14/01/2021
Piles or Hemorrhoids(Arsha)
Haemorrhoids or piles are dilated or swollen veins (low pressure blood vessels that return blood to the heart) under the re**um around the a**l opening.
They occur frequently in the adult general population. Notably, a considerable number of people with hemorrhoids do not complain about symptoms. Many people have hemorrhoids at some point in their lives. Over 50% of the population, in fact, will experience this condition. The prevalence of hemorrhoids is equal between men and women but men are more likely to seek treatment.
Causes of Hemorrhoids or Piles(Arsha)
The exact cause of hemorrhoids is unclear, but they’re associated with increased pressure in the blood vessels in and around your a**s. This pressure can cause the blood vessels in the re**um and a**s to become swollen and inflamed.
Factors predisposing to the development of hemorrhoids include:
o irregular bowel habits (constipation or diarrhoea)
o Sitting for long periods of time can start the hemorrhoidic process
o increased intra-abdominal pressure (prolonged straining)
o a low-fiber diet
o Obesity can be a factor by increasing re**al vein pressure. Poor muscle tone or poor posture can result in too much pressure on the re**al veins
o the absence of valves within the haemorrhoidal veins
o aging: as we grow older the body’s supporting tissues get weaker
o being overweight or obese
o Increased straining during bowel movements caused by constipation or diarrhea may lead to hemorrhoids
o Hypertension, particularly portal hypertension, can also cause hemorrhoids
o Pregnancy may lead to hypertension and increase strain during bowel movements, so hemorrhoids are often associated with pregnancy
o Cigarette smoking during bowel movements, may worsen hemorrhoids and may lead to severe internal bleeding of veins inside re**um area
The pressure causes the normal a**l veins and tissue to swell. This tissue can bleed, often during bowel movements.
Symptoms of Haemorrhoids or Piles(Arsha)
• Blood in stools
• Pain while defecating
• Painful hard lump in the a**s
• Mucus discharge while defecating
• Itching sensation around the a**s
• Feeling of fullness in the bowels even after passing a stool
• Secondary anaemia
Main classification of Piles or Hemorrhoids(Arsha)
They can be classified into internal and external hemorrhoids. There is a dentate line in the a**l ca**l, which separates two types of a**l skin. While the skin above the dentate line is not sensitive to pain, the skin below this line is quite sensitive to pain.
1. Internal hemorrhoids occur above the dentate line and are, therefore, usually painless. They can cause bleeding or they may push out of (pr*****ed) the a**l opening when they become quite large.
2. External hemorrhoids occur below the dentate line and are generally painful. External hemorrhoids can become very distressing when the blood in the hemorrhoid clots and inflammation irritates the nearby pain-sensitive skin
Treatment for hemorrhoids (Arsha) should be carried out in four ways with each having its specific indications.
These are:
1. Medical management (Bheshaja chikitsa)
This mode of treatment can cure first degree hemorrhoids. In other degrees of piles it may be used along with other procedures. This treatment is done after assessing dosha predominance.
2. Operative management (Sastra chikitsa) – Application of Kshara-sutra Therapy.
In this process hemorrhoids are tied off at its base (pedicle) by Kshara-sutra or specially processed thread with medicines. By the principle ofpressure necrosis, it prevents blood supply to the respective pile mass immediately. Eventually hemorrhoids shrink, shrivel up, die and ultimately fall off within 10 days, leaving some scar tissue which supports the corresponding veins in that area, preventing them to distend or bulge further.
3. Application of Ayurvedic Kshara (Caustics made of Ayurvedic herbs)
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. It is a type of chemical cauterization. Application of kshara is considered superior over other procedures used for the treatment of hemorrhoids or piles.
4. Cauterisation or Agnikarma
Agnikarma in the form of thermal cautery is a suitable procedure in the excision of sentinel piles and a**l warts falling in Vatha Kaphaja type of Arsha.
Do’s and Don’ts for Hemorrhoids or Piles
Do’s
• Drink Plenty of fluids
• Do take adequate fibers in the diet
• Exercise regularly. Walking is the one of the best things
• Train yourself for regular food intake of lunch and dinner
• Lose weight, if you are overweight
• Chew your food properly which enable digestion
• Take buttermilk, onion, leafy vegetables and gree gram etc
• You should not eat any food which is hard to digest
• You should also cut back on spicy and oily foods
• Increase your intake of okra, spinach, carrots, radish and yam in your everyday menu
• You should take the medications as prescribed
• You should avoid lifting heavy weights for at least 5 to 7 days.
• Drink plenty of water and other fluids—at least 10 glasses a day.
• Eat foods, which are good sources of fibre, such as whole grain or bran, cereals and breads, fresh vegetables and fruits, and, if necessary, add bran to your foods (about three to four tablespoonfuls per day)
• Keep the a**l area clean
• Take warm baths
• The hot poultice of dry radish is very good in non-bleeding piles
• Have enough sleep
Don’ts
• Don’t sit too much on a hard surface because it can restrict blood flow around the a**l area
• Don’t sit in the toilet for long periods. This position causes extra pressure on the a**l area
• Don’t drink coffee or alcohol
• Hurry, worry and curry is absolutely not advisable for a piles patient
• Don’t lift heavy objects. Even if you lift anything heavy exhale and don’t hold your breath
• Don’t use laxatives regularly as it may become a habit and cause the bowels to lose its ability to function normally
• Don’t consume any medication directly; this can be harmful for your stomach as well as diseases