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Do you suffer from piles?
Kanchan Maslekar
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February 21, 2007

Lack of exercise, junk fund, a sedentary lifestyle -- these three factors have seen more and more young adults affected with piles.

The good news is -- it can be treated.

First, though, let's understand what this health problem is all about.

What are piles

In general terms, 'piles' is a condition where the veins in the anal region get swollen and start to bleed.

"Piles are abnormally enlarged and dilated blood vessels (mainly veins) around the back passage or anus. They are also known as haemorrhoids," explains Dr Mrunal Ketkar, associate professor, department of surgery, Bharati Vidyapeeth, Pune.

Piles are not to be confused with fissures. "Most patients who come to us complaining of anal bleeding think they have piles; in many cases, though, bleeding could involve 'fissures' which is a temporary injury to the anal passage caused by hard stools," she says.

Types of piles

There are two types of piles -- internal and external.

As the name suggests, internal piles occur inside the anus and cause the release of blood.

External piles can be seen and felt on the outside of the anus. Though they are painful, they do not bleed as much.

The most common form of piles is intro-external types -- a combination of internal and external piles.

Stages of piles

Piles develop in different stages (called grades in medicinal terms).

~ First-grade piles develop inside the rectum or anal canal.

~ Second-grade piles protrude from the anus when the bowels are opened, but return inwards of their own accord afterwards.

~ Third-grade piles are similar, but only return inside when pushed back physically.

~ Fourth-grade piles hang permanently outside the anus.

Most piles infections are of the second- and third-grade variety.

Symptoms

~ Chronic constipation

The pressure exerted to evacuate the constipated bowels affects the surrounding veins. This leads to piles.

~ Bleeding

Says Dr Mrunal, "The earliest symptom is often the fresh, red blood from the anal passage when the bowels are opened."

Bleeding from the anus is more common with internal than external haemorrhoids. It can occur before, during or after defecation, she adds. Patients suffering from piles often have a feeling of incomplete evacuation because of the protrusion.

Causes

Piles take time to develop and hence are found very rarely in children; its most common causes are consistent bad diet and bad lifestyle habits.

~ Diet

Wrong diet habits and a sedentary lifestyle are main causes of piles, says Dr Mrunal.

The increased Westernisation of our diet, which now includes more bread, colas and junk food, has an adverse effect on our bowel movement. The lack of vegetables and fruits, raw salads, etc, in our regular diet and cups and cups of tea or coffee are fatal for regular bowel movement.

~ Lack of exercise

Combine this with long working hours, sitting for long hours, lack of exercise or physical activity and you are most likely to suffer from irregular bowel movement.

~ Stress

Bowel movement is often related to mental well-being. Stress can have an adverse effect on your regular bowel movement, resulting in constipation. This can develop into piles.

~ Wrong bowel habits

Sometimes, people have the habit of straining when passing stools -- ie, applying more pressure then necessary -- which leads to piles.

With everyone chasing the clock these days, defection is many times according to the time available, resulting in incomplete or even postponed bowel movement.

~ Pregnancy

The weight of the foetus on the abdomen and the increased blood flow, as well as the effect of hormones on the blood vessels, can be responsible for development of piles.

~ Childbirth

Pushing during childbirth increases pressure in the veins.

Treatment and prevention

Dr Mrunal stresses on the need to inculcate the right bowel habits during childhood itself; this goes a long way in avoiding piles in the long run.

The best way to clear up existing piles is to avoid constipation. By having regular bowel movements, stools pass easily and do not put pressure on the blood vessels in the anal area. Slowly, the condition improves.

Also, the stools should be soft, so they pass easily, thus decreasing pressure and strain.

One should try to empty bowels as soon as possible, when the urge occurs.

Diet control

Most piles cases can be cured by diet control. According to Dr Mrunal, increased fibre in the diet helps reduce constipation and straining by producing stools that are softer and easier to pass.

She advises the following important changes to diet:

Diet changes helped Sanjana Mane, 30, a software manager with an IT firm in Pune. "I was a coffee addict and it resulted in acute constipation and in due course, I was affected by piles as well. It was so painful, it was getting impossible to sit on my chair for work. I was restless through out the day."

Severe diet control and regular intake of water throughout the day is what cured the problem for her.

~ Exercise

"Exercise for at least 30 minutes a day, this will aid your bowel movement," says Dr Mrunal. 

Other treatments

Most piles cases in the first stage can be prevented by diet control. If that does not happen, one might need to go for any of the following treatments.

~ 'Rubber band ligation' is a procedure in which a small rubber band is placed at the base of the internal pile. The rubber band cuts off the blood supply to the haemorrhoid and it falls off in about four to five days.

~ 'Infrared coagulation' uses an infrared light source to coagulate the dilated veins of the haemorrhoid. This causes the haemorrhoid to shrink since blood does not flow through the coagulated blood vessels.

~ 'Injection sclerotherapy' involves injecting an irritating chemical into the haemorrhoid which causes inflammation and closure of the veins, thereby shrinking the haemorrhoid.

~ In cases of large haemorrhoids, one may have to go for a surgery known as haemorrhoidectomy (removal of the haemorrhoid).

Mahesh Ganeshan, 29, a media developer recalls, "I was struggling with irregular bowel movements for almost two years and this resulted in piles." 

When Mahesh began passing blood through his stool, he consulted a doctor. "We tried to control the problem through a diet regime but unfortunately it did not work. So, the doctor advised a haemorhoitdectomy.

Mahesh realised the importance of healthy diet and exercise, after the operation. 

So, for all of you on your way to developing the problem, it is best to take preventive measures by improving your own diet and lifestyle.

* names changed to protect identity


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