Understanding piles

Piles, medically referred to as hemorrhoids, are swollen and inflamed veins in the lower part of the rectum and anus. This condition can cause significant discomfort, bleeding, and other distressing symptoms, affecting millions of people worldwide.

Dr Aishatu Garba Daya, a medical expert at the Federal Medical Centre (FMC) Nguru LGA, Yobe State, said while piles are common, they could range in severity, with some cases requiring medical or even surgical intervention.

Piles are categorised into three main types, depending on their location and degree of prolapse.

Internal Piles: These are located inside the rectum and are generally not visible or painful. However, they may cause painless rectal bleeding, especially after bowel movements.

External piles: These occur under the skin around the anus and are more likely to cause discomfort. External hemorrhoids can become thrombosed (filled with blood clots), leading to severe pain and swelling.

Prolapsed piles: When internal hemorrhoids swell and extend outside the anus, they are known as prolapsed piles. In more advanced cases, these hemorrhoids may remain outside the anus, causing pain, discomfort, and potential complications if left untreated.

Narrating her experience with the condition, Ladi said she experienced difficulty stooling and even sitting down. She said it got so bad that she had to be pushing the pile in with her hands.

"I finally got relief when I continued to go to the hospital for treatment. I delayed going to the hospital because I thought there was no medical treatment for it," she said.

Symptoms of piles

The symptoms of piles can vary depending on the type and severity of the condition.

Dr Aishatu said some of the most common symptoms include:

- Discomfort or pain especially when passing stool or while sitting for long periods, itching or irritation. Persistent itching around the anus can lead to further discomfort.

- Bleeding, blood may be noticed on the toilet paper or in the toilet bowl after a bowel movement. This is typically a sign of internal hemorrhoids.

- Swelling or a lump near the anus may be indicative of external piles, which can become tender and painful.

In severe cases, the piles may lead to complications such as infection, severe bleeding, or strangulation, where the blood supply to the hemorrhoid is cut off, resulting in extreme pain and the need for immediate medical attention.

When to see a doctor

While piles often resolve on their own, the medical expert emphasised the importance of seeking medical attention when the following occur:

- Severe discomfort or pain, persistent or worsening pain should not be ignored.

- Heavy bleeding, if bleeding during bowel movements becomes frequent or severe, it is important to consult a healthcare provider.

- Prolapse, If the piles prolapse and do not retract naturally, medical intervention may be required to avoid further complications.

Factors contributing to piles

She also explained that several lifestyle and genetic factors can contribute to the development of piles. Some common risk factors include:

- Chronic constipation-straining during bowel movements increases pressure on the veins in the rectum and anus.

- Pregnancy-the increased pressure on the pelvic area during pregnancy can lead to the development of piles, particularly in the third trimester.

- Obesity- excess weight puts additional pressure on the veins in the rectal area.

- Sedentary lifestyle- prolonged sitting, particularly on the toilet, can contribute to the development of piles.

- Aging-as people age, the tissues supporting the veins in the rectum and anus can weaken, increasing the likelihood of piles.

Ways to prevent piles

Preventing piles largely involves making lifestyle changes that promote regular bowel movements and reduce pressure on the rectal veins. Dr Aishatu recommends the following prevention strategies:

-Eat a high-fiber diet

Consuming plenty of fiber-rich foods such as vegetables, fruits, and whole grains helps to soften the stool and prevent constipation, which reduces the need to strain during bowel movements.

-Increase Water Intake

Staying well-hydrated is key to preventing hard stools and ensuring smoother bowel movements.

-Maintain a healthy weight

Weight loss can reduce the pressure on the pelvic region and veins, lowering the risk of piles.

-Avoid straining during bowel movements

Straining increases pressure on the veins, so it is important to take time and avoid rushing during bowel movements.

-Exercise

Regularly engaging in physical activity helps stimulate bowel function and prevents constipation.

How piles are treated

Dr Aishatu explained that treatment for piles also depends on the severity of the condition. While mild cases may resolve on their own, more advanced cases require medical intervention. The treatment options include:

-  Dietary adjustments: a high-fiber diet, along with plenty of water, can prevent constipation and ease symptoms of piles. Foods like leafy vegetables, fruits, whole grains, and bran-based breakfast cereals are highly recommended.

- Stool softeners: in cases where constipation is an issue, stool softeners or laxatives may be prescribed to help pass stools more easily without causing strain.

- Pain relievers: over-the-counter pain relief options, including anti-inflammatory medications, can help alleviate pain. Topical treatments such as steroid creams may also be used to reduce swelling and discomfort.

- Surgical treatment for severe or persistent cases of piles: surgical intervention may be necessary. Procedures like hemorrhoidectomy (surgical removal of hemorrhoids) or hemorrhoid stapling are often recommended for high-grade internal, external, or mixed hemorrhoids.

She emphasised that surgery is the most effective treatment, particularly for advanced cases, and is generally safe with minimal risk of complications.

She advised that patients consider surgical treatment if their piles do not improve with conservative measures or if they have high-grade hemorrhoids.

"Surgery is the most effective and long-term solution for high-grade piles, and while complications are rare, they should not be overlooked," she said.

In addition, she warned against the overuse of home remedies or over-the-counter treatments without consulting a healthcare professional.

She said, "While some remedies may provide temporary relief, they should be used with caution, as certain products can exacerbate the condition if not used properly."

Dr Aishatu added that piles are a common condition, but with proper care, prevention, and treatment, they can be effectively managed.

She stressed that individuals should not hesitate to seek medical advice if they experience symptoms, as early intervention can prevent complications and improve quality of life.

By understanding the risk factors, making lifestyle adjustments, and seeking timely treatment, those affected by piles can manage the condition and lead a healthier, more comfortable life, she added.