It’s a Pile of Trouble
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Lately a number of people have approached me about what many think of as an embarrassing topic. Except for the very unabashed the conversation is always conducted in hushed tones. So what is this great problem afflicting so many of us? Spice delves deep to bring you the lowdown on haemerhoids.
Haemorrhoids, AKA piles are enlarged and swollen blood vessels in or around the lower rectum or anus. They are no more than swollen and dilated blood engorged veins caused usually when straining to pass stools, but other causes are chronic constipation, diarrhoea, aging, overweight, lifting heavy objects, pregnancy and anal sex. Sitting on a cold surface or having a sedentary occupation does not cause piles. Haemerhoids are very common, by the age of 50, 50 percent of us will have one or more haemorrhoids.
Piles can cause temporary discomfort and itching, a feeling of incomplete emptying of the bowel, a swelling around the anus, an ache or pain, and bleeding. Bright red blood may be seen to streak stools or be seen on toilet paper or in the toilet pan.
Piles are usually not dangerous or life threatening but bleeding piles may cause anaemia or in very rare cases death. There are two types: internal and external haemerhoids, internal haemerhoids are the more common.
Internal piles are divided into four classes with one being the least troublesome and can not been seen or felt from outside the anus to four where the piles permanently protrude outside the anus and can not be pushed back inside. There may be discomfort, itching, pain and bleeding. However, if you experience any sudden and unexplained bleeding it is vital that you consult your doctor you should also see him or her if the piles are very painful see your doctor.
External haemorrhoids are small lumps that appear outside the anus they do not often cause problems but if a blood clot forms in them they can be very painful and may require immediate treatment.
Piles are diagnosed usually by simply feeling for them, the doctor inserts a gloved finger and feels for any abnormalities. The examination may also require the insertion of a tube called a proctoscope to delve deeper into the anus and rectum and to clearly see the piles (or other abnormalities like colo-rectal cancer). Occasionally your doctor may suggest doing a colonoscopy to examine the total length of the large bowel.
Haemerhoids usually settle down over a few days and treatment is not necessary. But it the symptoms persist then special creams or suppositories can be used to reduce the symptoms. Warm sitz baths or cold compresses may be effective too.
Preventing the stools from hardening is important also, empty your bowels as soon as you fee the urge. Sitting on the toilet for long periods is bad as it distends the venous bed putting pressure on the veins; so don’t read the paper, answer the phone, play a game on your phone or watch TV as you are more likely to sit there for longer than five minutes and this contributes to the development of piles.
However sometimes internal intervention may be required.
There are many techniques to treat haemorrhoids but the most commonly used one is placing a tight rubber band around the base of the hemorrhoid, this cuts off its blood supply and in a few days the haemorrhoid falls off leaving only a small scar. Banding is a painless easy and quick treatment that can be done in the out patient department. Up to three haemorrhoids can be treated at one sitting and it is painless as the part of the rectum where haemorrhoids occur has very few pain sensing nerves. Banding is 80% successful at the first attempt.
For large internal haemorrhoids that can not be treated with banding then a haemorrhoidectomy is performed. This is done under a general anaesthetic to cut off the blood supply, leaving a raw area of bowel which heals in about four weeks. Haemorrhoidectomies are usually successful.
Other, alternative methods of treating haemorrhoids include, injecting them with a solution that causes blood to clot, freezing, and laser treatment. Complications from haemorrhoid surgery are rare.
Preventing haemorrhoids includes drinking 1-2 liters of fluid daily, this can include tea but not coffee (as this heightens skin sensitivity), fruit juices etc, but not alcohol. Eating more fruit and high fibre vegetables, taking exercise will all help to soften stools and encourage bowel movements so preventing haemorrhoids.