Common ailments of the anus i.e. piles, fissure and fistula-in-ano continue to bother a large segment of our population. Though very common sources of embarrassment and distress, many misconceptions exist regarding these illnesses. The following information is intended to shed light and allay the usual fears regarding these common diseases.
Note: The information provided below is addressed to the non-medical community as an educational reference and to answer some of the frequently asked questions (FAQ) on the subject. Please do not take this as a substitute for medical advice or resort to self medication. Kindly contact our consultant team for an accurate diagnosis of your ailment.
PILES – Frequently Asked Questions
1. What is piles?
Piles or haemmorhoids is a common anal condition. It consists of some prominent anal vessels and the tissue (mucosa), which covers it.
2. What causes haemmorhoids?
Though a single cause is not known, this is the price we human beings have to pay for our 2 legged upright posture which causes a great deal of force on the rectal veins. Some contributory factors are ageing, chronic constipation/diarrhea, heredity, pregnancy, spending long times in the toilet (reading), straining at stools etc.
3. Is this a rare condition?
Not at all. In fact it is one of the commonest conditions to affect humans. It is thought that approximately 50 to 70% or more of the population have piles. However, all of them do not require treatment and it does not become a disease till it produces symptoms.
4. What are its symptoms?
It can cause bleeding during passage of motion and a swelling, which comes out from the back passage during defecation. As time goes on this swelling may become larger and larger and remain outside all the time. This can be very distressing.
5. Is severe cutting pain during defecation one of the symptoms?
Usually not. In fact such pain would call the attention of your doctor to look for some other anal ailment. However, when the piles become large enough to remain outside all the time it may cause fairly severe discomfort and pain which is usually persistent and not just during defecation.
6. How will you confirm whether you have pile or not?
The diagnosis can be confirmed by a simple clinical examination of the anus and rectum in the surgical gastro outpatient department.
7. Is this examination very long and painful?
No, it is not. It takes only as much time as any other form of clinical examination though the anal examination naturally is a little more uncomfortable than say examination of the chest, but not unduly painful.
8. What are the different grades of piles?
Piles are graded based on the symptoms.
Grade I – Bleeding alone
Grade II – Protrudes from the anus during defecation, but goes back in
Grade III – Protrudes from the anus off and on, despite attempts to return it to the anal canal
Grade IV – Permanently protruded dark red, swollen and very painful piles
9. If I am found to have piles what forms of treatment are available?
There are many forms of treatment available for piles and the current favourites are
• Infra red coagulation (IRC)
• Rubber banding
• Laser coagulation
• Open surgery
• Stapled haemorrhoidectomy
10. Can I have laser treatment doctor?
The choice of treatment should be left to your doctor. All piles are not suitable for all forms of treatment, Injections, banding and IRC work well only for early e.g. Grade I or Grade II piles while open surgery and stapled haemorrhoidectomy would be ideal for Grade III or Grade IV piles, Once again, let your doctor decide the best option for you.
11. Can I have some pills and creams for my piles rather than these frightening procedures?
No pills and creams that can cure piles exist. These procedures need not be frightening at all.
12. Should I be avoiding some foods, say chicken?
There is no evidence to suggest that a particular food substance worsens piles. However if you do not feel comfortable with a particular food it is only common sense to avoid it. It is certainly beneficial to increase the fiber content of your diet. A high fiber diet is the key.
13. Is this condition serious, doctor?
Piles, as such is not a serious condition, despite the alarming blood loss that it can sometimes cause. However, long neglected piles can be the source of repeated blood loss, which can lead to severe anaemia that can be serious.
Another danger is attributing the symptoms of blood loss and irregular bowel habits to piles. Many patients resort to herbal medicines and proprietary creams for such symptoms. This is not to be recommended as these symptoms could be the result of serious underlying diseases like cancer of the rectum which if not treated early can have disastrous consequences.
14. Can piles turn cancerous?
No, piles cannot turn cancerous. However as mentioned above, if proper clinical examination is not performed by a qualified medical practitioner early enough, cancers of the anus and rectum could easily be missed.
15. Is my constipation due to piles?
No, your constipation is not due to piles. The reverse could be true i.e. longstanding constipation can lead to piles. In fact no bowel symptoms could be attributed to piles.
16. When can I see you doctor?
You are most welcome to the piles clinic every Wednesday between 9 and 12 in the morning and between 5 and 7 in the evenings.