-Dr.Manoj Kuriakose
B.H.M.S

Piles (Haemorrhoids)
Piles, or haemorrhoids, are areas in the anal canal where the tissue, which contains lots of blood vessels, has become swollen. They can be internal, occurring inside the anus, or external, when they can be seen and felt on the outside of the anus. When visible they look like round pink swellings, the size of a pea or a grape. Piles are common in pregnant women, but are rare in children.

What causes piles?
Straining to empty the bowels when constipated.
Chronic diarrhoea.
Pregnancy – the weight of the fetus on the abdomen and the increased blood flow, as well as the effect of hormones on the blood vessels.
Childbirth – pushing during childbirth increases the pressure in the veins.
Straining to pass urine, especially in men with prostate problems.
Cancer or growths in the pelvis or bowel, which may exert pressure in a similar way to a pregnancy. Family history – piles can run in families and are potentially hereditary, perhaps because of weak veins in the anal area.
Obesity.
Varicose veins – many people with these also develop piles, although piles are not varicose veins.

Different types of piles
Piles are classified according to their position. First-degree piles remain inside the rectum or anal canal. Second-degree piles protrude (or prolapse) from the anus when the bowels are opened, but return of their own accord afterwards. Third-degree piles are similar, but only return inside when pushed back. Fourth-degree piles hang permanently outside the anus.

What are the symptoms?
Most people affected have internal piles and may not have any symptoms at all. The earliest symptom is often bleeding of fresh, red blood from the anal passage when the bowels are opened. There may be itchiness around the anal area. Third and fourth degree piles may be more painful and tend to produce a slimy discharge of mucus that leaks from the exposed lining of the pile.

There are conditions other than piles that can cause bleeding from the anus, so anyone who notices bleeding in their stool should visit a doctor for advice.

Diagnosing piles
The doctor will ask about your health and carry out a physical examination.

If there are external piles, these will be spotted on examination. A rectal examination, where a gloved finger is gently inserted into the anal canal, will be performed. Internal piles cannot normally be felt in this way, but the examination can reveal other problems such as an anal fissure - a painful tear of the lining of the anus. These other conditions need to be excluded before a diagnosis can be made. 

Relieving symptoms
Regular warm baths may relieve the irritation; Ice packs may help reduce swelling,

Treatments
Piles can usually be treated at home. The most important element in encouraging existing piles to clear up is to avoid constipation. By having regular bowel movements, and avoiding straining, stools pass easily and do not put pressure on the blood vessels in the anal area.

Eating plenty of fibre-rich foods such as fruit, vegetables and wholegrain cereals (eg brown rice, wholemeal bread), and drinking plenty of fluids, especially water, should keep bowel movements soft.

Avoid rich and spicy food,non-vegtarian food,strict no to pickles

It may help to take a fibre supplement or mild laxatives which soften bowel motions.

Homeopathic treatment for Piles
Homeopathy greatly helps in curing piles specially the 1^st 2^nd and 3^rd degree piles and no surgery should be thought of till homeopathy has been tried. Some of the most commonly used medicines in treating piles are:
Hamamelis –Q –very very useful in controlling bleeding caused due to piles
Aesculus hip-piles with acute pain in the back
Collinsonia..chronic painful bleeding piles with pain as if sticks were placed in the rectum.
Graphitis-for piles and fissures with hard stools
Ratanhia-pain as if splinters of glass were sticking in the rectum

Other commonly used medicines are ..Sulphur,Nux.Vomica,silicea etc.

Read atest Newsletter on Piles Treatment (April '2010)