Piles are cushions of tissue which normally line the last part of the large bowel just above the anal canal. For reasons that are not entirely understood but likely to be associated with straining during passage of stools, the size of these cushions gradually enlarges. During the process at times abrasions from hard stools cause few vessels in the cushion to bleed and the patient may see this in the stool.
As the size grows larger, these cushions start to come out through the anal canal and the patient may then notice a lump following evacuation. Spices on their own are not known to cause bleeding from rectum or piles. However, based on common experience people do feel a burning sensation during evacuation after eating spices.
The treatment of piles depends upon the size and the patient's preferences. A general surgeon is the most suitable specialist for the job. Options vary from injecting these piles with a sclerosing agent, use of haemorrhoidal bands or a formal surgery for removal of piles.
Among the latest operative techniques for removal of piles is the use of a stapling device. Though widely available and is fairly safe, the cost involved is significantly higher.
Piles, or haemorrhoids, are areas in the anal canal where the tissue has become swollen. Around half the population of the UK will have suffered from piles at some point. They are common in all age groups from mid-teens onwards and particularly common in pregnant women. Piles look like round pink swellings, the size of a pea or a grape. Sometimes they are a blue colour. Piles can be internal, inside the anus, or external, and be seen and felt on the outside of the anus. You can have internal and external piles at the same time. Common symptoms include blood from the anus, itchiness around your anal area1, pain and discomfort after you have opened your bowels, a slimy discharge of mucus and a feeling that your bowels have not completely emptied. The symptoms may be relieved with regular warm baths, ice packs or soothing creams but for long term treatment it is recommended that you contact your GP.
Piles are swellings or dilatations of the veins in the anus; actually varicose veins at the lower end of the large bowel or rectum. Basically, there are two kinds—internal and external piles. When complications arise, they may be quite painful and perhaps may rupture, causing bleeding. According to some authorities, one third, if not more, of all adults have piles in one form or another. In many cases, however, the situation is not such that the person is aware of having them. The affliction of piles goes back as far as written history. Ancient records of both Egypt and Babylon show that doctors were familiar with this malady, and even the Bible tells us about them.
According to historians, piles (or haemorrhoids, as the doctors call them) have changed the course of history. Thus Rudolph Marx tells that Napoleon failed to exploit a gap in the flank of Wellington's army because of his being groggy owing to a lack of sleep as well as opiate medication taken to ease the pain caused by his haemorrhoids.
Piles are also known as hemorrhoids, haemorrhoids or emerods. They are varicosities or swelling and inflammation of the veins that are found in the rectum and anus. External hemorrhoids are those that are located on the outside of the anal verge. Thrombosed hemorrhoids occur when the vein ruptures and what develops is a blood clot. These are very serious. Piles that develop inside the rectum are called internal hemorrhoids.
Other types include prolapsed hemorrhoids and strangulated hemorrhoids. One of the most widespread causes of piles is straining during bowel movements. There is also the factor of genetic predisposition. While the exact causes are still controversial, some causes are believed to include sedentary lifestyle, chronic diarrhea and constipation. It has also been linked to anal infections, being overweight, pregnancy and to some diseases.
To avoid having piles, the recommendation is to exercise if yours is a sedentary occupation and to be sure to eat plenty of food that has high residues. Foods that do not have high residues are those largely made with white flour, also white or polished rice, spaghetti and chocolate. Eat sparingly of these foods but plenty of those having high residues, such as bran muffins, whole wheat bread and whole grain cereals. Also, eat plenty of leafy and other vegetables, especially celery and cabbage. Eat baked potatoes with the "jackets," and fruits with their peelings—apples, peaches and suchlike fruits. If you already have piles, just returning to a natural diet as noted above may relieve you of the problem if it is not severe or complicated. But you may need more definitive treatment. What is known in the medical profession as "ligature and excision" is the most common surgical treatment, although only about 10 percent of those afflicted need such surgery. Some types of uncomplicated internal hemorrhoids are successfully treated by one of several injection techniques. Still another procedure employs the use of elastic bands, which are placed so as simply to strangulate the mass of involved venous tissue. Such methods of treatment are done as office procedures under local anesthesia and without much postoperative disability for the patient.
It has long been stressed that among the main causes of piles are sedentary occupations and poor bowel habits. But today we are told that piles are found among heavy labourers, military personnel and many others whose work is not sedentary. Among the factors charged by some with bringing on piles are excess use of spices, vinegar and coffee. A most likely basic cause is a hereditary weakness that makes one a good candidate for piles. It is believed that constipation and straining when having bowel movements are to blame in a large measure for the prevalence of piles. But, conversely, an acute case of diarrhea can bring on an attack of complicated haemorrhoids. Inability to relax the muscles in the anus may also bring them on, and this, in turn, may well be caused by modern man's improper eating habits. Additionally, piles are one of the common complications of pregnancy, due apparently to increased intra-abdominal pressure brought on by the enlarged uterus.
It is not understood why hemorrhoids enlarge. There are numerous concepts about the source, consisting of inadequate consumption of fiber, lengthened sitting on the toilet, and chronic straining to have a bowel movement (irregularity). None of these concepts has strong experimental support.
Pregnancy is a clear cause of enlarged piles though, once again, the reason is unclear. Growths in the hips likewise cause augmentation of piles by pushing on veins draining up from the anal canal.
One concept recommends that it is the shearing (pulling) force of feces, specifically tough stool, travelling through the anal canal that drags the hemorrhoidal cushions downward. An additional concept suggests that with age or an annoying condition, the supporting tissue that is responsible for anchoring the piles to the underlying muscle of the anal canal deteriorates. With time, the hemorrhoidal tissue loses its mooring and slides down into the anal canal.
