Piles (Hemorrhoids)

Hemorrhoids are swollen tissues that contain veins and that are located in the wall of the rectum and anus. Hemorrhoids may become inflemed, develop a blood clot (thrombus), bleed, or become enlarge and protude. Hemorrhoids that remain in the anus are called internal hemorroids (piles); those that protude outside the anus are called external hemorrhoids.

Causes of Piles

• A number of factors are responsible for the development of piles.
• Irregularity in bowel movement with susceptibility towards constipation and diarrhea is one of the causes.
• Constipation with repeated and prolonged straining.
• Spicy food, imbalanced diet with insistence on junk food contributes towards piles.
• Hereditary factors may also be responsible for the pathogenic condition of piles.
• Sedentary life
• Pregnancy
• Obesity
• An obstruction or abnormal growth on the way to the anal canal can also lead to piles.
• Other factors contributing to the pathological condition of piles include age, Alcohol , Tobacco, Ghutkha chewing.

Symptoms of Piles

• Bleeding:Profuse bleeding is one of the most common clinical features of piles includes passage of blood along with stool.
• Prolapse :The patient complain of a protruding mass on straining while defaecation.
• Discharge :Patient with permanently prolapsed piles may complaint of mucoid discharge.
• Anal irritation:Mucoid discharge from the anus irritates the peri-anal skin. Internally located piles can be a source of extreme irritation when they tend to hang out through the anal passage.
• Secondary Anemia :Since the bleeding from internal piles is severe it results into secondary Anaemia (less hemoglobin) in patient.

Stages in piles (hemorrhoids)

• First degree hemorrhoids:At this stage the anal veins become congested, inflamed at defecation, and the chief complain of the patient is bleeding.
• Second degree hemorrhoids:However, the piles tend to form larger swelling which not only protrude into the canal, but also descend towards the anal orifice and it can be felt in the form of protruding mass at the time of defecation by the patient, but it disappears spontaneously after passing out the stools.
• Third degree hemorrhoids :(prolapsed piles) At this stage the pile mass (large swelling) prolapse even more readily and not only protrude during defecation but remain prolapsed afterwards until they are digitally replaced within the anus.
• Fourth degree hemorrhoids:Lastly, some very long standing piles become so large and developed and protrude out from the anus and remains permanently protrude.

Diagnoses of Piles

The piles which exist in prolapsed form can be usually diagnosed by means of an external examination of areas surrounding the anal cavity.

Proctoscopy, By means of Proctoscopy the presence of tumors or polyps and that of an inflamed prostate are also detected as the detection is valuable in determining the line of treatment.

Treatment

Kshara karma is the choice of treatment.

Kshara karma (application of Pratisaraneeya teekshna kshara): It is a non-surgical procedure of Ayurveda indicated for the management of hemorrhoids. A medicine (alkaline in nature) derived from a combination of various herbs is applied to the pile mass with the help of a special slit proctoscope. Pratisaraneeya teekshna kshara was applied to the internal hemorrhoids. After that the Pile mass became black in 35 seconds, then Lemon juice (citric acid) was used to neutralize the kshara after proper burning of pile mass. Pratisaraneeya teekshna kshara causes coagulation of Hemorrhoid plexus (cauterization of pile mass), necrosis of tissue followed by fibrosis of plexus, adhesion of mucosal, submucosal coat helps in prevention of further dilatation of veins and prevents prolapse of regional mucosa of anus. This makes permanent radical obliteration of Hemorrhoids.

Advantages of Kshara Karma Therapy

In present day practice, application of Kshara is found to be a safe, efficacious, and cost-effective method for management of internal hemorrhoids.

• Postoperative pain is mild.
• No bleeding.
• Minimum hospitalization – one day care
• No possibilities of recurrence
• Systemic diseases are also undergoing this procedure.
• Kshara karma procedure can be performed at OPD level with proper prophylactic measures.
• No complications like incontinence, stenosis and stricture.
• Treating all pile mass in one sitting.
• It requires less time and can perform his/her routine work from next day of kshara karma.