Piles - Hemorrhoids

What are Piles/Hemorrhoids? 
Piles (also known as Hemorrhoids) are enlarged and engorged blood vessels in or around the anal passage (or anus). These may be associated with pain, bleeding, itching and a feeling of a lump hanging from the anus. Piles are swollen but normally present blood vessels in and around the anus and lower rectum that stretch under pressure, similar to varicose veins in the legs. The increased pressure and swelling may result in strain, pain, bleeding and in some cases also lead to movement in the bowel. Contributing factors include pregnancy, ageing, and chronic constipation or diarrhoea. Piles are either inside the anus (internal) or under the skin around the anus (external). Piles are usually not dangerous or life threatening. In most cases, hemorrhoidal symptoms go away within a few days.  

How would I know if I have Piles? 
The most common symptom of piles (internal hemorrhoids) is bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding, or prolapsed, haemorrhoid. Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid or Piles. Common Symptoms of Piles include Itching around the Anus, Pain, sometimes very severe, especially during bowel movements and whilst sitting for long periods. Piles usually show up as a lump or lumps near the anus. This is often associated with a feeling of bulge. What follows is blood loss from the anus, bright red in color, usually seen when wiping following a bowel movement it can also be in the stool. 

How are Piles (hemorrhoids) diagnosed?  
Most episodes of trouble from hemorrhoids come and go quite quickly. If simple measures do not help or the problem is lasting, keeps returning or worsening, then you should see your doctor, especially if you have any other associated symptoms eg weight loss; change of bowel habit; slime (mucus) in the motions; darker, changed blood mixed in with the stools. On examination your doctor will usually be able to make a diagnosis quickly. Your doctor will ask a few questions and is likely to examine you and may want to feel inside the anus with a gloved finger. Sometimes he will look inside with a metal instrument. Sometimes a sigmoidoscopy (a small camera put into the lower end of the bowel and rectum) may be required. This enables him or her to confirm the diagnosis, and to rule out other, more serious problems such as cancer.     What Causes Piles ?   Hemorrhoids are very common. They are said to be more common in countries where the diet has traditionally been more processed and low in fibre. The main contributory causes are those things that cause us to raise the pressure in the abdomen. This causes the blood vessels to swell and become engorged. The people most at risk of developing hemorrhoids are those who have more causes for raised abdominal pressure, such as:  

• Those chronically straining with constipation.

• After or during pregnancy. Here, the baby may actually press on the main blood vessel that returns blood to the heart (the vena cava).

• Overweight people.

• People with heavy lifting jobs.

• Diseases such as liver cirrhosis.

What is the Treatment for Piles? 

It is usually best, with hemorrhoids, to get by with the least treatment possible, as even after the most extensive treatments they may still return. Many times they will settle down over a matter of days without any treatment. Cream or suppositories (bullet-shaped tablets to be inserted into the anus) may be bought over the counter, or your doctor may prescribe one. These soothe itching and pain, and cause swelling and bleeding to diminish. Cold compresses, even ice can be helpful. There are a number of products available, such as corticosteroid and lignocaine products from your pharmacy that can sooth the itching and pain, diminish the swelling and stop bleeding. These come in suppository form, as creams or lotions. Witch hazel on cotton wool, applied to the outer anus can help with itching. Cold compresses and warm baths can also help relieve symptoms. Using stool softeners, eating a high fiber diet and drinking plenty of fluids to avoid constipation should also improve your discomfort.   If these treatments for your hemorrhoids do not work your doctor may advise one of a number of surgical procedures that are available- Tying a rubber band around the piles until they shrivel and disappear, injecting a fluid into the piles (sclerotherapy), or surgically cutting them off (haemorrhoidectomy).  

How can I Prevent Piles from coming on?
Piles are very common, and may occur anyway, but some useful aspects of prevention are: 

Avoid becoming overweight, and lose weight if you are.
Eat a high fibre diet.
Exercise regularly.   

Prevention of a recurrence of hemorrhoids is aimed at changing conditions associated with the pressure and straining of constipation. Doctors will often recommend increasing fibre in the diet. Eating the right amount of fibre results in softer, bulkier stools. A softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Eliminating straining also helps prevent the hemorrhoids from protruding.  

Should I be seeing a Doctor for Piles?
Not necessarily. As mentioned above quite often Piles will disappear by itself without causing too much pain and damage. Or you might be able to remedy the problem yourself with some Over the Counter Drug or some product you buy off some online store. However, You SHOULD Go see your doctor if: 

the piles get worse and keep returning.
you have unexplained weight loss.
you suffer constant fatigue. (This may be a result of regular blood loss and anaemia or signs of an undiagnosed disease process)
you experience a change in your bowel habits.
you get mucus in your bowel movements.
you have dark colored blood in your stools (faeces).
you you have lost a significant amount of blood and feel dizzy and light headed. A call to emergency services should be considered when any large amount of blood is lost.  

How common are Piles?
Piles (Hemorrhoids) are very common in men and women. About half the population have Piles by age of 50. Piles are also common among pregnant women. The pressure of the foetus in the abdomen, as well as hormonal changes, cause the hemorrhoidal vessels to enlarge. These vessels are also placed under severe pressure during childbirth. For most women, however, hemorrhoids caused by pregnancy are a temporary problem.