Suffer In Silence With Piles

Piles, otherwise known as haemorrhoids, are swollen vascular cushions within the anal canal. As it is perceived as an embarrassing topic, sufferers often live in extreme discomfort due to the pain and itching. As a result, sufferers are unable to lead a comfortable life as it interferes with their daily routines.

Piles is actually a common condition and affects all racial groups in Malaysia. Doctors estimate that about 1 in 3 adults will suffer from symptoms attributable to piles during their lifetime.

Piles usually occur in adulthood and sufferers can be from any age group, ranging from late teens to retirement age. Males and females are equally susceptible to the condition.

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Piles are often categorised as external or internal. Beneath the mucous membrane lining, the anal canal is a network of vascular cushions. A portion of this is inside the rectum, which causes internal piles when they become swollen with blood. The other is under the skin around the anus, giving rise to external piles when they are swollen.

The severity of the condition ranges from first degree (mild) to fourth degree (severe).

Internal Piles (piles that occur in the anal canal)

1. First degree piles bleed but do not prolapse (protrude out of the anal canal).

2. Second degree piles prolapse during bowel movement but reduce spontaneously afterwards.

3. Third degree piles prolapse during bowel movement, but only return inside the anal canal when pushed back physically.

4. Fourth degree piles have a blood clot within them, which cause severe pain and difficulty in passing motion. They prolapse permanently outside the anus.

External Piles (piles that occur around the anal opening)

External piles form a soft lump around the anal opening. They frequently co-exist with internal piles. When a blood clot develops and the lump becomes hard, the condition is known as thrombosed haemorrhoids.

What Causes Piles?

The exact cause for piles is unknown, but it may be linked to excess pressure in the anus and lower rectum. Some factors which may contribute to the formation of piles include :

* Excessive straining during bowel movement, or when constipated
* Chronic diarrhoea
* Lack of adequate fibre in the diet.
* Pregnancy and childbirth
* Family history
* Cancer or growths in the pelvis or bowel
* Age, which causes the anal cushions’ supporting ligaments to lax

Symptoms of Piles

The following symptoms could indicate the presence of piles :

* Bleeding and/or discomfort during bowel movement/strain
* Protrusion during bowel movement
* Pain or itching in the anal area
* Anal lumps

Prevention of Piles

Piles can actually be prevented in the following ways:

* Improving and regularising bowel habit
* Increasing the amount of fibre intake and fluid
* Eliminating excessive straining during bowel movement
* Exercise regularly
* Avoid becoming overweight

Treatment of Piles

Depending on the severity of piles, the condition can be treated in a variety of ways.

First-degree piles :

* Improving and regularising bowel habit
* Increasing the amount of fibre intake and fluid
* Eliminating excessive straining during bowel movement
* Local and general medication
* Sclerotherapy
* Infrared coagulation

Second-degree piles :

* Sclerotherapy
* Infrared coagulation
* Rubber band ligation
* Procedure for Prolapse and Haemorrhoids (PPH)

Third-degree piles :

* Rubber band ligation
* Conventional haemorrhoidectomy
* Procedure for prolapsed haemorrhoids (PPH)

Fourth-degree piles :

* Conventional haemorrhoidectomy

Here, we will discuss on the differences between the treatments mentioned :

Sclerotherapy - essentially an injection of sclerosant which will shrink dilated vessels.

Infrared coagulation - uses heat energy by means of infra red technology to burn the vessels and make them shrivel.

Rubber band ligation - the application of a tight rubber band around the vascular pedicles of the haemorrhoids.

All three treatments may be performed as outpatient treatments for early, non-prolapsing haemorrhoids at surgical clinics and are also known as office treatments for haemorrhoids. However, one must remember that these techniques are only for 1st or 2nd degree haemorrhoids.

More info on PILES HERE.

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