Piles: Treatment, symptoms, advice and help
Piles often termed as ‘haemorrhoids’ are swellings of the normal tissue present in and around the region of the anus. These tissues are highly vascular and consist of several blood vessels. This disorder occurs when these blood vessels get congested and swollen. The most prominent symptom of piles is bleeding during defaecation.
Piles: Incidence, age and sex
This disorder commonly occurs in the general population and both genders are affected equally. Though the condition is more common in the elderly age group, it has also been observed in young and middle aged individuals. Obese individuals or pregnant women are highly prone to get piles.
Signs and symptoms of piles: Diagnosis
The most significant clinical feature of piles is painless bleeding during passage of stools. The affected individual may complain of fresh blood on toilet paper. Piles is mostly associated with a chronic history of constipation. Other features like increased mucus discharge and itching around anal region may also be experienced. As the condition advances, the blood vessels get heavier due to congestion and hence the underlying musculature along with veins tends to hang down through the anal opening. This swollen mass usually hangs through anal opening during excessive straining and reduces back spontaneously; however in severe cases, the mass may not reduce.
The diagnosis of piles is made upon complete medical history and physical examination. Proctoscopy may be considered, wherein an instrument is inserted into anal region for visualization of piles.
Causes and prevention of piles
There are multiple factors leading to this disorder. A prolonged history of constipation, irregular bowel habits like alternating constipation or diarrhoea and excessive straining may lead to increased intra abdominal pressure which may result in development of piles. Preventive measures include dietary changes and regular exercise.
The common complications of piles are profuse bleeding and secondary infection of piles. In rare cases, the piles cannot be reduced and may get strangulated leading to gangrene (death of tissue due to lack of blood supply). This is a surgical emergency and must immediately be handled.
Management of piles is usually done in a conservative manner with medications and rarely surgery is indicated. Such medications aim at providing symptomatic relief to the patient. Laxatives and high fibre diet is advised for relieving constipation, if present. Local application of pain-relieving ointments or creams may also be prescribed. The affected individual is encouraged to have plenty of fruits and vegetables in his or her diet, increase the intake of fluid for softening of stools. Regular physical exercise like walking or jogging is recommended. Surgical intervention may be required in individuals who do not respond to the medical line of treatment and manifest persistent or painful piles. Surgical techniques largely depend upon the stage of the disease. Sclerotherapy is one of the surgical techniques wherein sclerosing agents are injected into the congested blood vessels. Other operative procedures include rubber band ligation and cautery methods. Haemorrhoidectomy (excision of piles) may be
considered in severe cases. Generally most cases of piles, suffice with conservative line of treatment while a few individuals may require surgical treatment for adequate elimination of piles.