Tackling Haemorrhoids
Tackling Haemorrhoids
Piles, a grave pathological condition, can affect anyone. But with an appropriate treatment and a change in lifestyle, the condition can be effectively treated
By Dr Sandeep Kumar
Piles, also known ashaemorrhoids, are inflamed veins and muscles around your anus or in your anal canal. The anal canal is a short, muscular tube with blood vessels that connects your rectum (back passage) with your anus. Piles develop when the anal canal becomes swollen with clumps and cushions of tissues possibly as a result of straining on the toilet. Sometimes, piles can be painful and bleed if they become damaged.
In the majority of cases, piles are effectively treated with over-the-counter medications, a good fluid intake and by following a diet high in fibre. However, in severecases, the piles may have to be surgically removed.
Causes
Piles are common in people with chronic digestive disturbances – especially constipation.Constipation is frequently caused by improper diet, lack of exercise, inadequate intake of water, and stress. Other contributors include laxative abuse, irritable bowel syndrome, and hypothyroidism.
The condition is also observed in the elderly people and during pregnancy period. If a lady is pregnant, the additional pressure that her growing baby places on her uterus can result in piles.They may also develop due to changes in the hormones in the body and the increased pressure in your abdomen (tummy), although doctors aren’t sure.
Childbirth can increase the problem, but fortunately, most haemorrhoids caused by pregnancy get resolved after delivery.Another common cause of piles is obesity, because when any one is overweight, his/her body simply does not have enough force to generate proper elimination of the waste fluids and matter through intestine.
Moreover, due to the lack of proper balanced diet the incidence of piles is increasing day by day.
Symptoms
In most cases, piles are not serious and go away on their own after a few days. An individual with piles may experience the symptoms like a hard lump around the anus. It consists of coagulated blood known as thrombosed external haemorrhoid. Accompanied with a feeling that the bowels are still full, this can become painful after going to the toilet. Itchiness around the anus, redness and soreness around the area of the anus, bright red blood after a bowel movement, mucus discharge when emptying the bowels and pain while defecating are some of the common symptoms of a thrombosed external haemorrhoid.
Piles can be at any age, but they are most common in people aged between 45 and 65. So it is difficult to know exactly how many people get piles. According to the National Institute of Diabetes and Digestive and Kidney Diseases, both men and women could have piles by the age of 50.
Depending on your toilet habits, the problem can become severe thereby resulting in additional irritation, bleeding and itching. If you suffer from haemorrhoids, it’s important not to strain from a bowel movement. Excessive rubbing or cleaning of the area can also exacerbate your problem. Other conditions with symptoms which can mimic those of haemorrhoids are anal abscesses, anal fissures and fistulas, and non-specific itching or irritation (commonly termed pruritus ani).
Treatment
Treatments can help significantly reduce the discomfort and itching that many patients experience. Water is the best drink and the patient may be advised to increase his/her water consumption. Some experts say too much caffeine is not good.
A good doctor will initially recommend some lifestyle changes like diet and body weight. A change in diet can help keep the stools regular and soft. This involves eating more fibre, such as fruit and vegetables, or switching your cereal breakfast to bran.
Nowadays, stapled haemorrhoidectomy is being successfully used for surgical technique for treating haemorrhoids. It is the treatment of choice for third-degree haemorrhoids (haemorrhoids that protrude with straining and can be seen on physical exam outside the anal verge. Persistent or intermittent manual reduction is necessary). Stapled haemorrhoidectomy is a misnomer since the surgery does not remove the haemorrhoids but, rather, the abnormally lax and expanded haemorrhoidal supporting tissue that has allowed the haemorrhoids to prolapse downward.
The technique does not involve any stitches, is painless and needs no longer stay in hospital. For stapled haemorrhoidectomy, a circular, hollow tube is inserted into the anal canal. Through this tube, a suture (a long thread) is placed, actually woven, circumferentially within the anal canal above the internal haemorrhoids. The ends of the suture are brought out of the anus through the hollow tube.
Stapled haemorrhoidectomy, although it can be used to treat second degree haemorrhoids (haemorrhoids that extend outside the anus after a bowel movement or straining, but return inside by themselves), usually is reserved for higher grades of haemorrhoids – third and fourth degree. If the external haemorrhoids are large, a standard surgical haemorrhoidectomy may need to be done to remove both the internal and external haemorrhoids.
Steps to prevent constipation
Eat fibre-rich foods. Vegetables are a great source of fibre. Ideally, you’d want to eat those recommended for your individualnutritional type. Consuming a wide variety of vegetable fibre will provide the bulk needed for your stool to pass comfortably through your intestines.
If you need extra fibre, the doctors suggest whole organic flaxseeds. Grind them in a coffee grinder and add one or two tablespoons to your food. You can also try organic psyllium, which helps alleviate both constipation and diarrhoea.
They recommend avoiding any type of non-organic psyllium, such as Metamucil. Proceed slowly if you are not used to getting much fibre in your diet, as you may experience some bloating and gas as your digestive system gets accustomed to the added fibre.
Consider eating fresh oranges for the flavonoids they contain. Flavonoids are powerful photochemical, which promote the health of your veins. You might also consider adding coconut oil to your diet. South Pacific tropical islanders are known to consume at least half the fat in their diets from coconuts, with the result that many typical Western illnesses and conditions – including haemorrhoids – are uncommon.
Drink plenty of pure water either clean spring water or water filtered by reverse osmosis. Use your thirst and the colour of your urine as guides for whether you’re adequately hydrated. Your urine should be a light yellow colour. If it is dark yellow, then it is quite likely that you are not drinking enough water. (A bright yellow colour is usually the result of vitamin B2, found in most multi-vitamins.)
Adequate fibre and water create softer stools. A softer stool moves more easily through your colon and lessens the need for straining.Exercise regularly to keep your digestive tract stimulated.Take a high-quality probiotic. Balancing your gut bacteria will not only help your constipation, but your overall health as well.
Practice Good Toilet Habits
Allow your body to work naturally by using the toilet whenever you feel the urge to have a bowel movement. Go as soon as you feel the need – delaying can cause or aggravate constipation.
Don’t sit on the toilet for prolonged periods. This increases pressure on your rectum. Limit time on the toilet to three to five minutes per sitting. If necessary, get up, walk around or otherwise distract yourself and wait for the urge to return before returning to the toilet. You can also use a small footstool while seated on the toilet to elevate your legs and relieve pressure on swollen tissue.
Don’t strain excessively to have a bowel movement. Exert gentle pressure only, for no more than 30 seconds per attempt, focus on using your abdominal and pelvic muscles.Don’t aggressively rub the area with toilet paper or other types of wipes, as this will further irritate and inflame your skin.If possible, clean the area in a bath or shower without using soap – soap is an irritant. Make sure to rinse the area well and gently pat dry with a soft towel.
(The author is Senior Consultant,Surgery, Sri Balaji Action Medical Institute, New Delhi)