“Blood in my stools! I have piles!”
When someone sees blood in the pan, has pain while passing stools or feels a swelling in the anal region, the first thought is of piles. Piles symptoms might not always mean piles. The truth is, piles is just one of many conditions that affect the anal region.
Piles, Anal Fistula and Anal Fissures are not the same.
They are different pathologies and differ in their symptoms and methods of treatment. Let’s take them one at a time.
1. PILES
Medically speaking, ‘Piles’ are swollen blood vessels in the anal canal. They usually occur when a person suffers from chronic constipation and straining at stool because of poor diet / smoking / bad genetics.
Piles Symptoms
Piles are (and I will emphasise) mostly painless. They bleed (like drops in the pan after bowels). Piles may not be associated with a swelling initially but one begins to feel it in the second and third stages of piles or in external piles. They are permanently felt and become painful when they reach the fourth stage when blood clots in them (what we call thrombosis).
Piles Treatment
Early stages of piles are never operated and need only medications, good high fibre diet with plenty of liquids to prevent constipation and straining. Piles in the third stage and beyond need surgery and today there are many improved techniques such as MIPH ( Minimally Invasive Procedure for Haemorrhoids ) which considerably decrease pain and speeden recovery with shorter hospital stays.
Piles Prevention
High fiber diets with plenty of liquids work best. If you have constipation – see a doctor and get treatment. Do not exert too much pressure while passing stools.
2. ANAL FISSURES
Fissure are cracks in the skin of the anal canal. They are extremely frequent in the general population. So frequent that its said to occur once in man’s life.
Anal Fissures Symptoms
Firstly, anal fissures hurt a LOT (so much so that a person may actually want to avoid using the toilet). Bleeding is infrequent in fissure and may be just a streak on the stool.
Anal Fissures Treatment
The procedure of choice for treating anal fissures is a Lateral Sphincterotomy, which gives immediate relief from pain and is done as a daycare procedure. However, most fissures (>90%) do not require surgery. Surgery may be a better option only when fissures are recurrent. Fissure are treated with medications and good high fibre diet (being a vegetarian helps) and plenty of liquids.
Anal Fissures Prevention
A good hi-fiber diet with plenty of liquids goes a long way in preventing Anal Fissures.
3. ANAL FISTULA
Fistulas occur when an infected anal gland bursts into the anal canal internally, and then becomes a conduit for pus discharge to the anal skin area.
Anal Fistula Symptoms
Fistulas show up with pus discharge in the anal area (a ‘wet feeling’ at the anal area). They may also go through periods of pus discharge and quiet periods when there are no symptoms.
Anal Fistula Treatment
Bear in mind the path taken by a fistula can be varied and hence imaging such as an ultrasound scan (sonofistulogram) or an MRI will help delineate the path a surgeon will have to take to treat it correctly.
There are many new methods of treating fistulas such as VAAFT – video assisted anal fistula treatment, wherein a camera is used to move through and identify the tract and then destroy it with electric current and seal it with staples and glue. VAAFT is daycare surgery.
However the surgeon must make a decision whether a given fistula is best treated with open conventional surgery or VAAFT.
Anal Fistula Prevention
Hygenic toilet habits are very important in preventing infections in the anal canals (that lead to Fistulas).
See a doctor!
In general, when symptoms associated with the bottom occur, seek medical care and obtain a proper understanding of the problem. Do not live in fear and worsen the situation.
Remember, good diet, good habits and proper exercise goes a long way in keeping you healthy.
Take care, and stay healthy!