Understanding piles

Maxwell Adeyemi

PILES, medically referred to as haemorrhoids, are swollen and inflamed veins in the lower part of the rectum and anus. This condition can cause significant discomfort, bleeding and other distressing symptoms affecting millions of people worldwide.

While piles are common, they could range in severity, with some cases requiring medical or even surgical intervention.

Piles are categorised into three main types, depending on their location and degree of prolapse.

Internal piles: These are located inside the rectum and are generally not visible or painful. However, they may cause painless rectal bleeding, especially after bowel movements.

External piles: These occur under the skin around the anus and are more likely to cause discomfort. External haemorrhoids can become thrombosed (filled with blood clots), leading to severe pain and swelling.

Prolapsed piles: When internal haemorrhoids swell and extend outside the anus, they are known as prolapsed piles. In more advanced cases, these haemorrhoids may remain outside the anus, causing pain, discomfort, and potential complications if left untreated.

The symptoms of piles can vary depending on the type and severity of the condition. Some of the most common symptoms include:

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Discomfort or pain especially when passing stool or while sitting for long periods, itching or irritation. Persistent itching around the anus can lead to further discomfort.

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Bleeding – blood may be noticed on the toilet paper or in the toilet bowl after a bowel movement. This is typically a sign of internal haemorrhoids.

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Swelling or a lump near the anus may be indicative of external piles, which can become tender and painful.

In severe cases, the piles may lead to complications such as infection, severe bleeding, or strangulation, where the blood supply to the haemorrhoid is cut off, resulting in extreme pain and the need for immediate medical attention.

While piles often resolve on their own, it is important to seek medical attention when the following occur:

* Severe discomfort or pain: Persistent or worsening pain should not be ignored.

* Heavy bleeding: If bleeding during bowel movements becomes frequent or severe, it is important to consult a healthcare provider.

* Prolapse: If the piles prolapse and do not retract naturally, medical intervention may be required to avoid further complications.

Factors contributing to piles

Several lifestyle and genetic factors can contribute to the development of piles. Some common risk factors include:

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Chronic constipation – straining during bowel movements increases pressure on the veins in the rectum and anus.

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Pregnancy – the increased pressure on the pelvic area during pregnancy can lead to the development of piles, particularly in the third trimester.

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Obesity – excess weight puts additional pressure on the veins in the rectal area.

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Sedentary lifestyle – prolonged sitting, particularly on the toilet, can contribute to the development of piles.

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Ageing – as people age, the tissues supporting the veins in the rectum and anus can weaken, increasing the likelihood of piles.

Ways to prevent piles

Preventing piles largely involves making lifestyle changes that promote regular bowel movements and reduce pressure on the rectal veins. The followings are generally recommended strategies:

Consuming plenty of fibre-rich foods such as vegetables, fruits and whole grains helps to soften the stool and prevent constipation, which reduces the need to strain during bowel movements.

Increase water intake

Staying well-hydrated is key to preventing hard stools and ensuring smoother bowel movements.

Maintain a healthy weight

Weight loss can reduce the pressure on the pelvic region and veins, lowering the risk of piles.

Avoid straining during bowel movements

Straining increases pressure on the veins, so it is important to take time and avoid rushing during bowel movements.

Exercise

Regularly engaging in physical activity helps stimulate bowel function and prevents constipation.

Treatment of piles

Treatment for piles also depends on the severity of the condition. While mild cases may resolve on their own, more advanced cases require medical intervention. The treatment options include:

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Dietary adjustments: A high-fibre diet, along with plenty of water, can prevent constipation and ease symptoms of piles. Foods like leafy vegetables, fruits, whole grains, and bran-based breakfast cereals are highly recommended.

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Stool softeners: In cases where constipation is an issue, stool softeners or laxatives may be prescribed to help pass stools more easily without causing strain.

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Pain relievers: Over-the-counter pain relief options, including anti-inflammatory medications, can help alleviate pain. Topical treatments such as steroid creams may also be used to reduce swelling and discomfort.

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Medical therapy: In addition to using haemorrhoids preparation creams or ointments, as well as some steroid creams, medications such as Daflon can also be used to ease discomfort and enhance blood flow in the area for the overall benefit of symptom relief.

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Surgical treatment for severe or persistent cases of piles: Surgical intervention may be necessary. Procedures like haemorrhoidectomy (surgical removal of haemorrhoids) or haemorrhoid stapling are often recommended for high-grade internal, external, or mixed haemorrhoids.

Surgery is the most effective treatment, particularly for advanced cases, and is generally safe with minimal risk of complications.

Patients should consider surgical treatment if their piles do not improve with conservative measures or if they have high-grade haemorrhoids.

In addition, the overuse of home remedies or over-the-counter treatments without consulting a healthcare professional is not advised.

While some remedies may provide temporary relief, they should be used with caution, as certain products can exacerbate the condition if not used properly.

Generally, piles are a common condition, but with proper care, prevention and treatment they can be effectively managed.

Individuals should not hesitate to seek medical advice if they experience symptoms, as early intervention can prevent complications and improve quality of life.

By understanding the risk factors, making lifestyle adjustments, and seeking timely treatment, those affected by piles can manage the condition and lead a healthier, more comfortable life.

Contact Dr Maxwell on 3631807 or 7575411