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!

Is Constipation the Only Cause of Piles? + It's Symptoms

Piles, which are also called hemorrhoids, refer to the swelling of the veins near the anus and rectum, which get irritated during bowel movements, causing pain and bleeding during stool motions. The veins near the rectum or the anus may rupture during strained bowel movements and thus, cause the blood to come out with the stool. This can be very painful for the patient and has a very disruptive effect on their lives.

Causes of Piles

There may be many causes for piles or hemorrhoids and the cause may vary from patient to patient. Let's have a look at a few of them.

Straining when passing a stool - This is by far the most common reason for piles and this is what causes the irritation on the veins or causes them to rupture

Chronic Constipation: People suffering from chronic constipation due to gastrointestinal problems may also suffer from piles due to putting pressure constantly to relieve themselves.

Lifting a heavy weight or doing strenuous work: This can also put physical stress on the anus or rectum and cause swollen veins, which may then rupture during the passage of stool.

Pregnancy - Pregnancy causes many hormonal changes in the body and the strain may also result in piles.

Symptoms of Piles

Some of the symptoms of piles or hemorrhoids are:

- Painful bowel movements, which hurt the rectum or the anus, accompanied by general tenderness within the region
- Bleeding or seeping of a bright red color blood onto the stool on the toilet or even on toilet paper
- Itching in the anal areas, which may be continuous or intermittent
- A swelling or lump near the anus, which is painful
- A mucus-like discharge from the anus

There may be one or more factors present in particular cases and if there is a pain in the rectal area, it is best to get it checked out by a doctor as soon as possible.

If you would like to consult with me privately, please click on 'Consult'.

Is Constipation the Only Cause of Piles? + It's Symptoms

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

The human body is an intricate mechanism that functions amazingly. And when there is any trouble it does not fail to show signs of trouble, and all we need to do is, to notice it and solve our problems. This is applicable to all types of health issues, including a perianal abscess.

What is Perianal abscess?
Perianal abscess is an extremely painful condition of anal abscess that occurs when one cavity in the anus starts getting filled up with pus. Very often it appears as a painful swelling similar to boil just near the anus. Usually, it appears red in color as well as slightly warm to touch. If the location of the anal abscesses is in the deeper tissue, then it might be less visible and it occurs in people suffering from inflammatory bowel disease.

The worst part is that in certain cases, anal abscesses might lead to more painful anal fistulas. Generally, fistulas occur only if the abscesses fail to heal and break open on the skin s surface. Therefore, it is important that the abscess heals properly or else it may lead to intolerable pain and may even require surgery.

Symptoms of Perianal Abscess
The immediately noticeable and probably the most common anal abscess symptom is constant and throbbing pain around the anal area. Swelling accompanies the pain and its rate increases during bowel movements.

Various common signs of Perianal abscess are:

bleeding or rectal discharge
constipation 
fatigue
Swelling or tenderness,
Skin irritation all around the anus.
Patients with deeper abscess might also show symptoms such as chills, fever, malaise, etc. Various reports state that certain people also feel a lump or nodule at their anus s rim. Facing difficulty while urinating might also be experienced by some people affected by perianal abscess.

HOW TO DIAGNOSE PERIANAL ABSCESS?
One must immediately seek medical if they experience any of the above-mentioned signs or symptoms. Clinical evaluation along with digital rectal exam is sufficient for the proper diagnosis. But, in some cases, patients might need other tests to screen for rectal cancer, diverticular disease, inflammatory bowel disease and sexually transmitted infections. Your physician might also suggest a CT scan, an MRI, or an ultrasound.

HOW DO YOU TREAT PERIANAL ABSCESS?
Just after the diagnosis, prompt surgical drainage would be carried out by the doctor before the abscess erupts. A deeper or larger abscess might require hospitalization as well as an anesthesiologist s assistance. In most cases, patients are prescribed certain medications for pain relief just after the procedure. Antibiotics are mainly given to those people who have comparatively weaker immunity or suffer from diabetes.

Know More About Perianal Abscess!

If you notice blood in the stool or the toilet bowl, it could be a case of rectal bleeding. There are many reasons why rectal bleeding can occur, the most common one being haemorrhoids. If the rectal bleeding is not significant then it is not a cause for concern. But if you lose a lot of blood then it can be a major problem.

What are the signs?

The most obvious one, in this case, is the presence of blood in your stool. But it's not just the presence of blood that is important here, the colour of the blood is also a very important indicator of what is wrong.

Black colour indicates that you are bleeding from the upper region of the small intestine

A bright red colour is an indication of the blood loss from the lower part of the gastrointestinal tract   rectum or colon

Dark red indicates that the bleeding is taking place at the initial region of the colon

Some other symptoms you may experience are  

Confusion

Pain in the rectum

Stomach cramps

A sensation of dizziness

Causes of rectal bleeding

Causes of rectal bleeding can be divided into mild and serious. 

Mild causes  

Constipation 

Small tears in the anal lining (anal fissures)

Haemorrhoids

Small growths of tissue in the rectum or colon

Serious causes  

Cancer of the colon and anus

Inflammatory bowel disease

An infection of the intestine such as salmonella

How is it treated?

If you lose a lot of blood, then it is a medical emergency. You should rush to the doctor if you experience the following   fainting, intense pain in the stomach, confusion, and rapid breathing.

The doctor will prescribe treatment based on the cause of your rectal bleeding. For example, if the cause is haemorrhoids then warm baths will help soothe the pain. If the haemorrhoids are large then invasive methods such as laser treatments and surgery are prescribed. 

Or if it is constipation then stool softeners are a good option. In addition, you may have to eat a high fibre diet and exercise regularly to normalize your bowel movements. 

Rectal bleeding can be a minor inconvenience or a major problem depending on the cause. So it is best to consult a doctor and seek immediate treatment.

Rectum Bleeding - How To Administer It?

Haemorrhoids or piles is a condition where the veins in and around your anus become swollen. This swollen vein sticks out from the anus and can make sitting and moving difficult. Laser haemorrhoidoplasty is one of the best ways to treat advanced forms of the condition. However, before knowing more about the procedure, you should learn more about piles in general.

Causes of piles-
You are likely to develop piles in the following events  
  If you strain excessively during bowel movements
  If you sit for prolonged periods on the toilet
  If you suffer from constipation or chronic cases of diarrhoea
  If you are overweight or obese
  If you are pregnant
  If you engage in anal sexual intercourse
  If your diet lacks proper quantities of fibre
The likelihood of having piles increase with your age. This is because the tissues supporting your veins tend to lose their strength, as you grow old.

Symptoms of piles-
If you suffer from piles, you can easily notice certain symptoms from the condition. Here are the most common signs of haemorrhoids  
  You will notice bleeding during bowel movements. However, you will not feel any pain from the said bleeding.
  Your anal and rectum area will itch throughout the day. You will experience irritation in the region as well.
  You will notice a lump formation near the anus, which will lead to extreme pain and discomfort. Sitting and walking may also become painful due to the presence of the lump
  You may also notice a general swelling in your anus region.
However, the exact symptoms may vary from one affected person to the next, based on the location and type of haemorrhoids.

How does laser haemorroidoplasty help in the treatment of piles?
While most haemorrhoids are treated with medication and lifestyle changes alone, advanced cases require additional procedures. Laser haemorrhoidoplasty is one such procedure used to treat severe piles cases.
This treatment results in the reduction of the size of the haemorrhoid. The laser energy passes through the haemorrhoidal node, destroying it in the process.

Here are some advantages of laser haemorrhoidoplasty  
  Closes the arteries carrying blood inside the haemorrhoid
  Reduction of the haemorrhoidal node tissues
  Preservation of most of the mucosa, anal lining and muscle
  Rectifies the issues with the anatomical structure and restores it to normal
  A minimally invasive procedure, which limits post-operative pain and scarring

If you suffer from an advanced stage of piles, speak to your doctor and see whether laser haemorrhoidoplasty is an option for you.

Laser Haemorrhoidoplasty - What All Should You Know About It?

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