- Pain while defecating
- Red patches around the anus
- Presence of blood in the stools
- Discharge of mucus while passing stools
- Feeling like bowels are still full although they have been emptied
- Hard lump can be seen or felt around the anus
- Itchiness and irritation sensation around anus
- Causes of piles:
When too much pressure is applied on the area of lower rectum or lower part of anus, it results in swelling or bulging of haemorrhoids. Other factors that can be attributed to formation of piles are:
- Chronic constipation and diarrhea
- Pregnancy- During pregnancy, enlarged uterus can apply pressure on anus and lower rectum. This causes weakening of rectum muscles and can cause piles
- History of rectal surgery
- Lifting heavy weights
- Putting undue strain on anal muscles while passing out stools
- Diagnosis of piles:
Diagnosis of piles can be performed using physical examination. Doctor may ask you several questions related to passing out stools. He may even ask if there is any history of piles in your family. Doctors can easily recognize external piles as they can be easily seen and felt.
To detect the presence of internal piles, doctors will use proctoscope or perform DRE (Digital Rectal Examination). Proctoscope is a hollow tube that is fitted with light. It assists doctor in examining anal canal and takes out a sample of tissue. This sample of tissue can be sent to laboratory for further analysis.
- Treatments and Precautions for piles:
Initial symptoms of piles can be cured by making few changes in your diet. If these symptoms persist for long time, doctor will advice to you to take medications or recommend you some therapies.
- Consuming fiber rich diet proves extremely beneficial for piles patients. Roughage should be an integral part of diet as it facilitates bowel movements and regulates smooth flow of stools. It is not digested by our body and does not provide any nutritional benefits. Foods rich in fiber are salads- cucumber, tomatoes, carrots, green leafy vegetables and fruits like banana, melons, dragon fruit etc. Regular consumption of fiber rich foods will reduce problems related to constipation.
- Avoid extremely spicy food. Too much of spice can deteriorate your digestive and excretory system.
- Increase your fluid intake. Drink at least 3-4 liters of water everyday. Apart from drinking water, try to incorporate fluids in form coconut water, sugarcane juice, fruit and vegetable juices etc. To add flavor to drinking water you can infuse some herbs such as basil, mint in to it. More you drink fluids and consume fiber rich food, more it will help in recovery of piles.
- Avoid taking pain killers such as co-codomol as it may increase chances of constipation.
- Visit toilet immediately when you feel the need to. Controlling bowel movements will add undue pressure on anal muscles; thereby helping haemorrhoids to develop further. Do not strain toilet and resist the temptation to empty bowels. Patients suffering from piles feel the need to empty bowels eben though they have already emptied them.
- You can apply some ointments and creams to reduce discomfort, itchiness and redness caused by piles. You may sometimes take paracetamol to ease some pain. If you want to take over the counter medications, do it so with doctors prescription.
- To cure grade 2 and grade 3 piles, doctors use banding treatment. It is a sort of surgery. It is performed under the administration of anesthesia. Haemorrhoid is removed by the surgeon using a suction device or by forceps. To cut off blood supply to haemorrhoids, a rubber band is placed at the base of it. Haemorrhoids will eventually die after few days and drop off.
Piles can occur at any stage of life. Your diet and lifestyle plays an important role in controlling and prevention of the disease. However, if not cured there are many renowned hospitals that provide cost effective surgery treatments. List of hospitals with addresses and cost of piles surgery in many Indian cities can be found here.