Dr. Pooja Roy

Piles, fistula and fissures are the most common problems affecting the rectum and the anus. Both the rectum as well as the anus has a very rich vascular supply. There could be swelling of these blood vessels or tearing which can lead to the above conditions. Read on to know additional details about each of these conditions. 

Piles: In simple words, swollen blood vessels of the anal region are called piles. It can be internal or external, depending on how far it is from the anal canal. If it is located farther inside the anal canal, it is called internal piles.

Causes:

• Chronic constipation, where the person has to strain to pass stools
• Smoking and genetics can also lead to piles.

Symptoms: Starts off as painless bleeding, which happens in drops after bowel movement; the swelling happens much later. They can continue to grow and develop blood clots.

Treatment:

• In the early stages, once identified, simple topical medications for symptom relief are sufficient.
• Diet should be rich in fiber, with fruits and vegetables
• Increased water consumption
• Surgery if the disease has reached the stage of blood clots
• Prevention is advised if there is a family history by consuming a fiber-rich diet and maintaining hydration

Fistula: When an infected anal gland bursts into the anal canal, it constantly discharges pus into the anal canal and becomes a fistula. Hygienic toilet habits can help in preventing fistulas.

Symptoms:

• A constant wet feeling in the anal area, due to pus discharge.
• This would be intermittent, and there would be periods with no discharge.
• There could be a foul smell due to pus discharge.

Diagnosis and Treatment:

• Identifying the exact location is important as surgery may be required.
• An ultrasound scan or an MRI is usually done.
• Newer techniques like Video Assisted Anal Fistula Treatment (VAAFT) are used. This locates the piles accurately and uses electric current to seal it with staples and surgical glue.
• Conventional surgery is also used for economic or accessibility reasons.
• Fissures: These cracks anywhere in the length of the anal canal are extremely common.

Symptoms

• Very painful and the person may not want to go to the toilet
• Rarely bleeding is also seen, maybe in very small amounts

Treatment:

• Over 90% of the fissures do not require surgery
• Switching to a high-fiber diet and improving hydration will help in managing these symptoms.
• Topical relief can be provided by medications.
• When they are recurrent, a procedure known as lateral sphincterotomy is done. This is an outpatient procedure and provides immediate relief.

Though one condition can lead to another, in most people, there is a strong genetic component, and working towards prevention is highly recommended.

Piles or haemorrhoids is a condition in which the rectal veins become inflamed, thus causing bleeding and swelling. Hemorrhoids are clumps or cushions of tissue which get aggregated around the anal canal and are full of blood vessels, muscles and elastic fibres. Piles can be of various sizes and are found inside the anus or around the anal region. However, piles found inside the anal canal are way more common than the external ones.

In most cases, this condition can be treated by taking required medicines along with following a high-fibre diet. However, in some cases, the piles might be severe and need to be removed surgically. The common symptoms of piles are blood discharge while eliminating faeces and abnormal enlargements around the anal region. Piles might also be characterised by excessive itching of the anal region and pain during defecating.

In Ayurvedic terms, piles are called ArshaShoola which translates to extremely painful conditions akin to the piercing of needles. This condition can be gotten rid of by availing of various Ayurvedic remedies.

Treatment-

Surgical treatment of piles is not necessary; rather it has been observed that recurrence of the condition is experienced by people who usually undertake surgery. Treatment of piles using Ayurveda usually includes dietary and lifestyle changes; making most of the remedies easily implementable. Listed below are some Ayurvedic remedies:

1. Herbs: Herbs used for ayurvedic treatment of piles include Haritaki and jimikand.
2. Diet: Permanent moderation of diet is needed for the treatment of piles. Some dietary changes include:
   • Starchy foods such as yellow pumpkin and potato should be avoided and replaced with fibrous foods.
   • Inclusion of mango and sesame seeds adds bulk to the diet and helps in preventing constipation.
   • Natural food softeners such as ‘jambul’, ‘amalaki’, dried figs and papaya are also recommended.
   • Vegetables having larger amounts of roughage, such as turnip, onions, radish, ginger and bitter gourd should be added to the diet.
3. Lifestyle Changes: Some of the basic lifestyle changes include:
   • Regular cleansing of the colon.
   • Regular exercise is mandatory.
   • A normal and healthy sex life should be followed. Aggravation of symptoms of piles is caused due to abnormal or excess sex.
   • Avoiding sitting for long periods.
   • Consume enough water in a day (about 2-3 liters).

Ayurvedic Agni karma For Treating Piles-
In Sanskrit, the word 'Agni' refers to 'Fire'. Agni karma is an ayurvedic therapy, which involves the use of agni or fire. It is also called cauterization. Agni karma is popularly called Dahan Karma. Agni karma is used in the treatment of many diseases of different type. It is a good method for the treatment of bleeding piles.

In this process, any ailing surface of the body or a tissue, such as haemorrhoids, is destroyed and burnt by using a heated instrument using electric current and by freezing. An acidic agent for cutting like kshar karma is also used in the process of agni karma for the treatment of bleeding piles.

The different types of agni karma include:

1. uchchh dagdha /scarce agni karma
2. Durdaghda/ inappropriate burning surgery
3. Aati dagdha /powerful or excess cauterization
4. Samyak dagdha / appropriate agni karma

Infra red Coagulation Therapy

Infra red coagulation therapy or infra red photo coagulation is a medical process which is used to treat bleeding piles or haemorrhoids, and can only cure internal haemorrhoids.

During the process, a device is utilized, which produces a beam of intense, powerful infrared light. The heat released by the infrared light causes scar tissue and blood supply to the haemorrhoids to be cut off. This results in the death of haemorrhoid or piles, and a scar forms on the anal canal wall. The surrounding veins are held together by the scar tissue which avoids them bulging into the anal canal.

Agni karma, the Ayurvedic treatment, is considered to an effective medical treatment procedure of infra red coagulation therapy. This is because:

• Agni karma is a much more natural method of treatment for bleeding piles, and no unnatural substance like infra red light beam is used.
• Agni karma provides treatment without failure, and success is guaranteed. 

Besides, guggulu kshar sutra therapy is also one of the best therapies - No side effects & no chances of recurrence, no hospital stay, no pain, join duty immediately.