Hemorrhoids/Piles

 

Hemorrhoids are swollen veins around the anus and in the rectum (end portion of the colon) that protrude from the anus. A Greek term, it means ‘blood discharging’. Also known as piles, an Italian term for ‘ball’. Doctors estimate 1 out of 3 adults is suffering from this medical condition silently at one point or another in their lifetime. No other creature, other than humans develop this problem. This is because the blood vessels involved must continually battle gravity to get blood back up to the heart and thus may be the price we pay for being upright creatures.

The condition is swollen tissues and blood vessels losing its elasticity and often associated with bleeding. Upon further exertion with even mild physical activities like sitting or standing for prolonged periods, coughing, lifting a light object and straining the bowels can cause great discomfort, intense pain and heavy bleeding.


Causes


Traditionally hemorrhoids are associated with chronic constipation, straining during bowel movements and prolonged sitting on the toilet — all of which interfere with blood flow to and from the area, causing it to pool and enlarge the vessels. This also explains why hemorrhoids are common during pregnancy, when the enlarging uterus presses on the veins.

Other contributory factors include heredity, obesity, lack of exercise, liver damage, food allergies, aging (anal cushions’ supporting ligaments become lax)


Symptoms

The most common symptoms to observe are: itching, burning pain, inflammation, swelling, irritation, seepage and bleeding (bright red blood).


Conditions


There are two kinds of hemorrhoids:

(1)  Internal hemorrhoids which occur in the lower rectum are typically painless. Even when there is bleeding, visible bright red blood can be spotted on the toilet paper or dripping into the toilet bowl. They may also prolapse or extend beyond the anus causing several potential problems. Small amounts of mucus and microscopic stool particles may surface and cause an irritation which need to be wiped constantly to relieve the itching but can worsen the problem.
(2)  External hemorrhoids which develop under the skin around the anus are the most uncomfortable, because the overlying skin becomes irritated and erodes. If a blood clot forms inside an external hemorrhoid, the pain can be sudden and severe. You might feel or see a lump around the anus. The clot usually dissolves, leaving excess skin (a skin tag), which may itch or become irritated.

The severity of piles ranges from first degree (mild) to fourth degree (severe):

+ 1st degree or internal hemorrhoids is usually painless and discharges bright red blood. Increase fibre and fluid intake is sufficient.

+ 2nd degree is an internal hemorrhoids that collapses and protrudes outside the anus, usually accompanied by a mucous discharge and heavy bleeding. Take more fibre, fluids, iron-laden supplements and avoid excessive straining.

+ 3rd degree is an external hemorrhoids where lumps are formed around the anus and no longer able to recede, thus requiring digital (manual) reduction.

+ 4th degree is where the lumps hardened to become firm but sensitive and turns blue or purple in color. Once blood clot forms, there is no turning back and can be extremely painful and difficult to pass motion. Surgical treatment is the only way out.

Surgical treatment

The conventional surgery procedure of removing the piles by cutting them off together with the surrounding skin tissue can take 1-2 months to heal with pain experienced for 1-2 weeks. Post operation complications include difficulty with urination and passing motion.

The current popular surgery method called Procedure for Prolapse and Hemorrhoids (PPH) is performed under general anesthesia. This is carried out by pulling the displaced piles back to their normal positions. At the same time, blood supply to the piles is stapled and cut off, causing the piles to regress and shrink. Pain subsides within 2-3 days for 80% of PPH patients and usually heals within 1-2 weeks.

Home treatment


As most instances are due to chronic constipation, eating a diet higher in fibres is the most important consideration in the treatment and prevention of hemorrhoids. However, some people find that boosting fiber causes bloating or gas. Start slowly and gradually increase your intake to 25–30 grams of fiber per day together with higher fluid intake. Those who bleed persistently should consider taking vitamin and mineral supplements to prevent anemia.

Care and attention

*  Do not strain during bowel movements
*  Keep the problem area clean and bathe in warm water preferably immersed
*  Avoid sitting on hard surfaces
*  Learn proper lifting techniques
*  Engage in regular moderate exercise/do not sit in one position for too long
*  Avoid strong or harsh laxatives/rough toilet paper
*  Do not use aspirin for hemorrhoid pain – can aggravate bleeding condition


Word of caution


Anyone experiencing rectal bleeding frequently should do a physical examination. Accompanied by  symptoms including significant amounts of bleeding, dizziness, and a fainting sensation, emergency care should be arranged. Bear in mind the other possibilities like colorectal and anal cancers share similar symptoms.



VIVA corner

VIVA Green Barley promotes peristalsis or gastrointestinal movement and prevent constipation or colon disease with its high concentration of fibres, minerals, enzymes and phytochemicals.

VIVA Floraguard with its abundant probiotics helps to maintain a balance and healthy gastrointestinal tract.


VIVA Hemoberry makes a great drink for those who need to see a quick rise in the blood count as it contains ferrous lactate - an important nutrient for hemoglobin production.

VIVA Omega3 helps to reduce inflammation and provides essential fatty acids to create new membranes.

Vivaguard contains enzymes that assist in healing after surgery.