Written by Dr. Shailesh Doshi

Piles, also known as haemorrhoids, are swollen veins in the anus and lower rectum, similar to varicose veins. They can develop inside the rectum (internal haemorrhoids) or under the skin around the anus (external haemorrhoids). They are a common condition, but many people feel embarrassed to talk about them and often seek treatment only when they become severe.

...... Types ......

There are two main types of piles:

1. Internal Piles : These are located inside the rectum (lies beneath the mucosa) and are usually not visible. They can, however, bleed when irritated.
2. External Piles : These occur under the skin around the anus. When irritated, external haemorrhoids can itch or bleed. They can also cause pain and discomfort.

When the internal piles grow to involve the anal skin they are called Interno-external Piles.

...... Piles can also be classified as ......

Haemorrhoids are also classified based on their severity and position, typically ranging from Grade I to Grade IV:

1. Grade I : No prolapse, just prominent blood vessels.
2. Grade II : Prolapse under pressure but spontaneously reduces.
3. Grade III : Prolapse that needs to be pushed back manually.
4. Grade IV : Prolapse that cannot be pushed back and is at risk of becoming strangulated or thrombosed.

...... Causes ......

The exact cause of haemorrhoids is unknown, but several factors contribute to them, including:

1. Exciting causes : Straining during bowel movements induced by -
   • Chronic constipation
   • Over use of purgatives
   • Diarrhoea of enteritis, colitis - Dysenteries aggravates latent Haemorrhoids.
2. Obesity
3. Low-fiber diet
4. Pregnancy : due to
   • Compression of rectal vein by pregnant uterus
   • Relaxing effect of progesterone hormone on smooth muscle wall of veins
   • Increased pelvic circulating volume
5. Hereditary : The condition is frequently seen in members of the same family. The predisposing factors could be
   • Congenital weakness of vein walls
   • Abnormally large arterial supply to rectal plexus
6. Morphological : Due to erect posture weight of the column of blood in the valveless rectal venous plexus produces high pressure in lower rectal veins.
7. Other anatomical factors

...... Clinical Features ......

1. Bleeding : Main and earliest symptom; at first it is slight, bright red; occurs during defecation (splash in the pan), it may continue intermittently for months or years.

2. Prolapse : In the beginning protrusion is slight, occurs only at stool, reduction is spontaneous. Later they do not reduce by themselves and have to be reduced by the patient digitally.

Degrees of Hemorrhoids :

• First Degree : Haemorrhoid bleed but do not prolapse out side the anal canal.

• Second Degree : They prolapse on defecation but get reduced spontaneously or are replaced manually.

• Third Degree : They are permanently prolapsed. They may become infected or there may be thrombosis of veins. The hemorrhoids then cause discomfort and a feeling of heaviness in the rectum.

3. Discharge : It is mucoid, composed of mucus, secreted by engorged mucosa.

4. Pain : There may be no or minimal pain in cases if internal piles. Throbbing and burning pain is oftenly seen in cases of external piles and in cases of fissure and fistula.

5. Anemia occurs rarely and is due to persistent profuse bleeding.

...... Complications ......

1. Profuse bleeding : Often in early stages of second degree. The bleeding occurs mainly externally but may occur internally following retraction of the piles.

2. Strangulation

3. Thrombosis

4. Ulceration : Of the exposed piles

5. Gangrene

6. Fibrosis

7. Suppuration

...... Taking Care ......

Simple lifestyle changes can often alleviate mild symptoms of haemorrhoids or prevent them from getting worse:

1. Eat high-fiber foods : More fruits, vegetables, and whole grains can help soften the stool and increase its bulk.

2. Drink plenty of fluids: Stay well-hydrated to keep stools soft.

3. Consider fiber supplements: Most people don't get enough fiber from their diet.

4. Don't strain : Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum.

5. Exercise: Stay active to help prevent constipation and to reduce pressure on veins.

6. Avoid long periods of sitting: Sitting too long, particularly on the toilet, can increase the pressure on the veins in the anus.

...... Homeopathy Treatments ......

It's important to consult a healthcare professional if you experience any symptoms of haemorrhoids to rule out more serious conditions and to discuss the best treatment options for your situation. Early intervention can prevent complications and improve quality of life.

Unlike conventional medicine which treats symptoms with pain relievers or procedures like rubber band ligation, sclerotherapy, infrared, laser or surgeries, Homeopathy treatment takes holistic approach. Homeopathic practitioners believe in treating the individual as a whole rather than just the disease. Homeopathy considers the emotional, mental, and physical state of the person. It aims to stimulate the body's own healing responses. Treatments are highly individualized. Two people with the same condition may receive different treatments based on their unique symptoms and overall health.