Piles or hemorrhoids is a painful condition of inflammation and swelling that affects the veins around the anus or rectum. Although the pain can often be unbearable, in most cases the condition itself is not threatening. The condition is characterized by severe pain, especially with the passage of stools, and in some cases there may also be bleeding. Hemorrhoids may disappear by themselves without any treatment or may become itchy or inflamed and cause a significant amount of discomfort. Piles can also recur and cause internal bleeding and in some cases there may be a need for surgical intervention.
There are two main types of piles internal piles that develop inside the anus and rectum (and can be felt and not seen) and external piles that occur outside and around the anal opening (that can be easily seen). When an internal hemorrhoid protrudes outside the anus, it is known as a prolapsed hemorrhoid. It is also possible that you may develop both types of piles at the same time. Internal hemorrhoids are rarely painful and you may not even be aware of them. External hemorrhoids however can be painful and uncomfortable and may bleed along with the itching and inflammation.
Due to the embarrassing nature of the problem, many patients avoid visiting or even consulting health care specialists about the problem. Piles or hemorrhoids is not an uncommon problem however and its one that is prevalent among men and women alike and can be treated easily if diagnosed in time.
Symptoms of Piles
Symptoms are not always present and in many cases patients may not even be aware of the presence of piles because of the absence of symptoms. In most cases of hemorrhoids however the typical symptom is rectal pain. Mild cases usually resolve naturally within a few days and may not even require any treatment.
Commonly observed symptoms of piles include:
- The presence of flecks of blood in the stool or on tissue paper, and possible bleeding after passage of a stool
- Severe pain
- Irritation and itchiness around the anus
- Swelling and tender lumps in the anal region
- Increased pain or pain whilst seated
- Presence of pain when passing stools
- In cases of internal piles where the inflammation or lump is not visible the piles may move on to the outside, called a prolapsed, during the passage of stools and may need to be pushed back in
- There may also be a discharge of mucus that follows the passage of stools
- Patients may also experience feelings of fullness and feel like the bowels still need to be emptied even after the passage of stools
Whether dealing with internal or external piles there are certain circumstances under which you should seek immediate medical treatment:
- In the case of internal piles the inflammation and lumps typically develop inside the lining of the anus and are not visible. These lumps may however become visible on the outside, typically during the passage of a stool. In such cases of prolapsed hemorrhoids where the lump cannot be pushed back in you need prompt medical treatment.
- Similarly if you suffer from external piles you may notice small, itchy and painful lumps on the outside of the anus, referred to as perianal hematoma. If blood clotting occurs inside you will need to seek immediate medical treatment. The condition of blood clotting in such external hemorrhoids is referred to as thrombosed external hemorrhoids.
Causes of Piles
More than 75% of Americans suffer from piles. Aging can contribute to developing hemorrhoids, as can constipation and straining during bowel movements. Typically the problem develops as a result of excessive pressure on the veins and blood vessels in the region or due to a weakness of the veins that could also be associated with other conditions like varicose veins. Conditions and circumstances that could therefore increase the risk of developing piles include:
- Sitting for long periods of time
- Sitting on the toilet for long stretches of time
- Medical conditions such as cirrhosis of the liver
- Severe diarrhea
- Low-fiber diet
- Poor diet high in fats and processed foods
- Bowel disorders
- Strenuous work or hard labor
- General weakness of the body
- Anal intercourse
Remedies for Piles
A diagnosis of external piles can be made by simple observation. For internal hemorrhoids however, you may need a rectal examination that can be slightly uncomfortable. If necessary, your doctor may also have to use an anoscope or sigmoidoscope to study the anal canal in closer detail.
The medications usually prescribed for piles treatment include corticosteroid creams or ointments that are available over-the-counter. Corticosteroid pads that you place on the affected area can also help with the swelling and pain. Special hemorrhoid creams that contain lidocaine can help reduce the pain. If constipation is the cause of the piles, medications such as stool softeners or bulk laxatives may be necessary.
The best cure for piles includes a combination of medications and a change in diet and lifestyle. Diet and lifestyle changes are also absolutely essential for a long term cure and to prevent frequent recurrences. Laxatives and stool softeners are simply a temporary solution and prolonged reliance on the same can result in severe complications. There are also some home remedies for piles that can provide pain relief while the hemorrhoids heal.
To tackle a piles problem, you must make the following changes:
- Use an inflatable ring or cushion to sit on to reduce pressure on the hemorrhoids
- Wear cotton underwear that prevents excessive perspiration and allows the skin to breathe
- Do not use perfumed toilet paper or cheap rough toilet paper that can damage sensitive skin
- Do not scratch the itchy areas and keep your nails short to avoid accidental scratches
- Avoid straining during a bowel movement and do not spend excessive amounts of time in the toilet
- Do not delay a bowel movement when the urge occurs as this can lead to constipation
Some natural remedies for piles include:
- Sit in a warm sitz bath once or twice a day to reduce inflammation of the area and to get some relief from the pain. Epsom salt added to the water can help relieve itching and inflammation as well. There is little evidence to support this remedy however.
- The application of cold compresses or ice packs is also believed to help reduce the inflammation and can provide some relief from the pain. The best way to get relief however would be by alternating between cold and warm compresses. First use cold compresses for five to ten minutes and follow this with a warm compress for an equal amount of time.
- Activities like yoga and aerobics can be therapeutic helping to improve circulatory functions, digestion included.
- Try to use a bath stool to support your feet when you are seated on your toilet. This is not really to support your feet, but the elevated position of your feet changes your posture on the toilet seat and consequently of the rectum, often facilitating easier passage of stools.
In most cases with the proper treatment, piles should clear up in a week so. In case the piles are still present and painful after two weeks, consult with your doctor to discuss other treatment alternatives. If the hemorrhoids do not respond to any form of medication or home remedies, your doctor may recommend one of the following medical procedures:
- Rubber band ligation where a rubber band is placed around the hemorrhoid and the blood supply is cut off. This causes the hemorrhoid to fall off in time.
- Sclerotherapy is the same procedure used to treat varicose veins on the legs. During this treatment, the hemorrhoid is made to collapse with the help of a chemical solution that is injected into the vein.
- Another new medical procedure that is used to treat piles is known as Doppler guided hemorrhoidal artery ligationi.
- A hemorrhoidectomy is the last treatment alternative and is recommended only for severe or chronic cases and when no other form of treatment has helped.
Diet for Piles
Certain nutritional and dietary supplements may help counteract the recurring problem of piles. These include fiber supplements that help soften stools and reduce painful bowel movements. If you take a fiber supplement that contains Psyllium or the like, make sure you drink at least 8 to 10 glasses of water daily for the best results. Increase your intake of yogurt with live cultures to help improve your digestive health and prevent piles. If you cannot consume too much yogurt, opt for a probiotic supplement that contains friendly bacteria such as lactobacillus and bifidus.
If you suffer from severe or chronic piles, it may be a good idea to switch to a cleansing all-fruit diet for a few days. Once your condition resolves however make sure that you continue to follow a healthy balanced diet. A diet for piles should also avoid processed foods, junk foods, foods that are high in fat and refined sugar, as well as caffeine and alcohol.
Suggestion for Piles
You can prevent piles by:
- Avoiding constipation
- Drinking plenty of water to stay hydrated
- Including more fiber in your diet
- Exercising regularly
- Avoid staying seated for prolonged periods; make it a point to stand and walk about at regular intervals if you have a desk job
- Alonso-Coello P, Mills E, Heels-Ansdell D, López-Yarto M, Zhou Q, Johanson JF, Guyatt G. Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Am J Gastroenterol. 2006 Jan;101(1):181-8. Review. PubMed PMID: 16405552.
- Tejirian T, Abbas MA. Sitz bath: where is the evidence? Scientific basis of a common practice. Dis Colon Rectum. 2005 Dec;48(12):2336-40. Review. PubMed PMID: 15981059.
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