Piles, also known as ‘Haemorrhoids’, swollen blood vessels / enlarged blood vessels situated either just inside or just outside the anal canal commonly called internal piles and external piles. In case of bleeding, they are termed as bleeding piles.
Causes of Piles/Hemorrhoids :-
It is very difficult to pinpoint any causative factor of piles . A number of factor are supposed tp play an important role in the genesis of piles.
- 1. Constipation– this is the most common cause which leads to straining during defecation. Straining leads to pressure on blood vessels causing them to swell, elongate and slide down the anal opening.
- 2. Eat a low-fibre diet- Lack of dietary fibre can cause hard stools, constipation and straining
- 3. Spend too much time in the toilet and holding the urge when you have to go.
- 4. Pregnancy -The return of venous blood from pelvis is interferedwith increased size of the pregnant uterus .The increased laxity and vascularity of pelvis with enlarged uterus also promotes the haemorrhoidal formation. after partuitionthe piles masses become larger and persistent.
- 5. Relaxation of sphincteric tone:- After age of 50 years and division of anal musculature during an operation for fistula in ano may cause vascular engorgement and descend of anal cushion.
- 6. Attack of diarrhoea & dysentery.
- 7. Hereditary factor
- 8. Abodminal tumour
- 9. Cirrosis of liver
Piles/Hemorrhoids Symptoms:-
Bleeding and prolaps are two cardinal symptoms of piles for which the patient consult the physician.
- 1. Parfused bleeding during defecation (During Passing Stools).
- 2. Itching and discomfort around the anus.
- 3. Feeling of a mass during defecation redused itself and digitally.
- 4. Feeling of mass near the anus which may be painful or painless.
- 5. Mucus & discharge after passing a stool.
- 6. Pain while passing stools and after passing stools.
- 7. Other symptoms of piles are itching at perianal region, anaemia due to chronic blood loss, palpitation, tachycardia and breathlessness.
TYPES OF Piles/Hemorrhoids:-
There are two types of piles/ Hemorrhoids.
Internal piles/Hemorrhoids:-these occur inside the anus – Usually painless .
External piles/Hemorrhoids:-these appear outside the anus – may become painful.
Degree of Piles/Hemorrhoids:-
There are two types of piles/ Hemorrhoids.
First-degree Piles:- Piles bleeds but do not prolapse (do not come outside the anus while passing stools).
Second-degree Piles:- Piles prolapse on straining and then reduce by itself (go back inside the anus by itself.
Third-degree Piles:- Piles prolapse on straining and do not reduce by itself and may require manual reduction (have to push it back inside the anus by using your fingers).
Fourth degree Piles:- Prolapsed piles are trapped outside the anus and may become strangulated, infected and painful.
Complications after surgery:-
Post operative severe bleeding, Anal abscess with fistula formation, recurrences and Anal Stricture.
Treatments:
- Medical Treatment/ lifestyle modification
- Injection treatment
- Band ligation
- Lord’s anal dilatation
- Cryo Surgery
- Haemorrhoidectomy
KSHAR SUTRA TREATMENT OF PILES
After diagnosis and investigations the Kshar Sutra is ligated into the piles mass under local anesthesia. All the piles masses are ligated at the same session. Patients is admitted in the hospital for one day and next day he is discharge. Post operatively 5-7 days Antibiotics and Analgesics are recommended. Hot sitz bath twice daily.
