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?

Piles or haemorrhoids might cause severe bleeding in the anal region due to an abnormal enlargement of the rectal veins. The bleeding occurs as a result of a sudden increase of pressure in the rectal area.

The haemorrhoids, which tend to grow on the exterior part of the anus, are usually severely painful as compared to the internal haemorrhoids (which are invisible and grow on the insides of the rectal area).

What are the possible causes?
The major causes of haemorrhoids are genetic factors, pelvic tumours, excessive alcohol consumption, obesity, lack of regular physical exercise, undiagnosed and chronic gastric disorders such as dysentery, diarrhoea or constipation and a significant increase in weight of the uterus during pregnancy.

Major Signs:
The signs and symptoms of this disease might include intense pain and irritation in the rectal area along with the presence of blood in the faeces and abnormal swelling of the affected area.

Homeopathy For Piles:

When it comes to alternative or complementary treatments for piles or hemorrhoids, Homeopathy offers the best treatment for piles. It is the best not only because the cure rate is exceptionally good but also because Homeopathic treatment for piles offers several more advantages. It is very economical when compared to any other alternative or complementary treatment for piles. At the same time, the homeopathic medicines do not have any side effects. This is one of the biggest advantages of Homeopathy over any other system of medicine. While you are under treatment of any other system of medicine, you run the risk of getting one or the other side effect while Homeopathic treatment for piles is absolutely safe. That is why I say that Homeopathy is the best when it comes to alternative or complementary treatment for piles or Hemorrhoids.

If taken in a prescribed dosage, homeopathy can be very effective to cure piles. The most beneficial homeopathic preparations for piles are:

Nux vomica: This homeopathic preparation is useful to cure piles that exhibit the symptoms of extreme irritability and intolerance towards cold weather. If the reasons behind piles include the consumption of spicy foods, excessive intake of alcohol and smoking, this particular remedy can work wonders. 
Hamamelis: This preparation is used to address such a condition if the symptoms exhibited include blood in the feces along with continuous discomfort and contusion (an area of injured tissues).
Ratanhia: This preparation provides an effective remedy for severely painful hemorrhoids (which cause complications during excretion) along with the symptoms of severe pain that persists even after several hours of excretion and a burning sensation in the concerned area.
Graphites:  This medicine works especially well for the fairer sex if the symptoms happen to include chronic constipation, skin eruptions in the rectal area and menstrual abnormal menstrual cycles. 
Aesculus HIppocastanum:  This homeopathic preparation provides an effective remedy for non-bleeding hemorrhoids that exhibit symptoms of severe back pain and pain in the anal regions.
Arsenic Album: This homeopathic offering eases the symptoms that worsen with any sort of movement. Severe bleeding of the hemorrhoids can also be treated with this medication. 

Role of Homeopathy in Hemorrhoids

Cow urine therapy has been in practice for many health problems in india for centuries. In india, cow is a symbol of spirituality and cow urine is not only used in devotional practices, but also comes packed with a bunch of health benefits.

'kamadhenu' is worshipped for thousands of years as the goddess who fulfils desire. In ayurveda, cow is considered as the mother of all entities as the products obtained from cow are beneficial to all mankind in many ways. The milk, urine, curd, ghee and dung obtained from cow are beneficial in different ways as food supplement and medicine. Cow urine or gomutra destroys the poisonous effects of residues and makes body disease free. The medicinal usage of panchgavya, especially cow urine is practiced in ayurveda which is classified as complementary and alternative medicine.

The two indian epics, shushruta samhita and charaka samhita, have described that the consumption of cow urine produces body warmth. In modern medical science, it has been well established that the thyroid hormones are responsible for producing body warmth. The oral administration of cow urine has thyroid stimulating effect and therapeutic value of urinary iodine present in the cow urine is immense. Cow urine or gomutra contains iodine, which is easily absorbable from the gastrointestinal tract. The mean urinary iodine levels in dairy cows may vary from 79.2 to 94.8 micrograms of iodine per litre of urine depending upon their physiological conditions. Iodine is an essential element to produce thyroid hormones such as triiodothyronine and thyroxine. These are catabolic hormones that generate heat and cause body warmth. It has been proven that the cow urine contains iodine in required level for normal functioning of thyroid gland.

Urinary iodine concentration in cow urine varies depending upon its biological status and it could stimulate the patient's thyroid gland activity on oral administration of iodine. Thyroxine stimulates more oxygen utilization and heat production by many different cells of the body.

During iodine deficiency, the pituitary gland secretes enhanced amounts of thyroid stimulating hormone (tsh), which causes compensatory adjustment. This leads in the production of more extensive secretory epithelium which in turn will result in enlargement of the thyroid gland and loss of colloid material in the thyroid follicles. In this scenario, exogenous supplementation of iodine brings back the normal thyroid status.

The administration of cow urine, which contain good levels of iodine, can keep the thyroid gland activity on a better footing. We now have the support of scientific validation for the experience of warming up of the human body after consumption of cow urine or gomutra.

Cow Urine Therapy for Thyroid

Gastrointestinal bleeding, as the name suggests, is characterized by bleeding in the gastrointestinal (GI) tract and its accessory organs (esophagus, stomach, colon, small intestine, rectum, and anus). The bleeding also referred to as gastrointestinal hemorrhage, is not a disease in itself. However, it may be an indication of a disease, injury or infection in the digestive tract of a person. The bleeding in the GI tract may be mild to chronic (often fatal), depending on the severity of the condition that triggers the bleeding.

What causes the gastrointestinal bleeding?
As stated, the gastrointestinal bleeding may be indicative of some digestive tract disorder. Some of the common conditions that may trigger the bleeding include

Tumors that are malignant in nature.
Hemorrhoids (a painful condition where veins around the anus, as well as the lower part of the rectum, swell up)
Peptic ulcers.
Diverticulosis (formation of diverticula or pouches in the walls of the large intestine).
Inflammatory bowel disorder.
Colon polyps (a small mass of cells that develop on the inner lining of the large intestine or colon).
There may be problems in the blood vessels (in the digestive tract).
Anal fissures.
Esophageal varices (the veins of the stomach or esophagus swell up due to a liver disorder, such as cirrhosis).
Angiodysplasia (it is a minute vascular malformation that takes place in the gut).
There may be an inflammation of the gastrointestinal lining.
Symptoms:
The appearance of blood in the stool and vomit is one of the characteristic symptoms of the gastrointestinal bleeding. Other symptoms indicative of a bleeding include

Weakness and fatigue.
The stool appears black and tarry.
A person may complain of uneasiness and shortness of breath.
The skin appears pale. In some cases, prolonged bleeding that goes unattended may result in anemia.
Abdominal pain.
The stool may also appear maroon or bright red (often in the case of bleeding from the lower gastrointestinal part).
Consult a doctor at the earliest if the symptoms persist for more than a week.Timely medical assistance can help to minimize the extent of the damage.

Diagnosis and treatment:
Gastrointestinal bleeding in the colon or the stomach is easy to diagnose. However, the diagnosis of the bleeding that occurs in the small intestine may be tricky and often requires the use of advanced and sophisticated equipment. The diagnosis is often done by

Physical examination.
Liver function tests.
Complete blood count.
Endoscopy, colonoscopy, and sigmoidoscopy.
Treatment:

Endoscopic injections (often diluted epinephrine) at the bleeding site provides great relief.
To close or clamp off a bleeding blood vessel, doctors may use Endoscopic clips.
Endoscopic intravariceal cyanoacrylate injection is used to treat varices in the stomach effectively.
There are medications available to treat GI bleeding triggered by ulcers.
In the case of an acute bleeding, a person may need surgery (Laparoscopy).

Gastrointestinal Bleeding - How It Can Be Treated?

Anal Fistula is a tunnel like communication structure between anal canal and outer skin. There are certain glands in anus whose secretions keep the anal passage lubricated. If due to any reason infectious agent invades these glands abscess formation occurs which subsequently spreads towards the skin and bursts outside forming an external opening.

So Anal Fistula presents itself as a nodular swelling in area surrounding anal opening. Intermittent pus discharge is seen from this swelling. When pus has accumulated there will be swelling and pain which subsides once the pus has been discharged and this cycle goes on.

Anal Fistula Treatment:

Anal Fistula cannot be treated by oral medicines only - Homeopathic/ Allopathic or Ayurvedic whatever it may be. Continuing oral medicines in hope for fistula treatment only worsens the problem. Different surgical options have been tried to treat Anal Fistula like Fistulectomy/ VAAFT/ Laser/ LIFT etc. but not satisfactory results have been found. A high incidence of recurrence around 20-25 % has been observed with these procedures. 

Besides this other complications like stool incontinence etc. are also seen if there is some damage to sphincter muscles. However Anal Fistula can be completely treated by Graded KsharsutraTM Treatment. Clinical trials conducted by Indian Council of Medical Research (ICMR) at AIIMS new Delhi; PGI Chandigarh and other premier institutes of medical sciences; have proved that Ksharsutra treatment is more convenient and more effective than Surgery in patients suffering from Anal Fistula.

In this treatment; first of all Fistula tract is defined with respect to depth, direction and branching pattern by careful manual probing and MRI Fistulogram. Once the Fistula tract has been defined properly; Graded KsharsutraTM - a specialized medicated thread is placed in Fistula tract. Medicine released from KsharsutraTM debrides the Fistula tract and induces healing. This medicine works for 5-7 days so old Ksharsutra needs to be replaced by a new thread at week or 10 days interval.

No. of Ksharsutra changes required for complete healing of Fistula depends on length of Fistulous tract. It has been observed that a Fistula tract of 3 cm length usually requires 4-5 Graded KsharsutraTM sittings at weekly intervals for complete healing. Thus with this recent concept of Graded Ksharsutra treatment of Anal Fistula has become more easy and more effective.

Anal Fistula - How Non Surgical Treatment Is Better Than VAAFT/Surgery?

A hernia occurs because of an internal weakening of the abdominal layer, resulting in tearing. The inner most layer of the abdomen forms a sac and pushes the weakening area. This results in the abdomen tissue being slipped into the sac, causing pain and other health problems. It can occur to both men and women. Apart from natural weakness of the abdomen, a hernia can get triggered from heavy weight lifting, constant coughing, gaining weight and from irregular bowel movement. 80percent of hernia cases originate near the groin.

What are the symptoms?
Some of the common symptoms of a hernia include:

Constipation
Nausea
Feeling of fullness even without eating a thing
Sharp pain while lifting weight
Burning sensation
Dull ache near the groin area
Bulge near the groin area
How is a laparoscopic hernia performed?
This mode of surgery uses a telescope-like instrument known as the laparoscope. With the help of a small incision, the laparoscope is inserted at the belly button. Since the procedure is performed withanaesthesia, it isessential for a doctor to do a routine medical check-up that evaluates the general health of the patient, past medical history, EKG, blood work etc.

Usually, the patient doesn t feel a thing while the surgery is performed. A video camera is connected to the instrument to get a detailed inside view of a hernia and the area that needs to be repaired. Before this, the abdomen is inflated with the help of carbon monoxide. A mesh is placed inside the abdomen to fix the defects of the abdominal wall and strengthen the weakened tissue of the abdomen. Once the procedure is done, the incisions that are made in the abdomen is closed with the help of surgical tapes. The mark of incision disappears within a month.

Benefits of Laparoscopic Hernia Surgery
The benefits of laparoscopic surgery are quite evident.

A lot of tiny incisions are made rather than making a large incision in the abdominal area. This ensures speedy recovery and a short stay at the hospital.
The pain is significantly less compared to the conventional surgery.
The cost of a laparoscopic surgery is lesser
Lastly, a speedy recovery can ensure that a person can return to work within a few days after the surgery is performed.
What to expect after the surgery
Doctors often suggest a week of complete rest after the surgery. The healing time can vary from person to person. A surgeon typically prescribes antibiotics and pain medications to cope up with the wound and pain. It must be ensured that these medicines are taken on time. A revisit to the surgeon might be required after a couple of weeks to assess the recovery.

An Overview Of Laparoscopic Hernia Surgery!

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