Do you bleed or feel pain during bowel movements, or the skin around your anus feels sore or itches? Or maybe there's a lump in or around your anus, or you feel as if your bowels haven't emptied completely? Then you may be suffering from piles. Piles or hemorrhoids are essentially swollen veins and muscles in your anal canal or around your anus. And they may stay inside your anus or come outside depending on the severity of the affliction.

Often, piles can be successfully treated with high-fiber diet, proper hygiene, and topical medicines or ointments. But in situations where non-surgical methods don't achieve desired results, surgery becomes the only option. And this may be particularly necessary for those suffering from large painful or bleeding hemorrhoids. The different surgical options are given below:

Hemorrhoidectomy - In this procedure, the surgeon makes incisions around the anus to remove the piles formations. Local or general anesthesia is offered during the operation, and you can usually return home on the same day. After the procedure, the area might require stitches and commonly remains very tender and painful for quite some time.
PPH or Procedure for Prolapse and Hemorrhoids - This method is minimally invasive and makes use of a stapler-like machine for repositioning the hemorrhoids and cutting off their blood supply. So eventually, the piles shrink and die without blood supply and your pain diminishes greatly. With this process, you can expect a faster recovery, less itching and bleeding, and minimal complications, if any.
Laser - An accurate and special laser beam is used in this method, to burn off the hemorrhoids.
Rubber Band Ligation - This procedure can be used for areas with fewer pain receptors. In this, a rubber band is tied around the base of hemorrhoid to stem the blood supply and destroy the affected tissue.
Sclerotherapy - This method involves the injection of a chemical solution around the blood vessel which supplies the hemorrhoid tissues, to shrink and kill them. Though non-invasive methods are preferred by many since they create less pain, hemorrhoidectomy may provide more long-lasting benefits. Here are some other aspects you need to consider regarding piles surgery:
Risks - Infection, bleeding, reaction to anesthesia, trouble with urination, fecal incontinence are some of the risks involved, though the surgery is usually quite safe.
Ways of treating pain - Pain, especially during and after a bowel movement, can be an issue for several days after the surgery. But it can be dealt with by taking prescribed pain medications, stool softeners, and soaking in a warm bath. Recovery can take up to 3 to 6 weeks after the procedure.
Avoiding recurrence - Following a high-fiber diet, maintaining good hygiene, taking lots of fluids, and avoiding straining or constipation can prevent piles from coming back.

What You Should Know About Piles Surgery

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!

Piles or haemorrhoids refer to a condition when the veins of the rectum or the anus get abnormally enlarged and causing significant bleeding and inflammation. Generally, there are two types of piles that are found in the human body. One is internal haemorrhoid which is generally painless and occurs in the inner layer of the anal region. The other is external haemorrhoid which occurs in the external layers of the rectum making it easily visible and extremely painful.

The causes of Haemorrhoids are obesity, a desk-bound lifestyle, untreated chronic gastric conditions like dysentery, diarrhoea, constipation, hereditary factors, pelvic tumours and significant increase in the weight of the uterus at the time of pregnancy.

The symptoms of piles include severe pain in the anal region followed by blood discharge with the faecal materials along with extreme irritability in the particular region and abnormal enlargement around the anal region.
In Ayurvedic treatments, piles are referred to as Arsha Shoola which means extreme painful conditions that resemble needle piercing. However, this intense sensation of pain can be eradicated by Ayurvedic treatments as it concentrates on the elimination of the symptoms. 

Some essential Ayurvedic remedies for piles are as follows:

Haemorrhoid is a medical condition that largely occurs due to a bad digestive system. A prescribed dosage of haritaki and jimikand might help in the overall improvement of your digestive system.
According to the Ayurvedic scriptures, piles can be treated, if you can maintain a healthy dietary regime that should include amalaki, papaya and jamrul, but not excessive starch-containing foods like potato and pumpkin.
A mixture containing radish and milk can be applied in the entrance of the anus twice a day to cure piles.
A juicy extract of mint leaves and ginger along with a pinch of lemon juice and honey can be consumed twice a day to get rid of piles.
If the bleeding is continuous a prescribed dosage of the herb nagakesara might provide adequate relief.

Piles - 5 Ways Ayurveda 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

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?

Colorectal surgery: How to be sure you need it?

Colorectal surgery is performed to repair damages that occur in the organs of the anus, rectum, and colon. The damage that takes place in these organs can be the result of problems with lower GI like diverticulitis (a condition wherein pouches known as diverticula in the colon wall become inflamed), cancer and inflammatory bowel disease (a group of intestinal disorders that bring about inflammation of the GI).

Who needs this surgery?

In general, colorectal surgery is an essential treatment option for ulcerative colitis, colorectal cancer, Crohn's disease (an inflammatory bowel disease that gives rise to inflammation of the gastrointestinal tract) as well as certain diverticulitis cases. In such cases, the intestinal tract undergoes major reconstruction.

There are also other bowel problems that may require surgery but not of a serious nature and these are anal fissures, hemorrhoids, bowel incontinence and rectal prolapse. Most of the surgical procedures will aid in repairing tears, get rid of blockages, or make tighter sphincter muscles (muscles that surround openings in the body).

Colorectal surgery is also performed in cases of pelvic floor disorders like rectocele (a condition in which the rectum bulges towards the vagina) and perineal hernia (a hernia that involves the pelvic floor).

At the same time, injury, ischemia or compromised blood supply and obstruction may require the performance of bowel surgery as well. Scar tissue and masses can form within the rectum, clogging the organ and preventing the normal discharge of feces from the body.

Problems like ulcerative colitis (an inflammatory bowel disease that leads to the development of ulcers in the colon as well as inflammation of the area) and diverticulitis can give rise to perforations in the rectum. Surgery is suggested in instances when drugs fail to treat the problem of ulcerative colitis.

Likewise, in the case of recurrent instances of perforations or complications in diverticulitis, surgery may be required to remove the portion of the colon affected.



Colorectal Surgery: How To Be Sure You Really Need it

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