Haemorrhoids are swollen blood vessels in or around the anus and rectum. The haemorrhoidal veins are located in the lowest part of the rectum and the anus. Sometimes they swell so that the vein walls become stretched, thin, and irritated by passing bowel movements. Haemorrhoids are classified into two general categories- Internal and External.

Internal Haemorrhoids

Internal haemorrhoids lie far enough inside the rectum that you can't see or feel them. They don't usually hurt because there are few pain-sensing nerves in the rectum. Bleeding may be the only sign that they are there. Sometimes internal haemorrhoids  prolapse, or enlarge and protrude outside the anal sphincter. If so, you may be able to see or feel them as moist, pink pads of skin that are pinker than the surrounding area. Prolapsed haemorrhoids may hurt because they become irritated by rubbing from clothing and sitting. They usually recede into the rectum on their own; if they don't, they can be gently pushed back into place.

External Haemorrhoids

External haemorrhoids lie within the anus and are often uncomfortable. If an external haemorrhoid prolapses to the outside (usually in the course of passing a stool), you can see and feel it. Blood clots sometimes form within prolapsed external haemorrhoids, causing an extremely painful condition called a thrombosis. If an external haemorrhoid becomes thrombosed, it can look rather frightening, turning purple or blue, and could possibly bleed. Despite their appearance, thrombosed haemorrhoids are usually not serious and will resolve themselves in about a week.

Causes

Anyone at any age can be affected by haemorrhoids. They are very common, with about 50% of people experiencing them at some time in their life. However, they are usually more common in elderly people and during  pregnancy. Researchers are not certain what causes haemorrhoids. "Weak" veins - leading to haemorrhoids and other  varicose veins - may be inherited. It's likely that extreme abdominal pressure causes the veins to swell and become susceptible to irritation. The pressure can be caused by obesity, pregnancy, standing or sitting for long periods, straining on the toilet, coughing, sneezing, vomiting, and holding your breath while straining to do physical labour.Diet has a pivotal role in causing - and preventing - haemorrhoids. People who consistently eat a high-fibre diet are less likely to get haemorrhoids, but those who prefer a diet high in processed foods are at greater risk of haemorrhoids. A low-fibre diet or inadequate fluid intake can cause constipation, which can contribute to haemorrhoids in two ways: it promotes straining on the toilet and it also aggravates the haemorrhoids by producing hard stools that further irritate the swollen veins.

Symptoms of piles

The symptoms of haemorrhoids include-

• Bright red bleeding from the anus. Blood may streak the bowel movement or the toilet paper.
• Tenderness or pain during bowel movements.
• Painful swelling or a lump near the anus.
• Anal itching.
• A mucous anal discharge.

How do I know if I have piles?

First, your doctor will look at the anal area, perhaps by inserting a lubricated gloved finger or an anoscope (a hollow, lighted tube for viewing the lower few inches of the rectum) or a proctoscope (which works like an anoscope, but provides a more thorough rectal examination). 

Treatment for piles available from pharmacies

Creams, ointments and suppositories can help relieve swelling and inflammation symptoms in the short term. Warm (but not hot) sitz baths are a traditional therapy for piles: sit in about 8 cm of warm water for 15 minutes, several times a day, especially after a bowel movement. Painkillers, such as paracetamol, can help relieve pain caused by piles. Products with local anaesthetic may be prescribed to treat painful haemorrhoids. If you are constipated, a GP may recommend using a laxative. If you are pregnant, discuss any treatment, including dietary changes, with your doctor before proceeding.

Nutrition and diet

You can prevent constipation by following a high-fibre diet. Meals and snacks should consist primarily of vegetables, fruit, nuts, and whole grains, and as few processed foods and meats as possible. If this is a big change for you, introduce the new foods slowly, to avoid wind. If you aren't able to eat enough high-fibre food, supplement your diet with stool softeners or bulk-forming agents. (Avoid laxatives, which may cause  diarrhoea that can further irritate the swollen veins). Drink at least eight glasses of water each day; if your life is especially active or you live in a hot climate, you will need more. Monitor your salt intake. Excess salt in the diet causes fluid retention, which means swelling in all veins, including haemorrhoids.

Home remedies

• Try not to sit for hours at a time. If you have to, take breaks: once every hour, get up and move around for at least five minutes.
• Insert petroleum jelly just inside the anus to make bowel movements less painful.
• Don't sit on the toilet for more than five minutes at a time, and when wiping, be gentle. 

How can we prevent piles ?

A healthy diet and lifestyle are good insurance for preventing haemorrhoids, whether you already suffer haemorrhoid symptoms or are intent on preventing them. Regular  exercise is also important, especially if you have a sedentary job. Exercise helps in several ways: keeping weight in check, making constipation less likely, and enhancing muscle tone.Healthy bowel habits also help prevent haemorrhoids. Use the toilet as soon as you feel the urge to do so. Also, avoid sitting on the toilet for prolonged periods (more than five minutes) and avoid straining during a bowel movement.

Rectal bleeding

Rectal bleeding  may be caused by a swollen blood vessel or a small tear around the anus, but it can have a more serious cause and should never be ignored.Don't let embarrassment stop you seeing your GP. You should always get rectal bleeding checked to rule out more serious causes. Most people with rectal bleeding will see small amounts of bright-red blood on the toilet paper after they have been to the toilet, or a few droplets that turn the water in the toilet pink. These are typical signs of piles (haemorrhoids) or a small tear (anal fissure) in the skin of your anus, the opening through which stools pass. Both of these are very common problems, but you should not assume they are the cause of your rectal bleeding. You should still see a GP if you have these symptoms. In general, bright-red blood means the bleeding has come from somewhere near your anus. If the blood is darker in colour and sticky, the bleeding may have occurred higher up your digestive system. This type of bleeding can turn your faeces black or plum-coloured (known as melaena).

Piles  Treatment

Homeopathic medication targets the cause and thus treats the disease from the roots thereby reducing the chances of relapse of the condition.Homeopathic medicines, on the other hand, work at the root level and treat the underlying cause such as chronic constipation, laxity of veins, etc. If there is an underlying genetic tendency to develop piles, even that can be taken care of with properly planned constitutional treatment along with dietary and lifestyle modification. At Astha Clinic we have treated a large number of cases of Hemorrhoids, fissure & fistula with good results and have given significant relief to patients in most cases.

Piles can be controlled by the following precautions

• Increase intake of water & fruit juices
• High fiber diet
• Eat more fresh fruits and vegetables
• Avoid processed foods
• Control your weight
• Avoid too much of alcohol
• Exercise regularly
• Sit in warm water tub for minimum 10 minutes