Times of India
03 December 2010

EVEN though piles have a genetic component, most of the incidences can be traced back to one thing – straining of the bowel muscles. Mostly, this straining is caused by constipation. The stool hardens and, as a result, it is harder for the bowel muscles to push it through. Therefore, in order to eliminate wastes, you are forced to strain. If done for too long, piles are almost certain to appear.

Apart from these, there are various other causes for the straining on the bowels. One of which is obesity. It is also the main reason why many people who are obese are more prone to the condition than those of normal weight. An obese person, who has fat pressing down on his/ her abdominal cavity is forced to exert more pressure when having a bowel movement.

The straining will eventually cause internal and external piles to manifest in the bowels and near the anus.

Piles do not appear at the first hint of straining. It takes some time, and hence many are surprised when they first get it. But the subsequent occurrences are triggered with less and less straining. This is because by this time the rectal veins have already been stretched out and the piles already created. It takes less effort to trigger a reaction from an already created hemorrhoid / piles than to produce the hemorrhoid in the first place.

So, the best chance of avoiding future occurrences of this condition is to avoid activities that put undue pressure on the bowels. Sitting or standing continuously, and lifting heavy weights incorrectly are also a few reasons that cause piles.

A condition that gives pressure on the rectum, and is very difficult to avoid is pregnancy. Just like all the other causes, as the fetus begins to grow it produces pressure and straining on the bowels – the perfect conditions for the development of hemorrhoids. Fortunately, in most cases, the hemorrhoids resulting from pregnancy will disappear once the child is born.

This is because the rectal veins have already been stretched; however, the mother is still at a higher risk for future reoccurrences unlike others. If piles are diagnosed in early stage by an expert proctosurgeon, then they can be very well managed by medication and lifestyle modifications.

Hence, early diagnosis of piles when they are in Grade One is of outmost importance. In early stages, piles may manifest in the form burning, itching, pain, constipation or sometimes bleeding. But in later stages ie prolapsing piles, surgery is a must.

One of the best surgical option which is associated with negligible pain and that includes merely 24 hours of hospitalisation, is the newly invented Stapler surgery. You need not worry going on bed rest too, because you can get back to your routine from the third day of the surgery. Also with the help of STARR surgery patients suffering from chronic constipation for years can now hope for cure.

Dr Ashwin Porwal is a renowned proctosurgeon from Poona Hospital and Research Centre and is among very few surgeons across the country to perform STARR surgery for piles, prolapse and constipation.

Consultant Anorectal Surgeon at Ruby Hall Clinic & Inamdar Hospital. Helpline : 81491 39460 www.healinghands clinic.co.in