Haemorrhoids | Piles

November 18, 2020Articles2

Haemorrhoids | Piles are enlarged blood vessels that you be present inside or around your anus. They are usually small round discoloured lumps. You might be able to feel them on your anus or hanging down from your anal canal. Your anal canal is that short muscular tube with blood vessels that connects your rectum with your anus.

It is completely normal to have blood in your anus . They have an important role to play in continence ,but they results in haemorrhoids when they get enlarged .Along with blood vessels haemorrhoids contains support tissues ,muscles and elastic fibres. Haemorrhoids can develop inside the rectum (Internal Haemorrhoids) or under the skin around the anus (External Haemorrhoids).

Symptoms –

Sign & symptoms of Haemorrhoids usually depends on the type of Haemorrhoids –

1) External Haemorrhoids –

These are under the skin around your anus having symptoms like –

• Itching or Irritation in your anal region.

• Pain or discomfort

• Bleeding

• Swelling around your anus

• Slimy discharge of mucus from anus

2) Internal Haemorrhoids –

It lie inside the rectum . Patient usually can’t see or feel them and they rarely causes discomfort ,but straining or irritation when passing stool can cause –

• Painless bleeding during bowel movements. Patient might notice small amounts of bright red blood on your toilet tissue or in the toilet.

• A haemorrhoid to push through the anal opening ( prolapsed or protruding haemorrhoid) resulting in pain and irritation.

3) Thrombosed Haemorrhoids –

If blood pools in an external haemorrhoid and forms a clot ,it can result in –

• Severe pain

• Swelling

• Inflammation

• A hard lump near your anus

Causes –

The veins around anus tend to stretch under pressure and bulge or swell. Haemorrhoids can develop from increased pressure in the lower rectum due to –

• Straining during bowel movements.

• Sitting for long periods of time on the toilet.

• Having chronic diarrhoea or constipation.

• Obesity

• Pregnancy

• Anal intercourse

• Having a low fiber diet

• Regular heavy lifting

Types –

Haemorrhoids | Piles are graded according to whether they come out and if so ,how far they come out.

1) First Degree Piles –

It may bleed but don’t come out of anus.

2) Second Degree Piles –

It comes out of your anus when you have a bowel movement ,but go back inside on their own after defecation.

3) Third Degree Piles –

It comes out of anus and only go back inside if you physically push them back inside.

4) Fourth Degree Piles –

It always hang down from your anus and you can’t push them back inside. They can become very swollen and painful if the blood inside them clots.

Risk Factors –

1) Getting older age –

As you grow older ,the risk of haemorrhoids also increases ,that’s because the tissues that support the veins in your rectum and anus can weaken and stretch.

2) During Pregnancy –

As baby’s weight puts pressure on the anal region ,risk of getting Haemorrhoids also increases.

Complications –

1) Anaemia –

It happens rarely , but chronic blood loss from haemorrhoid may cause anaemia.

2) Strangulated Haemorrhoids –

If the blood supply to an internal haemorrhoid is cut off , haemorrhoid may be strangulated ,which can cause extreme pain.

3) Blood clot –

Occasionally ,a clot can form in a haemorrhoid ( Thrombosed haemorrhoid). Although not dangerous ,it can be extremely painful and sometimes need to be lanced and drained.

Prevention –

The best way to prevent haemorrhoids | piles is to keep your stools soft ,so they pass easily. Try to follow these tips –

• Eat high -fiber foods like fruits , vegetables and whole grains.

• Drink plenty of fluids minimum of 6-8 glasses of water.

• Consider fiber suppliments like psyllium ,methy cellulose .

• Don’t strain while defaecating.

• Go as soon as you feel the urge.

• Exercise Regularly.

• Avoid long period of sitting in toilet.

Diagnosis –

Doctor can diagnose external haemorrhoid by normal external visual inspection of haemorrhoid. Diagnosing internal haemorrhoid might include examination of anal canal and rectum.

• Digital examination with gloved lubricated finger.

• Visual inspection by an anoscope ,proctoscope or sigmoidoscope.

Treatment –

1) Home Treatment –

Mild pain, swelling and inflammation of Haemorrhoids | Piles can be relieved by home treatments like –

• Eat high fiber foods.

• Use topical treatments like haemorrhoid cream or suppository.

• Soak regularly in warm bath or sitz bath with eposm salt in warm water.

• Take oral pain relievers like acetaminophen, ibuprofen.

2) External Haemorrhoid Thrombectomy –

If a painful blood clot has formed within an external haemorrhoid , your doctor can remove the haemorrhoid under local anaesthesia which can provide prompt relief.

3) Minimally Invasive Procedures –

• Rubber band ligation

• Injection ( Sclerotherapy)

• Coagulation ( Infrared ,laser or Bipolar )

4) Surgical Procedures –

• Haemorrhoidectomy

• Haemorrhoid Stapling

Ayurvedic Perspective & Treatment –

In Ayurvedic terminology Haemorrhoids | Piles is known as Arsha . It is mainly associated with Vata dosha equilibrium. Particularly it is Apanavata responsible for the movement and separation of urine ,stools and sexual activity. If Apanavata get out of balance unborn waste begins to accumulate in the body and varicose veins are formed inside the anal canal.

1) Home Remedies –

• Use of Triphla Powder to remove constipation.

• Use of Heeng (Asoefoetida) to improve digestion and it also helps to cure haemorroids.

• Use of Castor oil as it has Antioxidant , antifungal,antibacterial and anti-inflammatory properties.

• Take light and fibrous diet in dinner.

• Salad should be included in your full day diet parts especially cucumber and carrot.

• Drink lots of water.

2) Medication –

Mostly minor haemorrhoid can be treated with medication only. No other procedures are needed unless haemorrhoids are more severe .Some Ayurvedic Medications that can be used –

• Arshkalpa vati

• Triphala Gugglu

• Nagkesara Churna

• Abhyarhishta

• Kasisadi tail for external application

3) Ksharasutra Treatment –

In this treatment ligation of external and internal haemorrhoid is to be done ,as a result of which blood supply to the haemorrhoid get restricted and they shed down by theirselves.

4) Agnikarma or cauterization –

This is a procedure where haemorrhoid blood supply get to restrict by cauterization.

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