Piles - Causes, Symptoms, and Preventive Measures

Introduction:

The anal canal is a part of the rectum (segment of the large intestine) and the terminal portion of the bowel, which regulates the passage of fecal excretion. The final opening at the end of the anal canal is the anus.

The anal canal contains many vascular structures that act as a cushion while passing stools. The vascular bed in the anal canal consists of small blood vessels (sinusoids), smooth muscles, and loose connective tissue.

What Are Piles or Hemorrhoids?

Piles, otherwise called hemorrhoids, are inflamed veins at the anus or rectum. They arise from congestion of the internal or external venous plexus around the anal canal. They are extremely common in adults. Nearly every person would have faced minor problems with hemorrhoids at some point in time. Both sexes equally experience the incidence of hemorrhoids.

What Causes Piles?

Although the cause of piles is usually unknown, sometimes piles could be a result of:

• Bowel movement irregularity.

• Constipation.

• Straining while passing stool.

• Pregnancy.

• Chronic diarrhea.

• Lifting heavyweight.

• After giving birth to a baby.

• Lack of physical activity or exercise (sedentary lifestyle).

• Eating less fiber in the diet.

• Increased pressure in the abdomen due to any disease.

• Genetical predisposition.

What Are the Types of Piles?

There are two types of piles, depending on the location,

• Internal Piles: It is usually located about 2 centimeter to 5 centimeter above the anal opening.

• External Piles: It is located around the edge of the anus.

Sometimes, the piles can be mixed (internal-external) involving the area of both types.

Piles can also be classified based on the findings in their location. They are,

• Primary: The hemorrhoids are located in the anal cushions.

• Secondary: They typically occur in between the cushions or in the circumference.

Less frequently, hemorrhoids can be expressed as prolapsing and non-prolapsing about disease symptoms and progression.

What Are the Grades of Piles?

Piles have four grades or degrees classified based on the degree of prolapse and appearance,

• First Degree - Here, piles bleed but do not prolapse even during defecation.

• Second Degree - When piles prolapse and retract (go back inside) themselves, they fall under the second degree (remain inside the rectum).

• Third and Fourth Degree - Here, piles require manual replacement after prolapsing (visible and easy to feel around the anus).

What Are the Symptoms of Piles?

Patients suffering from piles may have the following symptoms:

• Pain in the rectum before, during, or after passing stool.

• Burning in the rectum before, during, or after passing stool.

• Pricking sensation in the rectum.

• Bright red bleeding after passing stool. This is mostly seen in the second and third degrees.

• Discomfort while sitting.

• Pruritus ani (chronic itching in the perianal region).

• Mucus discharge from the rectum.

• Incomplete bowel action because of pain.

• Hard stool.

• Sometimes piles lead to severe bleeding, which might cause anemia.

• Backache.

What Are the Risk Factors?

As individuals get older, the likelihood of developing hemorrhoids rises due to the weakening and stretching of the tissues supporting the veins in the rectum and anus. Similarly, during pregnancy, the pressure exerted by the baby's weight on the anal region can lead to the same condition.

What Are the Complications of Piles?

Complications from hemorrhoids are uncommon but can include:

• Anemia: In rare cases, persistent blood loss from hemorrhoids can lead to anemia, which occurs when there's a deficiency of healthy red blood cells to transport oxygen to the body's cells.

• Strangulated hemorrhoid: When the blood flow to an internal hemorrhoid is restricted, it becomes strangulated, causing severe pain.

• Blood clot: Occasionally, a clot may develop within a hemorrhoid, resulting in a thrombosed hemorrhoid. While not typically life-threatening, this condition can be extremely painful and may require drainage in some cases.

How Are Piles Diagnosed?

The general practitioner (GP) will inquire about their symptoms and conduct a physical examination. They may gently insert a finger into the anus to assess the rectum, ensuring comfort by using gloves and lubricating gel. If needed, the GP might recommend seeing a specialist who can perform a more thorough examination of the rectum using a short, rigid instrument called a proctoscope.

In case of significant bleeding, the person may require a blood test to check for anemia, characterized by low levels of red blood cells or hemoglobin in the blood.

If the symptoms, physical examinations, or test results indicate the possibility of an underlying condition, the GP may refer the person to a hospital for further investigations. These additional tests can help rule out other conditions such as bowel cancer.

How to Manage Piles?

The primary goal of treating piles is to diminish the acute symptoms based on the type and severity of the piles.

Conservative Method:

• Most of the cases respond well to conservative management.

• Dietary changes and lifestyle modifications are the initial treatment protocol suggested, and it is an integral part of the management of piles.

• Oral flavonoids and Calcium Dobesilate are venotonic drugs used to reduce the excruciating symptoms of piles.

• Topical ointments could subsequently control the symptoms.

• Medical therapies like rubber band ligation, sclerotherapy, radiofrequency ablation, infrared coagulation, bipolar diathermy, and cryotherapy have been recommended to manage mild to moderate-grade piles.

Surgical Method:

• Surgical management has opted for when there is no improvement in symptoms from conservative management.

• Surgical intervention includes hemorrhoidectomy, plication, Doppler-guided hemorrhoidal artery ligation, and stapled hemorrhoidopexy.

Homeopathy Method:

• Homeopathy is a popular alternative medicine. They treat the patients with individualized treatment based on their symptoms and severity issues.

• Studies suggested that with the use of custom-made individualized homeopathic treatment, there was a significant reduction in the piles symptoms like pain, itchiness, heaviness, and bleeding.

• Hence homeopathy remains a promising solution for piles problems.

What Are the Preventive Measures for Piles?

People can reduce their chances of developing hemorrhoids by making several lifestyle changes, such as:

• Following a Balanced Diet: Staying well-hydrated and consuming a diet abundant in high-fiber foods can promote softer stools and facilitate easier bowel movements.

• Avoiding Straining During Bowel Movements: Exerting excessive pressure during bowel movements can elevate the risk of hemorrhoids.

• Steer Clear of Heavy Lifting: Regularly engaging in heavy lifting activities increases the likelihood of developing hemorrhoids. By minimizing heavy exertion and employing proper lifting techniques, individuals can prevent the onset of hemorrhoids.

• Maintaining a Healthy Weight: Being overweight is a known risk factor for hemorrhoids.

• Remaining Physically Active: Regular exercise aids in the smooth passage of food through the digestive system and promotes regular bowel movements, which can help reduce the risk of hemorrhoids.

Conclusion:

Sometimes, piles reappear even after surgery. But with the help of homeopathy and natural remedies, a person can get rid of piles easily without surgery. So, follow some lifestyle changes and follow these tips to get rid of piles