Most people do not have the correct conception about piles (also called hemorrhoids). It’s only when the pain becomes unbearable accompanied with loss of blood, a person seeks advice from family members or close friends. Visiting a doctor for appropriate treatment is probably the last option that people choose.
In this article, we highlight the importance of seeking medical help for piles at the right time. We also discuss what exactly piles are, and its causes, symptoms and treatment with inputs from our expert Dr Ajit Naniksingh Kukreja, laparoscopic GI & colorectal surgeon.
What are piles? When do they occur?
Your anal wall and rectum is protected by smooth muscles and connective tissue. The smooth muscles are lined by blood vessels called hemorrhoids. But pathologically, the term ‘hemorrhoids’ is used for lumps of coagulated blood caused due to inflammation and swelling when pressure is exerted on these blood vessels.
‘Hemorrhoids occur more commonly in young and middle-aged adults than in older adults. The prevalence of hemorrhoids increases with age, with a peak in persons aged 45-65 years, though we have operated cases as young as 13 years and as old as 85 years’, says Dr Kukreja.
What causes piles?
Dr Kukreja says, ‘The exact reason of hemorrhoidal symptoms is poorly understood. But there are a lot of factors that contribute to piles other than constipation. The prevalence of piles is found in around 4% of the population in US, but it is mentioned in literature that half the population above fifty will have symptoms of piles some time in their life. Contributing factors include:
- Straining
- Obesity
- Pregnancy
- Chronic cough
- Pelvic floor dysfunction
- Accumulation of fluid in the abdominal cavity (ascites)
- Low fiber intake leading to the formation of hard stools and excessive straining
- Behavioral features such as prolonged time sitting on the toilet
- Diarrhea and frequent bowel movements have the same effect as constipation
- Ageing causes natural changes in supportive tissue making them less supportive
- Elevated sphincter pressure which impairs venous drainage’
When should a person suffering from piles see a doctor?
Dr Kukreja says ‘Many patients are too embarrassed to ever seek treatment. But people should definitely see a doctor if the pain becomes unbearable, if there is persistent bleeding through the anal opening, if the hemorrhoids are irreducible and if they obstruct the anal passage due to blood clot.’
What happens if treatment is delayed?
‘Hemorrhoids can cause a lot of complications if they’re not treated at the right time. These include:
- Excessive bleeding leading to anaemia
- Infection
- Anal fistula
- Gangrene
- Rarely incontinence’
What are the treatment options?
In most cases, piles get cured on their own with the help of dietary and lifestyle changes without the need for any treatment. High fibre intake by including cereals, fibrous fruits and vegetables in the diet helps in making the stool softer and relieving strain due to constipation.
Additionally, there are a few over-the-counter (OTC) medications in the form of creams and gels which help to reduce swelling and inflammation in the anal region.
Surgical intervention may be required in extreme cases. ‘There have been maximum advances in management of hemorrhoids ranging from stappled hemorrhoidectomy, radiofrequency, Doppler guided hemorrhoidal artery ligation and lasers.’ mentions Dr. Kukreja.
In hemorrhoidectomy, the extra tissue that causes bleeding is removed surgically. Hemorrhoid stapling is done when blood flow to the tissue of hemorrhoid is blocked. This procedure is less painful than hemorrhoidectomy.
Can haemorrhoid surgery cause loss of bowel control? What can be done in such cases?
‘This is a myth and rarely may occur if the sphincter fibers (muscles that control opening of anal movement) are damaged during procedures by quacks, in most cases if detected early the sphincter can be repaired. In case the sphincter is damaged to irreparable stages the patient might need artificial anal sphincters’, highlights Dr Kukreja.
Source: http://www.thehealthsite.com/diseases-conditions/piles-causes-symptoms-complications-and-treatment/
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