Those pesky piles


With Dr Alfred Dawes

Monday, September 23, 2013

Print this page Email A Friend!

PILES or haemorrhoids are enlarged clumps of tissue in the anal canal. Normally there are areas underneath the lining of the anus (mucosa) composed of veins, muscle and strengthening tissue. These areas help in containing intestinal gas and allow us to differentiate between stool and gas so we don't embarrass ourselves in public. However, in some cases these veins get larger and push the mucosa out to form "piles" of flesh.

Haemorrhoids are very common with up to half of adults having the condition at some point in their lives. They may cause bleeding on wiping or when stooling. When piles are big enough to come through the anal opening, this is known as prolapse. The danger with prolapse is that the anal muscle squeezes the pile, cutting of the drainage of blood out of its veins. The stagnant blood clots and this results in severe pain. The prolapsed pile may ulcerate, get infected and bleed. A severe infection can result if this goes untreated. Most people, however, complain of bleeding and discomfort.

Who gets piles?

Piles affect both women and men. Women may get piles during pregnancy because the pregnancy hormones cause relaxing of the vein walls making them bigger, much like spider veins. These piles usually get better after pregnancy although some cases may persist. Straining while defecating, as occurs when you are constipated, may lead to piles. Those who like to read on the toilet may be saddened to hear that this, too, poses a risk. In fact prolonged sitting at your job may be a risk factor. But contrary to popular Jamaican belief, sitting on cold concrete will not give you piles. Some medical conditions such as liver disease may cause piles. Obesity may play a role as well.

How do you treat piles?

1. Change your diet

The simplest and a very effective treatment for piles is changing your diet. Foods with a lot of fibre regularise your bowel habits leading to less constipation and straining. In addition, the softer stool with a high fibre diet irritates the piles less and results in less bleeding. Drinking plenty of water daily will also soften the stool and result in less straining. Some people may benefit from adding fibre powders and tablets to their diet.

2. Cut it short

Do not sit on the toilet all day reading. Many patients report significant relief once they abandon this practice. If sitting for prolonged periods at work, take a brisk walk or stretch.

3. Personal hygiene

Paying careful attention to anal hygiene will result in less irritating bits of you know what being left behind. This commonly occurs because of the folds of mucosa on the piles. Damp tissue or washing will leave you with a cleaner behind that won't be so uncomfortable.

4. Medication

Anal inserts block the pain and decreases the inflammation when piles act up. They are to be used in the short term only as prolonged use can cause side effects. Other medications may be used to soften the stool. Do not overuse laxatives as they have serious side effects in the long term and the diarrhoea they cause irritates the piles even more.

5. Surgery

There are several options for treating your piles. Injections create a scar in the piles and closes off the blood vessels. A laser beam or infrared light causes the same effect with less pain. Putting a rubber band over the piles cuts off the blood supply causing them to fall off in a few days. The most effective treatment overall is cutting out the piles at surgery. However, your lifestyle changes are your best bet to avoid developing or causing progression of the disease to the point where you need surgery.

Now you can read the Jamaica Observer ePaper anytime, anywhere. The Jamaica Observer ePaper is available to you at home or at work, and is the same edition as the printed copy available at




1. We welcome reader comments on the top stories of the day. Some comments may be republished on the website or in the newspaper � email addresses will not be published.

2. Please understand that comments are moderated and it is not always possible to publish all that have been submitted. We will, however, try to publish comments that are representative of all received.

3. We ask that comments are civil and free of libellous or hateful material. Also please stick to the topic under discussion.

4. Please do not write in block capitals since this makes your comment hard to read.

5. Please don't use the comments to advertise. However, our advertising department can be more than accommodating if emailed:

6. If readers wish to report offensive comments, suggest a correction or share a story then please email:

7. Lastly, read our Terms and Conditions and Privacy Policy

comments powered by Disqus



Today's Cartoon

Click image to view full size editorial cartoon