Health Talk: Hemorrhoids (Piles)

WHAT ARE HEMORRHOIDS?

Hemorrhoids are swellings that develop in and around the anal canal. It is the enlargement and engorgement of blood more than usual in the blood vessels in the anal cavity. These veins and overlying tissues form one or more swellings and lump inside the anus. This condition is otherwise called PILES.

CAUSES OF PILES

Piles are usually caused by increased pressure in the lower rectum due to straining during bowel movement, chronic diarrhea, sitting for long periods on the toilet—constipation, obesity or pregnancy, etc.

TYPES OF PILES

Hemorrhoids can be divided into two types;

1. Based on their location in the anus.
2. Based on their size and grade/degree

CLASSIFICATION BASED ON LOCATION

1. INTERNAL PILES: These are usually found in the deep inner parts of the anus from about 2–3 cm above the back passage (anus) in the upper region of the lower rectum. This pile can enlarge and prolapse, thereby hanging outside the anus, looking like discolored, rubbery lumps.
2. EXTERNAL PILES: These are usually found in the regions close to the lower rectum at about 1–2 cm from the anus. They aren’t always seen outside the anus.

CLASSIFICATION BASED ON SIZE AND GRADE/DEGREE

1. GRADE 1: They are usually small inside the anal cavity. They are ubiquitous and cannot be seen or felt outside the body. They may enlarge to other grades or heal up on their own.
2. GRADE 2: They may be pushed slightly outwards but retract back on their own. They are usually more significant than the grade 1 category.
3. GRADE 3:This category hangs out from the anus but can be pushed back inside by a finger.
4. GRADE 4: These hang down loosely and permanently. They are usually enormous and cannot be pushed back into the anus.

Small internal piles are usually painless. However, more enormous piles may produce a mucous discharge, pain, irritation, and itch, which may irritate the skin around the anus. Subsequently, one may feel a sensation of fullness around the anus.

SYMPTOMS AND TREATMENTS OF PILES

Piles is a prevalent condition and sometimes has no symptoms, especially in its early stage. However, some of the symptoms experienced are listed down below.

1. Slight bleeding after using the toilet.
2. Pain and discomfort in the anus after defecation, etc.

Piles that hang down can strangulate, a condition whereby the blood supply to the pile is entirely cut off due to an inner pile being pushed down and trapped by the sphincter muscles. THROMBOSIS, a blood clot can quickly form within the pile. An increase in pressure usually causes it.

Treatment of hemorrhoids is in three categories depending on the condition.

LIFESTYLE DRUGS

Eating foods high in fiber, like fruits, vegetables, cereals, and whole grain bread. Avoiding painkillers containing codeine (e.g., codamol) by using paracetamol instead. Regular exercise to reduce constipation and not delay in using the toilet. Diet modification and laxatives.

MEDICATIONS

Use of steroids, dietary supplements, use of counter-hydrocortisone, etc. In many cases, hemorrhoids will go on their own within a few days, including prolapsed hemorrhoids.

MEDICAL PROCEDURES

1. Cauterization.
2. Rubber band ligation.
3. Cryotherapy.
4. Sclerotherapy.
5. Stapled hemorrhoidopexy.
6. hemorrhoidectomy.