Coping with piles

Trouble going to the toilet.  Close-up view of male sitting on the toilet seat, feet cringing.Pic: Shutterstock / Fussypony

Haemorrhoids, or piles, are swellings that occur inside and around the anus and the anal canal, causing often painful symptoms. However, with proper treatment and a few self-help tips, you can minimise your chances of developing or exacerbating piles, or at the very least ease the symptoms.

Piles form as a result of tiny veins within the lining of the anal canal becoming wider and filled with more blood than usual. Though the reason for their formation is often unclear, it is thought increased pressure in and around the back passage is usually a factor. Those who suffer with constipation or are pregnant often develop haemorrhoids, while ageing and an inherited weakness in the wall of the veins in the area could also increase the chances of developing piles.

There are four grades of piles - some will be completely symptomless, while others can cause intense and persistent pain. They are categorised as internal piles, which form above 2 to 3cm inside the anus in the upper section of the anal canal, and external piles, which form below that point.

The lowest grade swellings generally do not cause pain and cannot be seen or felt. Grade 2 piles often partly protrude from the anus when you go to the toilet, but return inside quickly. Grade 3 and 4 swellings hang from the anus when you defecate, with the highest grade often quite large and hanging down.

Aside from the obviously physical signs, bleeding after passing stools is the most common symptom of piles. Larger piles may result in a muscous discharge, with pain and irritation around the anus, while a feeling that you have not fully emptied when you use the toilet is also a sign. In severe cases, the blood supply to the haemorrhoid can be cut off, leading to intense pain, while a blood clot will display similarly painful symptoms.

Both prescription and over-the-counter products can be used to treat piles, the most common of which is an ointment, cream or suppository available in pharmacies, some of which contain an anaesthetic to ease the pain. Corticosteroids may also be prescribed to help reduce inflammation.

Banding, which is performed by a surgeon, is a simple procedure often used to deal with grade 2 or grade 3 piles. The band is placed at the base of the haemorrhoid, cutting off the blood supply and causing the haemorrhoid to drop off within a few days.

If you think you may be suffering with piles, or are prone to developing them, it is important to avoid straining when you go to the toilet. Aim to eat plenty of fibre, including fruit, vegetables and whole grains, and drink six to eight glasses of water each day to help keep the stools soft and prevent constipation.

Fibre supplements may also help, but if you regularly suffer, it is wise to avoid painkillers that contain codeine, as this can cause constipation. Lastly, when you feel the urge to go to the toilet, do so as soon as possible. Putting it off often results in bigger, harder faeces, and inevitably, straining.

Do you suffer from piles? What do you find eases or prevents the problem? Leave your comments below...

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