Friday Health With Nyasha :Piles (Hemorrhoids)

With Nyasha Kawanzaruwa

*Piles (Hemorrhoids)*

 *Definition*

Hemorrhoids also called piles, are swollen and inflamed veins in your an*s and lower rectum. Hemorrhoids may result from straining during bowel movements or from the increased pressure on these veins during pregnancy, among other causes.

Hemorrhoids may be located inside the rectum (internal hemorrhoids), or they may develop under the skin around the anus (external hemorrhoids).

Hemorrhoids are common ailments. 

By age 50, about half of adults have had to deal with the itching, discomfort and bleeding that can signal the presence of hemorrhoids. 

Fortunately, many effective options are available to treat hemorrhoids. 

Most people can get relief from symptoms by using home treatments and making lifestyle changes.

 *Causes*

The veins around your anus tend to stretch under pressure and may bulge or swell. Swollen veins (hemorrhoids) can develop from an increase in pressure in the lower rectum. 

Factors that might cause increased pressure include:

     - Straining during bowel movements

     - Sitting for long periods of time on the toilet

     - Chronic diarrhea or constipation

     - Obesity

     - Pregnancy

     - Anal intercourse

     - Low-fiber diet

 *Symptoms* 

Signs and symptoms of hemorrhoids may include:

     - Painless bleeding during bowel movements and mdash; you might notice small amounts of bright red blood on your toilet tissue or in the toilet bowl

     - Itching or irritation in your anal region

     - Pain or discomfort

     - Swelling around your anus

     - A lump near your an*s, which may be sensitive or painful

     - Leakage of feces

Hemorrhoid symptoms usually depend on the location. 

Internal hemorrhoids lie inside the rectum. You usually can't see or feel these hemorrhoids, and they usually don't cause discomfort. 

But straining or irritation when passing stool can damage a hemorrhoid's delicate surface and cause it to bleed. 

Occasionally, straining can push an internal hemorrhoid through the anal opening. 

This is known as a protruding or prolapsed hemorrhoid and can cause pain and irritation. 

External hemorrhoids are under the skin around your an*s. 

When irritated, external hemorrhoids can itch or bleed. 

Sometimes blood may pool in an external hemorrhoid and form a clot (thrombus), resulting in severe pain, swelling and inflammation.

 *When to see a doctor* 

Bleeding during bowel movements is the most common sign of hemorrhoids. 

But rectal bleeding can occur with other diseases, including colorectal cancer and anal cancer. 

Don't assume that bleeding is coming from hemorrhoids without consulting a doctor.

 If your hemorrhoid symptoms began along with a marked change in bowel habits or if you're passing black, tarry or maroon stools, blood clots, or blood mixed in with the stool, consult your doctor immediately. 

These types of stools can signal more extensive bleeding elsewhere in your digestive tract. 

Seek emergency care if you experience large amounts of rectal bleeding, lightheadedness, dizziness or faintness.

 *Complications* 

Complications of hemorrhoids are rare but include:

     - Anemia. Chronic blood loss from hemorrhoids may cause anemia, in which you don't have enough healthy red blood cells to carry oxygen to your cells. This may result in fatigue and weakness.

     - Strangulated hemorrhoid. If blood supply to an internal hemorrhoid is cut off, the hemorrhoid may be strangulated which can cause extreme pain and lead to tissue death (gangrene).

 

Before you see your Dr take steps to soften your stools. 

Eat more high-fiber foods, such as fruits, vegetables and whole grains, and consider trying an over-the-counter fiber supplement. 

Drinking six to eight glasses of water a day also may help soften your stools and relieve your symptoms.

 *Lifestyle and home remedies*

 You can often relieve the mild pain, swelling and inflammation of hemorrhoids with home treatments. Often these are the only treatments needed.

     - Use topical treatments. Apply an over-the-counter hemorrhoid cream or suppository containing hydrocortisone, or use pads containing witch hazel or a numbing agent.

     - Soak regularly in a warm bath or sitz bath. Soak your anal area in plain warm water 10 to 15 minutes two to three times a day. A sitz bath fits over the toilet. You can get one at most drugstores.

     - Keep the anal area clean. Bath (preferably) or shower daily to cleanse the skin around your an*s gently with warm water. Soap isn't necessary and may aggravate the problem. Avoid alcohol based or perfumed wipes. Gently dry the area with a hair dryer after bathing.

     - Don't use dry toilet paper. To help keep the anal area clean after a bowel movement, use moist towelettes or wet toilet paper that doesn't contain perfume or alcohol.

     - Apply cold. Apply ice packs or cold compresses on your anus to relieve swelling.

     - Take oral pain relievers. You can use acetaminophen,aspirin or ibuprofen temporarily to help relieve your discomfort.

If  you have large hemorrhoids, your doctor may recommend a surgical procedure. Surgery can be performed on an outpatient basis or you may need to stay in the hospital overnight.

*Nyasha Kawanzaruwa is a nurse at Matizha Clinic in Gutu, Masvingo Province.