A person suffers from piles when the veins in the anal region become varicosed. The prime cause of piles is Constipation, the others being a Sedentary Life Style, Lack of Exercise and some other morbid conditions of the Liver, Inadequate intake of Fiber in the Diets, Prolonged Sitting on the Toilet, and Chronic straining to have a bowel movement (constipation). Pregnancy is a clear cause of enlarged hemorrhoids. Tumors in the pelvis also cause enlargement of hemorrhoids by pressing on veins draining upwards from the anal canal.
Piles or Hemorrhides are of two types: 1) Dry Piles and 2) Bleeding Piles.
Dry Piles in which there is inflammation of the external piles with a continuous Pain all through out the day, becoming unbearable at the time of voiding the bowels; and Bleeding Piles, in which the Internal Piles, there may be Excessive Bleeding, Leading to Anemia and Consequent Emaciation.
If piles are neglected, they may lead to Prolapse of the Rectum, in which the Rectum protrudes out of its casing; Impotence; Proctitis or Inflammation of the Rectum; and Hemorrhage. Excessive bleeding from Piles may, in some cases lead to Death due to Loss of blood.
Symptoms include: Pain, Bleeding, Anal Itching, Prolapse of the Rectum and Gangrene.
For convenience in describing the Severity of Internal Hemorrhoids, Grading system is used:
• First-degree Hemorrhoids: Hemorrhoids that bleed but do not Prolapse.
• Second-degree Hemorrhoids: Hemorrhoids that Prolapse and retract on their own.
• Third-degree Hemorrhoids:With Prolapse but must be pushed back in by a finger.
• Fourth-degree Hemorrhoids: Hemorrhoids that Prolapse and cannot be pushed back in.
In general, the symptoms of external hemorrhoids are different than the symptoms of internal hemorrhoids. External hemorrhoids can be felt as bulges at the anus, but they usually cause few of the symptoms that are typical of internal hemorrhoids. External hemorrhoids can cause problems, however, when blood clots inside them.
The Physician can Diagnose Hemorrhoids by the History of Symptoms and on the basis of a careful examination of the anus and anal canal using Sigmoidoscopy, Colonoscopy or Anoscope. If necessary, Scrapings of the Anus to diagnose Infections and Biopsies of the Peri anal Skin to diagnose Skin diseases are done.
In Ayurveda, Piles or Hemorrhoides are compared to "ARSHAS" described in Asta Maha Gadas meaning Eight Dreadful Diseases. Susrutha has advocated Surgery (Ksharasutra Technique), Raktha Mokshanam (Blood Letting by using Leeches etc), but Charaka, The Physician has adviced Drug Therapy, Panchakarma Therapies like Virechana (Purgation), Vasthi Karma (Enema Procedures) Raktha okshanam (Blood Letting), Diet Modifications and Life Style Changes, Sitz Baths etc. Ayurveda has recommended the use of many herbal medicines to increase the Digestive powers, to relieve Constipation and to relieve the Flatulence, which exacerbates the pain of Piles.
The Patient is advised to take a Bland Diet and foods that are easily digestible. He should be advised not to use a Hard Seat or Ride Horses during the course of Treatment. He should not indulge in too much of Sex, nor suppress the urge to void the Stools.