An anorectal abscess is a painful swelling near the anus or in the buttock. The swelling contains pus. 60% anorectal abscesses are superficial and resulting from infection in small anal glands present in between internal and external anal sphincters (intersphincteric space). They are known as a perianal abscess. 30% of anorectal abscesses are deep-seated and results in systemic infection. They are call Ischiorectal abscess. Submucous abscess, pelvirectal abscess and pilonidal abscess developed from versatile cause are comparatively less common. Inadequate and improper management of anorectal abscess may potentially cause complication like fistula formation.


Fast facts on Anorectal abscess-

* Anorectal abscess should be drained at the earliest.
* Conservative medical management almost invariably invites complication like fistula formation.
* Surgical drainage of pus reduces the chance of fistula formation by 50%.


What causes Anorectal abscess?

* Blocked and infected anal glands (cryptoglandular infection).
* Untreated anal fissure that becomes infected.
* Sexually transmitted infections.
* Penetrating injury of the perianal or buttock region.
* Crohn s disease.
* Colon cancer.
* Tuberculosis.



What are the symptoms of Anorectal abscess?

Superficial abscess-

* Constant and throbbing pain that worsens on sitting down.
* Swelling, redness and tenderness of the skin around the anus.
* Discharge of pus.
* Pain is often associated with bowel movement.

Deep abscess-

* All or some of the symptoms of a superficial abscess.
* Fever with chill and rigor.
* General weakness.
* Sometimes fever is the only symptom of the deep abscess.

The anorectal abscess should preferably be explored under general or spinal anesthesia. Medical management often fails and subsequently fistula is formed.

Anorectal Abscess - Know In Detail About It!

Are you suffering from piles and are looking for an effective and natural treatment measure? You can now opt for an Ayurvedic treatment of piles, which is an effective and an all-natural remedy. Piles or hemorrhoids refer to the swelling inside or near the bottom of your rectum, which contains enlarged blood vessels. The cause of piles is associated with increased pressure in the blood vessels near your anus. 

Here are some top Ayurvedic ways for treating piles:

Avoid a sedentary lifestyle: Sitting in the same posture for long hours without any movement can lead to piles. The lack of physical activity is a common cause of piles in modern day. Hence, it is important for you to work out, stay fit, and active. You must exercise every day strictly for treating and preventing piles.
Avoid food items which are difficult to digest: Piles develop because of an increased pressure on the walls of the rectum. So eat light food, which is easy to digest and eliminate as stool. You should add a lot of fruits and vegetables to your regular diet.  
Consume food items which improve your digestion: In case of a weak digestive system, you should add probiotic rich food to your diet. You can also take probiotic supplements which enhance your digestion, soften your stools, and exert less pressure on your rectum walls.
Have a detox drink daily: Prepare a mixture of ginger, fresh mint, lemon juice, and honey and drink it. This improves your digestion and treats piles. Add food items such as mango seeds, onion, radish, wheat, rice, turnip, sesame seeds, bitter gourd, papaya, and other  fiber rich stuff to your diet. 
Increase your water intake: Dehydration causes the stool to turn hard, making bowel movements difficult. So drink a lot of water for enabling the stool to pass easily.
Dried figs: Soak dried figs in warm water and consume them in the morning. This is very effective in curing piles.
Prevention
You can prevent piles or hemorrhoids from affecting you by taking some simple steps. 

Drinking sufficient water and eating fiber-rich food is the key. 
Also drink castor oil mixed with milk, which makes your stool soft, and helps it pass easily. It also reduces the pressure on your rectum walls and muscles. 
Massaging your abdomen using marjoram oil and rosemary oil is quite effective. 
To know more about the best Ayurvedic remedies, which are ideal for treating your condition and diagnosing the specific symptoms or problems you are facing, consult an Ayurvedic practitioner.

Piles - 6 Amazing Tips That Can Treat It!

Piles can be really painful and embarrassing but fairly common at the same time. it should not be taken as a social stigma as with awareness and proper treatment, the condition can be managed and treated well. If overlooked then it may lead to many complications which are difficult to manage.

In Ayurveda, a complete cure to haemorrhoids is possible, so seeking medical attention can be of great help to relieve you from this condition. Piles, also known as Haemorrhoids is a condition in which veins at the lower end of rectum get inflamed and enlarged. When pressure on the rectum and anus increases, it causes added pressure to these veins, resulting in formation of haemorrhoids. They may burst and cause rectal bleeding. Haemorrhoids are most commonly found in middle-aged and old people while also in people who suffer from regular constipation. 

Types of Piles -

Haemorrhoids are of two kinds, internal and external based on their location. Internal haemorrhoids are located in the inner lining of the anal tract. These veins within the rectum are concealed and cannot be felt so they are painless but when ruptured can lead to bleeding. External haemorrhoids are located on the outer surface of the rectum and can be seen, felt and when inflamed become painful. These are the more troubling type of piles. 

Causes and Symptoms of Piles 

Piles are caused mostly by constipation, but other causes may include untreated gastric conditions such as dysentery, sedentary lifestyle, obesity, genetic constitution and weight of increasing uterus during pregnancy. 
If you are experiencing bleeding in anal region during defecation without any pain; you are suffering from 1st stage of Piles. If problem is not treated at this stage; Pile masses start progressing. 
In starting, Pile mass come out during passing stool and go inside by itself (2nd stage). Later on these pile masses need to be reduced manually. If still Piles is not treated; Pile mass comes out again even after manual reduction while coughing, sneezing etc. (3rd stage). While piles may be an embarrassing issue to talk about, it should not be ignored either. It can be easily dealt with simple ways, and in most cases, all it takes is some lifestyle changes to get rid of the problem. 
However, if left untreated, there could lead to severe complications. Some of them have been listed below. 

Bleeding: In patients who have chronic bleeding, it could lead to chronic blood loss. Patient can develop anaemia because of this regular bleeding. 
Mass protruding out from anal opening: If Piles are not treated at 1st stage; it can lead to development of pile mass which protrudes out from anal opening while passing stool and go inside. In later stages; this pile mass come out even on sneezing and coughing. At this stage they are prone to get infected as most of the time Piles are outside the anal opening. 
Hygiene issues: The itching and discharges can lead to the patient having poor hygiene around the anal area. This further can lead to complications like infections. The area around the anus also becomes difficult to clean if the masses are more in number and size. 
Surgical correction may be attempted in severe cases, but this also can lead complications in some people. These include: 
Excessive bleeding which does not stop after the surgery. 
Postsurgical infection 
Anal fistula, which is a connection between the area of piles and the anal canal. 
Damage to sphincter muscles leads to faecal incontinence, which is a loss of control over passing stool.
Ayurveda Treatment of Piles 
Ayurveda has various approaches to the treatment of piles. Piles can be treated by diet, lifestyle, herbal supplements, Ayurvedic medication, and exercise. Ensuring good digestive health helps with piles if constipation is the cause of it. 

Vegetables such as onion, bitter gourd, radish, and turnip are high on roughage and are a must to add to your diet as well. 
Other than the diet you need to introduce specific lifestyle changes such as a colon cleanse every once in a while, and regular exercise. 
Increase water intake, up to 8 glasses per day. 
Keep away from processed foods 
Increase consumption of fruits and vegetables 
Do not sit for more than an hour in one position 
Stick to stool timings and develop good stool habits 
Do not suppress the urge to pass stools for too long and for too often 
So, follow the instructions of your Ayurveda doctor to embark on the road to cure. If these measurements are not successful; kshar karma or Ksharsutra ligation of Pile mass is necessary. In the ligation procedure; Ksharsutra   medicated thread is legated at the root of Pile mass. 

Medicine released from Ksharsutra blocks the blood supply to pile mass and Pile mass sheds off in 7   10 days. Ksharsutra ligation is a para surgical procedure done under local anaesthesia. No hospitalization or bed rest is necessary in Ksharsutra Treatment for Piles. Daily routine activities along with office work can be done during Ksharsutra Treatment. So Piles can be treated completely in all its stages with Ayurvedic treatment. However, this procedure is to be performed only by a surgical specialist of Ayurveda..

Painful Piles - Why You Should Not Ignore Hemorrhoids

Piles or haemorrhoids cause severe bleeding (coupled with severe pain and blood in the stool) in the anal region because of sudden increased pressure in the concerned area due to an abnormal enlargement of the rectal veins.

The haemorrhoids, which grow on the outer part of the anus, are more painful as compared to the internal haemorrhoids (which are generally not visible on the outside and grow on the insides of the rectal area).

Primary Causes-

The major causes of haemorrhoids are hereditary factors, excessive alcohol consumption, weight gain, lack of regular physical exercise, undiagnosed and chronic gastric disorders such as dysentery, diarrhoea or constipation, tumour in the pelvic areas and a significant enlargement of the uterus during pregnancy.

Out of all the diseases, the most feared are the ones are that remind one of surgeon s knife. Piles is just one out of those diseases. But with Homeopathic medicines one can can be saved from the surgeon s knife; moreover they are entirely safe, gentle and the cure of piles is permanent. This means that homeopathy can help in the complete recovery of piles. Homeopathic Remedies for hemorrhoids aim at correcting the internal disturbances of venous system by making the vein valves more strong which helps in a complete recovery. The sooner the patient approaches a homeopathic physician for piles treatment, higher are the chances of a  complete recovery and avoidance of surgery.  Homeopathy should be the preferred and the first mode of treatment in piles owing to the use of safe, natural nature of medicines before. Some of the most common homeopathic medicines for piles are-

Ratanhia: Piles, accompanied by severely painful hemorrhoids (which cause tremendous pain during excretion) and severe/persistent pain that stays for several hours after excretion, can be addressed by this medication.

Nux vomica: For extreme sensitivity to cold on having been diagnosed with piles, you might be recommended this particular medicine. This homeopathic preparation can also help if one is suffering from piles caused because of the excessive consumption of spicy foods, alcohol.

Graphites: It provides an effective remedy for piles along with symptoms of chronic constipation, frequent skin eruptions and persistent menstrual anomalies.

Arsenic Album: A burning sensation around the anal region that worsens with any form of physical movement or exercise can be taken care of with this particular antidote. It is also prescribed if the hemorrhoids bleed severely.

Hamamelis: This homeopathic preparation is useful to remedy cases of the presence of blood in the feces.

These are just a few of the commonly used Homeopathic remedies and are mentioned only to create awareness about the effectiveness of Homeopathic medicines for scabies. It is not advisable to resort to self-medication for any disease.

Homeopathy and Piles

Problems of the large intestine are very common and patients should usually consult gastroenterologists for the proper diagnosis and treatment

1. Bleeding per rectum: Bleeding through the anal canal or rectum is usually the most common problem of the patients. It can be due to following reasons: 

A. Piles also known as Hemorrhoids: Hemorrhoids are dilated venous channels of the anal canal. They occur due to long term constipation or chronic cough or due to less fibre intake in the diet. Sigmoidoscopy or proctoscopy is required for diagnosis. Treatment options include medicines and high fibre intake, Injection therapy(Sclerotherapy) for stopping bleeding from piles and Stapler hemorrhoidectomy if the piles are large.

B.  Polyps: Polyps are soft tissue growths seen in the large intestine. They are usually silent but can present with bleeding or anaemia. Polyps usually grow slowly in size and large polyps can turn into cancer of large intestine also known as colorectal carcinoma. Colonoscopy is required for the diagnosis. The gastroenterologists can diagnose the presence of polyps by colonoscopy. Smaller polyps can be removed by polypectomy by gastroenterologists without the need for open surgery. However large polyps or those polyps with suspicion of cancer require surgery.

C. Large intestine Ulcer: They can occur due to early cancer, SRUS, Infections or drugs. They require colonoscopy for the diagnosis. The gastroenterologists usually take Biopsy from the ulcer to know the cause of the ulcer. The mere taking of biopsy does not mean cancer and biopsy samples are seen in the microscope for better diagnosis.

D. Ulcerative Colitis and Crohn s disease: Ulcerative colitis is one form of Inflammatory bowel disease (IBD). The other IBD is known as Crohn s disease. Whereas ulcerative colitis involves only large intestine, Crohn s disease can involve any part of the gastrointestinal tract including small intestine. Ulcerative colitis and Crohn s disease present with Loose stools(diarrhea), bleeding , abdominal pain, weight loss, Anemia and Perianal fissures and  fistula. The diagnosis of IBD is challenging and involves blood tests, CT Scan abdomen, Colonoscopy with biopsy and clinical history. Management includes Medicines which control the inflammation such as Pentasa, Rowasa, Mesacol etc. Severe disease requires additional drugs such as Azathioprine and Anti TNF sich as Infliximab and Adalimumab. Occasional cases require surgery such as those with tight stricture of the intestine, severe dilatation of Large intestine (also known as Toxic megacolon), excessive bleeding, the disease not responding to medical management, or presence of cancer with IBD.

E. Anal fissures: Cut in the anal skin (fissure) causes severe pain in the anal area during passing motions. It is usually due to constipation or straining. It is usually treated by Gastroenterologists initially by medicines and ointments. If the pain continues Surgery is required named as Lateral internal sphincterotomy (LIS).

2. Loose motions or Diarrhea: Excessive passing of liquid motions is known as diarrhea or commonly lose motions. It is usually due to Infections caused by contaminated food and water. It is usually self-limiting. Severe cases with dehydration require admission for IV fluids and antibiotics for the infection. Loose motions for more than 6 to 8 weeks is known as chronic diarrhea. It is evaluated by blood tests and colonoscopy. Usual causes include tuberculosis, celiac disease, ulcerative colitis, microscopic colitis, Malabsorption such as chronic pancreatitis and small bowel bacterial overgrowth.

3. Irritable bowel syndrome (IBS): IBS is very common and at least 20 to 30 percent of Indian patients suffer from it. Symptoms include altered bowel habits such as diarrhoea or constipation, abdominal pain which is usually relieved or increased by defecation. Weight loss or bleeding is not the feature of IBS. Few simple blood tests are required and good medicines are now available for IBS. Few cases may require colonoscopy to rule out alternative causes of the symptoms.

Understanding colonoscopy: Colonoscope is a flexible tube with a camera at its tip to see the inside of the large and small intestine. Bowel preparation is required at least 8 hours before the procedure so that the inside of the large intestine can be seen clearly without the interference of stools.colonoscopy is an OPD based procedure where the patients are discharged the same day. A colonoscopy helps in evaluation symptoms of the large intestine such as loose stools, bleeding and abdominal pain.

In Detail About Colorectal Disorders!

Hemorrhoids, also known as piles, are swollen veins or blood vessels, which can be internal (located inside rectum) or external (located outside rectum). They might be managed by increasing fluid intake and a high-fiber diet. Sometimes, Hemorrhoids might get infected and irritated to an extent that they require surgical removal.

Causes of Hemorrhoids:

Hemorrhoids are caused by increased pressure in blood vessels around the anus, causing them to swell and inflame which might be caused by a number of reasons.

Prolonged constipation

Chronic diarrhoea

Obesity

Aging

Pregnancy as it increases pressure on pelvic blood vessels

Weight lifting

Family history of Hemorrhoids

Persistent cough

Vomiting repeatedly

Sitting continuously for a very long period of time.

Symptoms of Hemorrhoids:

Some of the common symptoms of Hemorrhoids are:

Internal Hemorrhoids might bleed painlessly after bowel movement, but are problematic if they bleed too heavily.

External Hemorrhoids might also bleed after bowel movement, but often become irritating and painful.

External Hemorrhoids can lead to blood clots inside the vessel, which can cause severe pain. Proper treatment for such Hemorrhoids involves  incision and drainage  procedure.

Itchy and sore bottom.

A lump hanging off the anus.

Types of Hemorrhoids:

The type of Hemorrhoids decides the course of action for treatment.

First degree Hemorrhoids are small swellings which develop on inner lining of anus, being invisible from outside.

Second degree Hemorrhoids are larger swellings which might come out of the anus during bowel movement before disappearing inside again.

Third degree Hemorrhoids are lumps hanging off the anus which can be pushed back inside.

Fourth degree Hemorrhoids are larger lumps hanging down from the anus but cannot be pushed back inside.

Surgeries without Anesthesia:

Banding or rubber band ligation involves using a tight band around the base of Hemorrhoid to cut off its blood supply. It takes two or more procedures to be performed about two months apart.

Having the best success rate for small and internal Hemorrhoids, sclerotherapy involves injecting a chemical into Hemorrhoids, causing them to shrink and stop bleeding.

Coagulation therapy or infrared photocoagulation uses infrared light (heat or extreme cold) to retract and shrink the Hemorrhoid and is usually performed along with an anoscopy.

Hemorrhoidal artery ligation (HAL) or transanal hemorrhoidal dearterialization (THD) locates blood vessels causing Hemorrhoids to close them off.

Surgeries with Anesthesia:

Hemorrhoidectomy is used for large and external Hemorrhoids which do not respond to non- surgical intervention. So, they are cut out. Anesthesia can be general, regional, or local in this procedure. It takes longer time to recover completely.

Hemorrhoidopexy or stapling requires general, regional, or local anesthesia, and is used to treat prolapsed Hemorrhoids. A surgical staple cuts off the blood supply to Hemorrhoids to make the tissue shrink and reabsorb. It takes relatively less time for a full recovery.

Post- Surgical Care:

Some of the post care instructions are as follows

Painkillers might be prescribed for rectal and anal pain.

Consumption of a high-fiber diet prevents constipation and recurrence of Hemorrhoids.

Staying hydrated helps a lot.

Avoid heavy weight lifting and pulling.

Sitz bath helps to deal with post- surgical discomfort.

Seek medical help if having painful urination, fever, or dizziness.

Non-surgical Management of Hemorrhoids:

Hemorrhoids can be managed non-surgically by reducing strain in and around the anus.

Consuming a high fiber diet including cereals, fruits, vegetables, pulses, nuts, seeds, etc.

Consuming healthy fluids like water but avoiding alcohol and caffeinated drinks.

No delaying the emptying of the bowels.

Preventing constipation.

Weight management to lose excess body weight.

Regular exercise.

Take Away:

Hemorrhoids, if not severe, can be managed non- surgically. But if they get very painful and severe, surgical intervention through a number of techniques might be required; each one of them being safe, depending upon the severity of the situation.

Surgery For Hemorrhoids - What Should You Know?

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