Nrs Oke Ololade
Recently, my roommate suggested to me to write on haemorrhoid which is generally known as pile. She shared with me her experience with some of her patients on different occasions and how that they (patients) are often negligent or treat the symptoms with levity, until it eventually deteriorates, leading to many complications before they show up at the health centres for proper management. Barely a week ago, a friend of mine called me on phone and was screaming and crying for help after the situation was almost out of control. She had visibly lost count of the number of times she visited the toilet yet she was having severe pain and difficulty defecating. Worst still, she was forced to use her bare hands to pull out faeces from her anus. She sometimes passes stool with blood. However, I was able to advise her on what to do to get a relief.
Report has shown that there are about 1.5 million cases of haemorrhoid per year in Nigeria. This is due to different causes but most of these cases are due to constipation. In this part of the world, we consume heavy foods without drinking adequate water to aid proper digestion. In many cases, people sit for longer periods and fail to engage in regular physical exercise. This subject of discussion was borne out of a genuine concern to enlighten many people about the dangers associated with haemorrhoid (PILE), as well as precautionary measures that may be considered to avert it and stay healthy.
Haemorrhoid is commonly known as pile which occurs as a result of Swollen and inflamed veins in the rectum and anus causing discomfort and bleeding. Hemorrhoids can either be internal or external. Internal hemorrhoids develop within the anus or rectum. External hemorrhoids develop outside of the anus.
External haemorrhoids are the most common and most troublesome.
Hemorrhoid swelling occurs when there is an increase in the pressure in the small vessels that make up the hemorrhoid causing them to swell and engorge with blood. This causes them to increase in size leading to symptoms. Increased pressure may be caused by a variety of factors:
- Pregnancy: They occur more common in pregnant women because, as the uterus enlarges, it presses on the vein in the colon, causing it to bulge.
- Aging: Hemorrhoids are most common among adults aged 45 to 65 years. This does not mean that young people and children do not get them.
- Diarrhea: Hemorrhoids can occur after cases of chronic diarrhoea.
- Chronic constipation: This mostly occur due to low fiber diet and causes a person to strain when having a bowel movement, increasing the pressure within the blood vessels.
- Sitting for too long: Staying in a seated position for long periods of time can cause hemorrhoids, especially on the toilet.
- Heavy lifting: Repeatedly lifting heavy objects can lead to hemorrhoids.
- Anal intercourse: This can cause new hemorrhoids or worsen existing ones.
- Obesity: Diet-related obesity can cause hemorrhoids.
- Genetics: Some people inherit a tendency to develop hemorrhoids.
Signs and symptoms of hemorrhoids usually depend on the type of hemorrhoid.
External hemorrhoids
These are under the skin around your anus. Signs and symptoms might include:
- Itching or irritation in your anal region
- Pain or discomfort
- Swelling around your anus
- Bleeding
Internal hemorrhoids
Internal hemorrhoids lie inside the rectum. You usually can’t see or feel them, and they rarely cause discomfort. But straining or irritation when passing stool can cause:
- Painless bleeding during bowel movements. You might notice small amounts of bright red blood on your toilet tissue or in the toilet.
- A hemorrhoid to push through the anal opening (prolapsed or protruding hemorrhoid), resulting in pain and irritation.
Risk factors
As you age, your risk of hemorrhoids increases. That’s because the tissues that support the veins in your rectum and anus can weaken and stretch. This can also happen when you’re pregnant, because the baby’s weight puts pressure on the anal region.
Complications
Complications of hemorrhoids are rare but include:
- Anemia: Rarely, 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.
- Strangulated haemorrhoid: If the blood supply to an internal hemorrhoid is cut off, the hemorrhoid may be “strangulated,” which can cause extreme pain.
- Blood clot: Occasionally, a clot can form in a hemorrhoid (thrombosed hemorrhoid). Although not dangerous, it can be extremely painful and sometimes needs to be lanced and drained.
Prevention
The best way to prevent hemorrhoids is to keep your stools soft, so they pass easily. To prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips:
- Eat high-fiber foods. Eat more fruits, vegetables and whole grains. Doing so softens the stool and increases its bulk, which will help you avoid the straining that can cause hemorrhoids. Add fiber to your diet slowly to avoid problems with gas.
- Drink plenty of fluids. Drink six to eight glasses of water and other liquids (not alcohol) each day to help keep stools soft.
- Consider fiber supplements. Most people don’t get enough of the recommended amount of fibre from 20 to 30 grams a day in diets. If you use fibre supplements, be sure to drink at least eight glasses of water or other fluids every day. Otherwise, the supplements can cause or worsen constipation.
- Don’t strain. Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum.
- Go as soon as you feel the urge. If you wait to pass a bowel movement and the urge goes away, your stool could dry out and be harder to pass.
- Exercise. Stay active to help prevent constipation and to reduce pressure on veins, which can occur with long periods of standing or sitting. Exercise can also help you lose excess weight that might be contributing to your hemorrhoids.
- Avoid long periods of sitting. Sitting too long, particularly on the toilet, can increase the pressure on the veins in the anus.