The use
of this term is frequently abused outside the hospital premises. Any reason why
people may have some discomfort within the anus is attributed to a pile.
When
they bleed from the anus, they often also say it is a pile. When people take
sweet things and feel strange down there, they quickly say it is due to a pile.
The truth is that it has nothing to do with any of that but rather to an innate
abnormality in the arrangement of the blood vessels in that region that make
them prone to distension, bursting and bleeding.
Sometimes,
abnormal growths within the rectum like cancers increase the pressure on the
vessels that increase the tendency to bleed. Besides all that, pain within the
anus can be caused by tears sustained within its wall causing plenty of discomfort.
Sometimes, there is associated bleeding too.
Speaking
now as it is recognised in medicine, a pile refers to the swelling which arises
because of the haemorrhoids caused by the abnormality in the disposition of the
veins written about in the paragraph above. There are internal haemorrhoids and
there are external ones. Most haemorrhoids are not even problematic and the
person who has them may be blithely unaware of their presence within their body
unless they go for an investigation conducted for some other problem. A good
number of times therefore, it is referred to as an incidental finding and may
subsequently not require any treatment.
When
people who have piles are examined, the swellings associated with the said
ailment involve both the blood vessels and the muscle elements in that region
and are displayed in particular positions around the anus and are described
with respect to a clock. That designation helps a lot in determining the
severity of the presentation and aids the treatment approach. A pile therefore,
is a haemorrhoid that gets inflamed. It is a mass of tissue resembling a
cushion that is full of blood vessels, elastic fibres and muscle tissue
together with their support material. We all probably have them but only a
handful of people suffer from any of its known symptoms.
The
size of piles can vary widely. As said earlier, they can be found within the
anus or outside of it. In the United States, half of the adult population is
affected by piles in one form or another by the time they are 50 years. Of this
number, about half will go to a doctor at some point of their lives to complain
of the problem but only a tiny fraction of that number will end up requiring
surgery. It is roughly estimated to be about 10 percent.
Those
who require such an operation are usually in grades three and four as we shall
see shortly. The common causes of piles are as follows:
1)
Pregnancy,
2)
Lifting of heavy weights,
3)
Chronic diarrhoea,
4)
Chronic constipation,
5)
Straining at all times when passing stools.
In many
cases, piles will go away on their own even without treatment. Some of the
time, a feeding regimen rich in water, vegetables and other dietary fibre as
well as medicinal supports using various types of anal suppositories would also
help. When there is associated pain related to swellings existing just outside
the anus, sitz baths using warm water with added salt will help reduce the
pain. Pain relievers can also be used in support of that. The tendency to
develop piles increases with age but there may also be an inherited tendency to
develop the condition.
A
person who has piles may experience the following symptoms in no particular
order. These are;
1) At
the beginning, there may be some itching around the anus.
2)
There may be pain while stooling.
3)
After using the toilet, there could exist a lingering feeling that the rectum
has not been fully emptied of its stool contents.
4) A
hard lump may also be felt around the anus and it may be painful because of its
contents. The lump usually contains coagulated blood and when this happens, it
is called a thrombosed external haemorrhoid. This is an emergency and any
person who suffers like this should go to the hospital without undue delay.
5)
Occasionally, there may be bleeding from the anus following stooling. The blood
is typically of a bright red consistency.
6)
There may be discharge of mucus as well when such a person passes stools.
Internal
haemorrhoids are more common than the external type. They are classified into
four grades. These grades are as follows;
Grade1: This is
made up of small inflammations inside the lining of the anus. They are not
visible and many people who have them at this stage are usually not aware of
them unless they bleed at some point.
Grade 2: In this
group, the swellings are larger than what obtains in grade one but they are
also contained within the anus. When stooling, they may get pushed out of the
anus but would usually get back inside without any active help.
Grade 3: In this
category, the haemorrhoids are said to have prolapsed. They are found outside
the anus. The person would usually feel them hanging out and they can usually
be pushed back inside with the aid of a firm pressure from the fingers.
Grade 4: In this
group is found the most troublesome haemorrhoids. They prolapse just like in
the group above but cannot be pushed back in. They are painful and often would
require a doctor’s attention with regards to the pain and the effort to treat
it.
When
the time comes for a doctor to examine a sufferer of this condition, some
questions will initially be asked before the doctor proceeds with a rectal
examination. He will want to find out if the following conditions have been
seen by the patient. They are:
(1)
Whether the stools have had blood stains?
(2) If
the stools have had any mucus associated with them?
(3) Has
there been any weight loss?
(4) Is
there any pain?
(5) Has
the colour of the stools changed in any way?
(6) Has
there been any recent change in the bowel habits?
(7) Are
there any close relatives, parents or siblings, who might have suffered from or
currently suffer from this condition?
A
doctor will then proceed to perform a digital rectal examination using a
lubricated glove to feel around the anus and rectum and to determine whether
there is anything of concern. Alternatively, and more effectively, he could
perform a procto-sigmoidoscopy to look at the anal canal and the rectum.
This is
an instrument that is essentially a hollow tube with a light bulb that enables
one see into the dark tunnel. Every detail is thus recorded and a biopsy sample
can be obtained thereby to send to a pathologist for histological analysis.
This is of absolute importance among people who have symptoms of other problems
of the digestive tract including for colorectal cancer. When there is a
lingering doubt especially after procto-sigmoidoscopy, a colonoscopy may be
requested instead. That is simply because a colonoscope can see farther and
deeper than a sigmoidoscope.
Preventive
measures you can take by yourself to avoid coming down with haemorrhoids are:
(1) Do not strain or make it a habit to strain while defecating.
(2)
Avoid using laxatives on a regular basis and almost to the point of abuse.
(3)
Exercise moderately as much as you can on a regular basis. You can see that not
taking sweets, not drinking milk and not taking soft (sodas) drinks are not a
part of the preventive measures recommended here.
Treatment
options will not be detailed here because it is better that your attending
surgeon offers you the options available based on what his assessment is.
However, it is important for you to know that there are various ways of
treating this condition.
Reference:
punchng
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