Thursday, 31 July 2014

‘Not all blood in stools is piles’


           

Blood in the stool can be quite frightening, whether you feel pain or not. The issue is most people believe that all such bleeding occurs due to piles. They either don’t do anything about it or opt for natural remedies and delay proper diagnosis and treatment. What they are not aware about is that a myriad of reasons ranging from anal fissures to cancer of the GI tract. Our expert Dr Vijaykumar Malladi, renowned laparoscopic and general surgeon says, ‘I have a number of patients who come to me with this symptom and say that they have piles. I have to explain to them that it is me who has to diagnose the problem and not them. In a large number of cases these people are diagnosed with fissures rather than piles.’

Firstly, one needs to understand that blood in a person’s stools could be from within the digestive tract (mainly bleeding in the rectum and anus or higher in the digestive tract like the colon). There could be a number of reasons for  bleeding within the digestive tract including:

Anal fissures: Is a cut or wound in the anus caused mainly due to passing hard stools, and in some rare cases due to frequent loose motions. The discerning characteristic of this condition is that the blood is usually bright red and is seen as either blood streaked stools or blood after the person has passed motion. Dr Malladi says, ‘ Fissures cause pain while passing motion. Patients describe it as a burning and pinching pain similar to when one gets cut or hurt repeatedly in the same place.’

Hemorrhoids or Piles: According to Dr Malladi  ‘The other common reason is piles, where there are certain blood vessels in the anal region that swell up, and then lead to bleeding. Within the digestive lining of the stomach there are a number of diverticuli or folds in the wall of the stomach. These walls are well supplied with blood vessels. In piles one section near the rectum or anus becomes swollen and ruptures leading to bleeding in the stool. In many people this is an intermittent problem and resolves itself.’ Patients with piles will generally not feel too much pain in the early stages. It is only when the condition worsens does the pain start. There are three degrees of piles. A first degree is where the swelling and bleeding is minimal. The second degree is where the piles temporarily protrude outside the anus, but retracts on its own. In the third degree or a prolapsed piles, it hangs outside the anus and does not retract.  To diagnose the extent of the condition a doctor will use something called a probe, with a camera fitted at the end. This helps the doctor look at the exact extent to which the disease has progressed. 

According to our expert Dr N.K Sharma, renowned naturopath, ‘Piles must be treated naturally. It is extremely important that one must correctly identify the exact source of the problem and not treat it superficially. Most doctors would recommend surgery, but it is my suggestion that surgery can lead to further problems.’As a remedy, I would suggest that the patient stop eating a high a protein diet. Avoid pulses, eggs, paneer and non-vegetarian foods.’

Peptic ulcers: Basically holes in the digestive tract, they are caused by infection by bacteria like Helicobacter pylori or excessive production of stomach acids. Constant irritation to this area causes bleeding, which is then seen in stools. In the case of peptic ulcers, the blood may not be visible to the naked eye. In such a case your doctor may prescribe a test called the faecal occult, which identifies the presence of small amounts of blood in feces
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Colitis: As the name indicates, it is an infection within the colon (part of the intestine). This leads to inflammation and bleeding once faeces passes through the region. Tarry stools along with abdominal pain and constipation are hallmarks of this condition. Often one might experience symptoms like incomplete evacuation or recurrent constipation.

Inflammatory bowel syndrome: This is a condition where the inner lining of the bowel (lower digestive tract) becomes inflamed (red and swollen). In some cases this may be due to an allergy or infection. Although the condition might get resolved on its own, when this condition becomes worse it leads to bleeding.

Diverticular disease: This is a condition that occurs most commonly in older people, or those that take laxatives regularly. Diverticulitis is a condition where the lining of the intestine gets infected, leading to bleeding. In such a case the patient will notice black or ‘tarry’ stools. This is because the excess acids change the color of the blood which then gets mixed with faeces.

Polyps: Are small outgrowths along the digestive tracts. They can be either cancerous or benign. Since these outgrowths are heavily laden with blood vessels, when they rupture, it leads to bleeding internally.

Stomach Cancer: Dr Malladi says, ‘Most people ignore bleeding in the stomach, but when it is associated with symptoms like severe abdominal pain, passing motion twice or lesser than that in a week, loss of appetite and mild nausea, the patient should immediately visit a physician.’ Stomach cancers are more common than most people might think, and detecting its presence early is extremely important for effective treatment.

The right diagnosis is key

Initially a doctor will assess the patient’s symptoms to decide what type of diagnostic techniques should be used. The patient might have to get a stool test done. While this can identify the presence of blood in stools, it cannot indicate the exact area of the bleed for which one may be asked to undergo tests where the doctor inserts a probe via the anus (colonoscopy) or the mouth. In some cases, the stomach contents of the patients are emptied and tested for the presence of blood. If the doctor suspects  peptic ulcer caused by infection, blood tests may be advised.

Treatment options vary as per the diagnosis

According to Dr Malladi, ‘Treatment for fissures is usually very simple and requires only medication. It can be easily cured and does not require surgery. In the case of piles, it is a common belief that a person with piles must have surgery. That is not at all true. Only once the doctor determines the extent to which the condition has progressed can he/she prescribes either a course of medication or surgery. It is very important to get a proper medical diagnosis in such cases.’

Lastly, Dr Malladi adds, ‘If you see blood in your stools, please make it a point to visit a good doctor who can correctly identify the cause of the bleed. Do not go to quacks or clinics that offer a painless remedy for piles because that can cause more trouble than good. Always remember that not all blood in stools is piles.’

Source:  http://www.thehealthsite.com/diseases-conditions/not-all-blood-in-stools-is-piles/

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