Take a Seat: Debunking Common Myths About Piles

While most of us probably wouldn't bring it up over coffee, haemorrhoids, or piles as they're commonly called, are more prevalent than you might think. In India alone, nearly 10 million people suffer from piles each year. The rise is linked to factors like stress, lack of sleep, constipation, our growing love for fast food, and the increasingly sedentary habits in urban cities. 

Take 28-year-old programmer Raj, for instance, who never imagined piles would be something he needed to deal with in his thirties! It's a condition often associated with older generations, right? But here's the thing: there's a lot of misinformation about piles, leaving people like Raj confused and maybe a little embarrassed.

So, let's clear the air. What are piles?

Haemorrhoids, commonly known as piles, represent swollen and inflamed veins located around the anus or within the lower rectum, akin to the varicose veins found in the legs.

When increased pressure is placed on these veins, they can become engorged and irritated, leading to uncomfortable piles symptoms.

The presence of blood during defecation is a sign of internal haemorrhoids. The common symptoms of external haemorrhoids are pain, anal swelling or lumps, bleeding during bowel movements, and itchiness.

Following Raj's story, it’s time to debunk some common myths surrounding haemorrhoids. We will also explore the causes and treatment options for piles and how to prevent them from recurring.

When Raj experienced itching and occasional bleeding during bowel movements, he was confused and a little worried. Piles are just something older people get, right?

Wrong. While the risk of developing haemorrhoids does increase with age, especially after pregnancy for women, it's far from being exclusive to the elderly. Studies suggest that nearly half of all adults under 50 will experience symptomatic haemorrhoids at some point.

So, what's causing piles in younger people? The rise in sedentary lifestyles and a diet heavy in processed foods and low in fibre are significant contributors. Exerting too much pressure during bowel movements is another contributing factor. These factors put pressure on the veins in the anal and rectal area, leading to the development of haemorrhoids.

Spicy food often gets the blame for causing haemorrhoids, and Raj initially wondered if his love for hot curries was the reason behind his discomfort. However, as he delved deeper, he discovered that the real risk factors for piles were closer to home — his desk job and unhealthy eating habits. Long hours spent sitting combined with a diet partial to fast food were the more likely causes of piles. While spicy food might irritate existing haemorrhoids, it’s not the main culprit.

• Straining puts extra pressure on the veins in your rectum, which can lead to haemorrhoids. Eating a diet that lacks fibre may cause difficulties in passing stool and the need to strain during defecation.
• Pregnancy puts increased pressure on your veins, including those in your rectum.
• Some people are more predisposed to developing haemorrhoids due to weaker vein walls or a family history of the condition.

• Not consuming enough fibre may result in constipation and the need to strain when passing stools.
• Regular exercise helps improve circulation and reduce pressure in the veins throughout your body. So, a lack of exercise can also lead to piles. 
• Sitting for extended periods, especially on the toilet, can put extra pressure on the veins in your rectum.

This might surprise you, but what you eat can significantly impact your risk of developing haemorrhoids. Constipation, a major risk factor for haemorrhoids, can be directly linked to a lack of fibre in your diet.

• Fibre aids in maintaining a smooth functioning digestive system, facilitating softer bowel movements and avoiding constipation.
• Drinking plenty of fluids helps keep your stools soft and easier to pass.

So, how much fibre should you aim for? Experts recommend consuming 20-35 grammes of fibre daily. If you have difficulty adding fruits, vegetables, and whole grains, which are rich in fibre, to your meals, consider consulting your doctor about fibre supplements that could be beneficial.

Haemorrhoids can be categorised into three main types, each with slightly different characteristics:

1. Internal haemorrhoids: Since these develop inside the rectum, they are typically painless. You may not even know you have them unless they bleed during a bowel movement. You may observe bright red blood on the toilet paper or inside the toilet bowl. In some cases, straining during bowel movements might push an internal haemorrhoid down enough to cause a feeling of fullness or bulging in the rectum.
2. External haemorrhoids: These form under the skin around the anus, so they can cause irritation, itching, and discomfort, especially when sitting or during bowel movements. You might also feel a tender lump near your anus. External haemorrhoids can sometimes bleed, but this is less common than with internal haemorrhoids.
3. Prolapsed haemorrhoids: These occur when an internal haemorrhoid stretches and bulges outside of the anus. This can be quite painful and may cause bleeding. Prolapsed haemorrhoids can also irritate the surrounding skin, leading to itching. In addition to the bleeding and discomfort, the prolapsed haemorrhoid itself might feel like a small, soft mass protruding from the anus.

The cause of haemorrhoids is generally the same for all types — increased pressure on the veins in the rectum. Nevertheless, symptoms may differ based on where the haemorrhoid is situated. By recognising the different types and their symptoms, you can be better prepared to discuss your situation with a healthcare professional and explore the most suitable treatment options.

While some symptoms of piles might overlap with other conditions, it's important to see a doctor for a proper diagnosis. Here are some red flags that might indicate a different condition:

• Severe rectal bleeding
• Persistent pain unrelated to bowel movements
• Change in bowel habits (diarrhoea or constipation) that are persistent or worsen over time
• Unexplained weight loss

A common misconception is that surgery is the only option for piles treatment. However, there are a variety of treatment approaches, many of which are non-invasive.

“Focus on getting more fibre and water in the diet, along with regular exercise. And listen to your body – don't ignore the urge to go! These steps can get things moving smoothly again,” says Dr Harsh Sheth, a gastroenterology surgeon in Mumbai.

• Dietary modifications: Adding fruits, vegetables, and whole grains while limiting processed foods can help regulate bowel movements and reduce pressure on the rectal veins.
• Fibre supplements: If dietary changes aren't enough, fibre supplements can help bulk up stools and make them easier to pass.
• Over-the-counter medications: Creams and ointments can offer temporary relief from itching, discomfort, and pain associated with piles.
• Minimally invasive procedures: For more serious cases, doctors may recommend minimally invasive treatments like rubber band ligation or sclerotherapy to reduce or remove haemorrhoids.

After discussing these options with his doctor, Raj decided to focus on lifestyle and dietary changes first. He increased his fibre intake, started drinking more water, and made a conscious effort to avoid straining during bowel movements. Thankfully, these changes provided significant relief, and Raj was able to manage his piles without resorting to surgery.

By comprehending the misconceptions and truths about piles, you can actively take measures to manage and avoid them. Remember, lifestyle changes and proper care can make a significant difference. Stay informed, stay healthy, and tackle piles head-on!