Do you suffer from Haemorrhoids(piles) ?

What are haemorrhoids ?

Haemorrhoids are bundle of veins in the rectum, which get swollen and bleed. Haemorrhoids may form on the inside or just at the opening of the anal canal. Accordingly, they are called internal or external haemorrhoids. 

What cause them ?

Haemorrhoids, which are normal structures present at the upper part of the anal canal are supported by two tissues: anchoring tissue & Park's ligament. Constant pressure on these tissues (e.g. straining when constipated or due to age) tends to degenerate the tissues. As a result the haemorrhoids tend to distend. Because of lack of support the haemorrhoids become swollen (like a balloon filled with water) and are now sensitive to injury. Constant rubbing by the hard faecal matter leads to bursting of the capillaries and thus leads to bleeding. As the condition progresses the connective tissue ruptures and the haemorrhoids become permanently protruded.

Symptoms of haemorrhoids:

• bleeding while passing the stool
• itching & soreness around anus
• lump feeling around anus
• discharge
• pain

What are the factors leading to haemorrhoids ?

• Constipation: Straining during constipation puts pressure on the veins which either bleed or protrude outside the rectum.
• Pregnancy: Pregnancy is a common cause for haemorrhoids in women. There is increased pressure in the veins due to the enlarging womb and increased blood volume.
• Standing or sitting for a long periods: People who tend to stand (e.g. teachers, factory workers) or sit (e.g. office workers) for a long periods tend to accumulate blood in the veins, which can lead to haemorrhoids.
• Overweight: Being overweight puts extra pressure on the haemorrhoidal veins.

Grades of haemorrhoids:

Grade 1:

• Symptoms: Bleeding, discomfort
• Signs: Haemorrhoids visible by proctoscopy, which may protrude while straining but which are not prolapsed.

Grade 2:

• Symptoms: Bleeding, discomfort, itching
• Signs: Prolapse visible at anal opening during straining efforts, but with spontaneous return to normal place when straining ends.

Grade 3:

• Symptoms: Bleeding, discomfort, itching, soiling
• Signs: Prolapse requires manual replacement with finger.

Grade 4:

• Symptoms: Bleeding, pain, soiling, discharge pruritus
• Signs: Irreducible prolapse

What is the cause of concern in haemorrhoids ?

Haemorrhoids are very common. One out of four adults suffer from this condition. In fact, half the population over 50 years of age suffer from haemorrhoids. Most haemorrhoids attacks are self curing and symptoms disappears within 7 to 10 days. As the condition worsens, one may suffer 4 to 6 episodes in a year. This cause considerable blood loss and may lead to anaemia, specially in women. Sometimes, haemorrhoids protrude out of the anal canal and in such cases, doctors might recommend surgery.

What is the treatment ?

• Regularise bowel movement: Increase fibre in your diet and drink plenty of water. This will help relieve constipation. Bulk laxatives like isapghol, bran are also helpful to relieve constipation if diet does not work.
• Medication: Flavanoid derivatives bring about rapid and marked relief in acute episodes and chronic symptomatology of haemorrhoids along with anti-inflammatory & hemostatic medication. Analgesics, antipruritic drugs & local soothing & anaesthetic agents may be used to relieve acute symptoms.
• Surgery: When the haemorrhoids are prolapsed, they require surgery. Band ligation, sclerotherapy, coagulation, haemorrhoidectomy are some of the surgical methods used.

How to prevent haemorrhoids ?

• Drink lots of water, at least 1.5 to 2 litres daily.
• Eat a balanced diet: food rich in fibres, cereals, fruits and vegetables.
• Take regular exercise such as walking, jogging, running, swimming, cycling etc.
• Avoid spicy food, alcohol, excessive tea or coffee, tobacco.