Those pesky piles

HEALTH

With Dr Alfred Dawes

Monday, September 23, 2013

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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.






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