Piles



What is Pile?

Piles are a common condition involving the rectum and adjacent tissues. However are several conditions involving the anus, the final part of the intestinal system, will be dealt with collectively, the first of these being hemorrhoids. These are common, and represent varicosity of the veins (i.e. varicose veins) in the lower bowel. Often there is an itch, irritation, burning or a discharge. Frequently they bleed, and this is often what prompts medical advice.



Large hemorrhoids may prolapse following a bowel action, and must be replaced manually into the bowel. They are common during pregnancy, but after the confinement most subside and give little further trouble. Sometimes a blood vessel actually ruptures and then clots, forming a very painful, acutely tender, swollen pile. This is often felt at the anal margin. Constipation and having to strain when undertaking a bowel action as well as prolonged sitting and anal infection are believed to aggravate them.

Piles can often be prevented by keeping the bowel actions regular and soft, and the current recommendation of a high-fiber diet (adding unprocessed bran and fiber to the daily diet) is often very effective. Many claim this may cause piles to subside and may reduce the need for surgery, even in severe cases.



Many types of treatment have been tried. Smaller piles that are producing symptoms are often injected with a sclerosing fluid that makes them shrink. Recently, anal dilation (Lord’s method) has been shown to be very effective without any cutting. Rubber-band ligation can be successful and done on an outpatient basis. A ligature is placed around the hemorrhoid at its base, and the pile gradually reduces in size.

Cryosurgery is also used, which involves the application of a frozen point. This may be used in conjunction with other methods. A thrombosed (clotted) external pile is usually treated by excision and removal of the clotted contents. This often affords remarkably prompt relief. Advanced hemorrhoids are frequently surgically removed, although the operation is far from pleasant. It takes quite a few days for the raw area to heal over and freedom from pain to be experienced once more.



Piles Treatment

It is completely wrong to imagine that any bleeding from the anus is due to hemorrhoids, unless proven by an adequate examination by the doctor. It is sometimes believed piles are the cause, when in fact it may be a more deep-seated cancer of the rectum. Any bleeding from the bowel must immediately be checked by the doctor and a proper bowel examination carried out, mainly to exclude the possibility of cancer.



Fissures occur when a break in the lining of the anal region takes place. It is common during constipation, when a small anal tear happens. Chronic fissures might develop and remain for some time, causing acute pain during a bowel action. There may be some spotting after an action as well as there may be a tendency to constipate from fear of the discomfort of bowel movement. A solitary pile (called a sentinel pile) may develop.

Correction of constipation is essential. Attention to diet, adding more roughage and fluid to the diet, and ideally using unprocessed bran each day will often assist both in recovery and checking recurrences. The local use of anesthetic creams and ointments often provides relief during normal, natural healing, but this should be purely temporary.



Fistulas, or abscesses, form about the anal entry, and a permanent narrow canal may form between the rectum and the area just near the anal opening. This may fill with pus and debris that discharges onto the skin, causing discomfort, itch and tenderness about the anus. Abscesses may recur regularly. Treatment and a final cure may be gained from surgery.

Pruritus Ani (Itching) is common, and many conditions may produce the persistent desire to scratch and rub the anus. Infections from organisms, worms, fungi; skin irritations from local applications or drugs, and many other causes abound. Medical attention is often necessary, first to pinpoint the cause if possible, and then treat whatever this happens to be. Often cold compresses give good symptomatic relief. Carefully cleansing the area completely and regularly is essential. Liquid paraffin cleansing is soothing and effective. Also the fluorinated steroid creams and ointments give excellent and prompt relief’. Anesthetic agents are frequently frowned upon, for they may aggravate the condition afterwards by producing added hypersensitive reactions.