Piles, also called haemorrhoids, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control.
They become a disease when swollen or inflamed; the unqualified term "hemorrhoid" is often used to mean the disease. The signs and symptoms of
hemorrhoids depend on the type present. Internal hemorrhoids usually present with painless, bright red rectal bleeding when defecating. External
hemorrhoids often result in pain and swelling in the area of the anus. If bleeding occurs it is usually darker. Symptoms frequently get better after
a few days. A skin tag may remain following heal thing of an external hemorrhoid. While the exact cause of hemorrhoids remains unknown, a number of
factors which increase pressure in the abdomen are believed to be involved. This may include constipation, diarrhea, and sitting on the toilet for a
long time. Hemorrhoids are also more common during pregnancy. Diagnosis is made by looking at the area. Many people incorrectly refer to any symptom
occurring around the anal area as "hemorrhoids" and serious causes of the symptoms should be ruled out. Colonoscopy or sigmoidoscopy is reasonable
to confirm the diagnosis and rule out more serious causes. No specific treatment is often needed. Initial measures consist of increasing fiber
intake, drinking fluids to maintain hydration, to help with pain, and rest. Medicated creams applied to the area are poorly supported by evidence.
A number of minor procedures may be performed if symptoms are severe or do not improve with conservative management. Surgery is reserved for those
who fail to improve following these measures. Half to two thirds of people have problems with hemorrhoids at some point in their lives. Males and
females are affected about equally commonly. Hemorrhoids affect people most often between 45 and 65 years of age. It is more common among the
wealthy. Outcomes are usually good.
Types of Heamorrhoids
Internal haemorrhoids lie far enough inside the rectum that you can't see or feel them. They don't usually hurt because there are few pain-sensing nerves in the rectum. Bleeding may be the only sign that they are there. Sometimes internal haemorrhoids prolapse, or enlarge and protrude outside the anal sphincter. If so, you may be able to see or feel them as moist, pink pads of skin that are pinker than the surrounding area. Prolapsed haemorrhoids may hurt because they become irritated by rubbing from clothing and sitting. They usually recede into the rectum on their own; if they don't, they can be gently pushed back into place. External haemorrhoids lie within the anus and are often uncomfortable. If an external haemorrhoid prolapses to the outside (usually in the course of passing a stool), you can see and feel it. Blood clots sometimes form within prolapsed external haemorrhoids, causing an extremely painful condition called a thrombosis. If an external haemorrhoid becomes thrombosed, it can look rather frightening, turning purple or blue, and could possibly bleed. Despite their appearance, thrombosed haemorrhoids are usually not serious and will resolve themselves in about a week. If the pain is unbearable, the thrombosed haemorrhoid can be removed with surgery, which stops the pain. Anal bleeding and pain of any sort is alarming and should be evaluated; it can indicate a life-threatening condition, such as colorectal cancer. Haemorrhoids are the main cause of anal bleeding and are rarely dangerous, but a definite diagnosis from your doctor is essential.
What causes Haemorrhoids?
Anyone at any age can be affected by haemorrhoids. They are very common, with about 50% of people experiencing them at some time in their life. However, they are usually more common in elderly people and during pregnancy.
Researchers are not certain what causes haemorrhoids. "Weak" veins - leading to haemorrhoids and other varicose veins - may be inherited. It's likely that extreme abdominal pressure causes the veins to swell and become susceptible to irritation. The pressure can be caused by obesity, pregnancy, standing or sitting for long periods, straining on the toilet, coughing, sneezing, vomiting, and holding your breath while straining to do physical labour. Diet has a pivotal role in causing - and preventing - haemorrhoids. People who consistently eat a high- fibre diet are less likely to get haemorrhoids, but those who prefer a diet high in processed foods are at greater risk of haemorrhoids. A low-fibre diet or inadequate fluid intake can cause constipation, which can contribute to haemorrhoids in two ways: it promotes straining on the toilet and it also aggravates the haemorrhoids by producing hard stools that further irritate the swollen veins.
Symptoms of Piles
In most cases piles are not serious and go away on their own after a few days.
An individual with piles may experience the following symptoms:
1..A hard lump may be felt around the anus. It consists of coagulated blood, called a thrombosed external hemorrhoid. This can be painful
2..After going to toilet, a feeling that the bowels are still full
3..Bright red blood after a bowel movement
4..Itchiness around the anus
5..Mucus discharge when emptying the bowels
6..Pain while defecating
7..The area around the anus may be red and sore.
Internal hemorrhoids are classified into four grades:7
Grade 1 - there are small inflammations, usually inside the lining of the anus. They are not visible
Grade 2 - larger than grade 1 hemorrhoids, but also inside anus. When passing a stool, they may get pushed out, but return unaided
Grade 3 - often called 'prolapsed hemorrhoids'; these appear outside the anus. The patient may feel them hanging out. They can be pushed back in if the patient presses with their finger
Grade 4 - these cannot be pushed back in and need to be treated by a doctor. They are large and stay outside the anus all the time. s
External hemorrhoids are called perianal hematoma. These are small lumps that are located on the outside edge of the anus. They are very itchy and can be painful if a blood clot forms inside (thrombosed external hemorrhoid). Thrombosed external hemorrhoid requires medical treatment straight away.
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