Haemorrhoids also called piles are swollen and inflamed veins in your anus and lower rectum. Haemorrhoids may result from straining during bowel movements or from the increased pressure on these veins

Types of Piles

•  External piles-present as a swelling outside the anus with irritation and itching. These can be painful sometimes and usually do not bleed.
•  Internal piles- Internal piles are usually not painful but these bleed when they are irritated such as during the passage of hard stools.

Primary haemorrhoids: These are three in number seen at 3, 7 & 11 o’clock positions.

Secondary haemorrhoids: Presence of additional haemorrhoids in between the primary piles is known as the secondary piles.

Signs and symptoms

Painless bleeding during bowel movements — 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 anus, which may be sensitive or painful
•  Leakage of feces

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Haemorrhoids symptoms usually depend on the location.
Internal haemorrhoids lie inside the rectum. You usually can't see or feel these haemorrhoids, and they usually don't cause discomfort. But straining or irritation when passing stool can damage a haemorrhoid’s delicate surface and cause it to bleed. Occasionally, straining can push an internal haemorrhoid through the anal opening. This is Known as a protruding or prolapsed haemorrhoid and can cause pain and irritation.

Causes of piles

The veins around your anus tend to stretch under pressure and may bulge or swell. Swollen veins — haemorrhoids — 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 diarrhoea or constipation
•  Obesity
•  Pregnancy
•  Dietary habits: elimination of cereal fibres from the diet results considerably in the high incidence of chronic constipation and ultimately haemorrhoids
•  hereditary: Some defect in the venous structure has been held responsible. e.g. congenital weakness of the walls of vein. Course
•  Constipation: Straining in constipated persons results in the engorgement of internal haemorrhoidal veins, giving rise to the disease piles.

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•  Ayurvedic medicines are very effective in management of piles and the symptoms associated with it such as pain, bleeding, itching, etc.
•  The point to be emphasized is that the relief of symptoms is obtained with absolute gentleness and without invasion or surgery of any kind.
•  Moreover, the condition has high relapse rate following surgical treatment, since surgery does not target the root causes like genetic tendencies, habitual constipation, etc.
•  Ayurvedic medicines work at the root level and can modify these genetic tendencies thus reducing chances of relapse and recurrence of the condition significantly.
•  Grade 1 and 2 of internal piles can be significantly helped with Ayurvedic Medicine.
•  Grade 3 piles can find some relief of symptoms with Ayurvedic Medicine, but may not be completely cured.
•  Grade 4 piles can get symptomatic relief with medicines.

Treatment

•  Ayurvedic treatment does not mean suppressing the main symptoms and creating some new ones as side effects of the main treatment. It is to remove the root cause and give permanent relief.
•  There are following parts of piles treatment
  •  Panchakarma Therapy
  •  Ayurved Medicines- shaman Chikitsa
  •  Ksharsutra Therapy
  •  Rasayana, or rejuvenation
  •  Satvajaya or mental hygiene
  •  Ayurved Aahar Vihar
  •  Ayurved Medicines- shaman Chikitsa

Mainly comprises of powders, tablets, decoctions, medicated oils etc. prepared from natural herbs, plants and minerals. Because the medicines are from natural sources and not synthetic, they are accepted and assimilated in the body without creating any side effects and on the other hand, there may be some side benefits.

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An anal fissure is a small tear in the skin that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. An anal fissure typically causes pain and bleeding with bowel movements.

Anal fissures most often affect people in middle age, but fissures also are the most common cause of rectal bleeding in infants. Most anal fissures heal within a few weeks with treatment for constipation, but some fissures may become chronic

common causes of anal fissures

Anal fissures can be caused by trauma to the anus and anal canal. The cause of the trauma can be one or more of the following

•  Chronic constipation
•  Straining to have a bowel movement
•  especially if the stool is large, hard, and/or dry
•  Prolonged diarrhoea
•  Anal stretching
•  Insertion of foreign objects into the anus

risk factors for anal fissures

Factors that may increase your risk of developing an anal fissure include

•  Infancy - Many infants experience an anal fissure during their first year of life, although experts aren't sure of the reason.
•  Aging - Older adults may develop an anal fissure partly because of slowed circulation, resulting in decreased blood flow to the rectal area.
•  Constipation - Straining during bowel movements and passing hard stools increase the risk of tearing.
•  Childbirth - Anal fissures are more common in women after they give birth.
•  Crohn's disease - This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing

prevention of anal fissures

•  Keep the anorectal area dry
•  Wipe the area with soft materials, a moistened cloth, or cotton pad; avoid rough and scented toilet paper
•  Promptly treat all occurrences of constipation and diarrhoea
•  Avoid irritating the rectum

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Ayurved advises internal medication as well as topical ointment application in the treatment of anal fissures.

To avoid further irritation to the damaged tissue, medicines which soften the stools and promote healing of the tissues are utilized. Ointments which are natural anti-bacterial and anti-septic are used for topical application.

Ayurvedic treatment for various anorectal diseases

•  Ksharsutra ligation – Famous and result oriented medicated alkaline setone technique for fistula in ano and internal piles (Hemorrhoids)
•  Kshara Varti & Kshara Pichu Technique – Very effective in Non Healing ulcers, sinuses, fistula and fissure in ano
•  Vran Upakrama (wound management) – Various ancient wound management for non healing, varicose, diabetic wounds and very effective management for fistula in ano as well as for abscess also.
•  Kshara karma – Chemical couterization for Hemorrhoids
•  Basti (Medicated Enema) – Basti is very effective for Chronic constipation, IBS; U and Colitis
•  Chemical Cauterization through Ayurvedic Drugs
•  Conservative Management –Shaman chikitsa for Ano-Rectal disorders
•  Surgery according to Ayurveda Principle
•  Surgery according to Modern Science
•  Jalouka –Leach application technique
•  IRC_ (Infra Red Coagulation) - For Haemorrhoids
•  Fistulectomy & Fistulotomy - Radio Frequency Cauterization

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