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This medical condition is commonly known as piles. Ancient references to symptomatic haemorrhoidal disease date back thousands of years and can be found in the Bible as well as early Egyptian, Babylonian, and Greek scripts. The first known mention of this condition is from an Egyptian papyrus in 1700 BC.
Hemorrhoids are basically dilated veins within the anal canal. It is one of the most common gastrointestinal disorders seen.
Hemorrhoids are mentioned in ancient medical writings of every culture. The word “hemorrhoids” is derived from the Greek “haema means blood, and “rhoos” means flowing and was originally used by Hippocrates to describe the flow of blood from the veins of the anus. Commonly in society, it is known as piles, the rod pile is derived from Latin, meaning a ball of a mass, as this condition may not always be accompanied by bleeding. The French call them figs, which means to clot.
- Medical Condition: Hemorrhoids
- Definition: Enlargement of veins in the walls of the anus and around the rectum
- Other name / Synonyms: Piles
- Main Cause: Chronic constipation and symptom of some other clinical condition
- Affected organs: Anus, rectum, and blood vessels
- Prevalence: More than half of men and women aged 50 years and older will develop hemorrhoid symptoms during their lifetime.
- Symptoms: Itching, bleeding, discomfort, pain, swelling in the anal region
Types of Haemorrhoids
Hemorrhoids can be broadly divided into two categories, based on location viz. internal and external.
Internal hemorrhoid means it is within the anal canal and the internal opening of the anus. It is often covered with mucous membrane and it is bright red or purple in color.
The external hemorrhoid is situated outside the anal opening and is covered by skin. Sometimes both the conditions coexist and the condition is called interno-external hemorrhoids.
Cause of internal hemorrhoids
There are many reasons which contribute to the development of piles in an individual. Some of them are described below:
Hereditary: It is often seen within family members.
Chronic Constipation: One of the major causes of hemorrhoids is straining to expel constipated stool. Some of the other medical condition is diarrhea, dysentery, enteritis increases hemorrhoids.
Low dietary fiber intake: Low roughage may excite hemorrhoid formation. Adding bulk or roughage to the diet can prevent hemorrhoid formation.
Hemorrhoids can be secondary to a few conditions, and this is known as secondary hemorrhoids. Some conditions which increase the risk of Hemorrhoids are:
- Carcinoma of the rectum
- Pregnancy causes pressure in the anal region and it may induce hemorrhoids.
- Chronic constipation that causes extra pressure.
- Difficulty in urination (conditions like enlarged prostate will cause increase intra-abdominal pressure and will raise the venous pressure in the veins to cause hemorrhoids)
In some cases, this condition can also be due to body habits, customs, passions, tight-laced clothes, climate, and seasons.
Conditions like spinal-cord injuries, constipation, chronic diarrhea, poor bathroom habits, postponing bowel movements can be contributing factors. Alcoholic cirrhosis can also cause severe hemorrhoids.
Symptoms / Clinical features
There are many symptoms of piles and the most common is discomfort in the anal region. Other symptoms include bleeding, itching, mucus discharge, and pain while motion.
Bleeding is bright red, painless, and occurs along with passing stools.
The patient complains that it splashes in the pan as the stool comes out. This may continue for months or even years. As the conditions advance partial prolapse will occur with each effort of passing stool.
Excessive straining, rubbing, or cleaning around the anus may make symptoms, such as itching and irritation
- Pain is not characteristic of hemorrhoid unless there is associated thrombosis or there’s is associated fissure.
- Mucous discharge is a particular symptom of prolapsed hemorrhoids. This softens and excoriates the skin at the anus.
- Anemia is often seen in long-standing cases of hemorrhoids due to persistent and profuse bleeding.
- Prolapse: is a later symptom. In the beginning, prolapse is minimal.
Prolapse can be divided into 3 degrees-
- First degree: hemorrhoid does not come out of the anus. The mucosa barely prolapse, but with severe straining may be trapped by the closing of the anal sphincter.
- Second degree: hemorrhoids come out only during stool and are reduced spontaneously after stool. With further protrusion of the mucosa, the patient complains of an obvious lump, but this disappears spontaneously and rapidly after passing stool.
- Third degrees: hemorrhoids come out only during stool and not return by themselves, but need to be replaced manually and then they must be reduced. Persistent prolapsing produces dilatation of the anal sphincter, and the hemorrhoids protrude with minimal provocation and usually require manual replacement.
- Fourth degree: The hemorrhoids that are permanently prolapse. At this stage, great discomfort is complained of with a feeling of heaviness in the rectum.
Complications of hemorrhoids
Bleeding: A patient with first degree and early stage of the second degree is seen with bleeding. In fourth-degree bleeding is not that profuse. A patient, with first-degree hemorrhoid for quite a long time will become anemic. Bleeding usually occurs externally.
- Thrombosis-Patient notices an acute swelling that is painful.
- Second-degree hemorrhoids are more often affected by strangulation.
- Gangrene occurs when the arterial supply of the hemorrhoid is constricted. Massive gangrene may initiate the spreading of anaerobic infection.
- Fibrosis occurs in some conditions.
- Pus can also occur in some conditions.
Diagnosis of hemorrhoids
Proctoscopic examination is always suggested and in some sigmoidoscopy or colonoscopy is also suggested. It will reveal the internal pile. Anoscopy is the most accurate method for examining the anal canal and the distal rectum.
Remedies associated with hemorrhoids
In Homeopathy, many remedies are available which are given according to symptoms seen in a particular individual.
The patient has a tendency to pain in the stomach along with flatulence. There is an alternation of haemorrhoidal suffering from cerebral and cardiac troubles. Hemorrhoids are seen during pregnancy and during childbirth, with constipation and malposition of the uterus.
There are chronic, painful bleeding piles, with the sensation of sticks in the rectum, dry balls of light-colored feces. The patient has so much straining so that prolapse of rectum occur with forcing -down pains even when urination. The tendency of dry feces. There is aching in the anus. Constipation during pregnancy. Alteration constipation and diarrhea and great flatulence. Itching in the anus is also seen.
- Symptoms Worse by: at night, from slightest mental emotion or excitement, cold
- Symptoms Better by morning, heat.
- Dosage: Collinsonia 30, 4 pills 3 times a day for 1 week.
2. Carbo veg
The patient has a discharge of a corrosive substance from the anus, causing much itching and some burning is also felt. There are much soreness and much itching. The patient has protruding large bluish piles with an offensive smell, and burning pains. A patient has constipation with burning stools and discharge of blood. This condition is seen in people who drink alcohol. Flatus hot, most and offensive. There is itching, and burning in the rectum. There is a soreness, itching in the anus. Painful diarrhea in old people. It is frequent, involuntary stools followed by burning. There are bluish burning piles with pain after stool.
- Symptoms Worse by evening, night and open-air, cold from fat food, butter, coffee, milk, warm damp weather, wine.
- Symptoms Better by: from eructation, from fanning, cold.
- Dosage: Carbo veg 30, 4 pills 2 times a day for 1 week.
3. Causticum: Haemorrhoids accompanies by obstinate constipation, with ineffectual urging and related to the fistula. There is itching, stinging, burning, painful when touched. The pain increased when walking, standing, when thinking of them, frequently sudden, pressing pain, penetrating pain in the rectum. The stool passes better standing, pain worse from mental exertion. Stool soft and small, hard tough, covered with mucus, shines like grease, small shaped, expelled after much straining, or only on standing, Rectum sore and burns. The patient was seen with a fistula and large piles.
- Symptoms Worse by dry cold winds, cold air, from the motion of vehicles.
- Symptoms Better by: in damp, wet weather, warmth, the heat of bed.
- Dosage: 200 1 time a day for 1 week.
3. Bryonia: Hard, tough stool with protrusion of rectum, long-lasting burning in rectum after hard stool. Or sharp burning pain in the rectum with soft stool, white and turbid urine, the sensation of constriction in the urethra when urinating. The sensation of a plug in the anus. Constipation stools hard, dry, as if burnt, seem too large. Stools brown, thick, bloody, worse in the morning, from moving, in hot weather, after being heated, from cold drinks, every hot weather.
- Symptoms Worse by Mornings, from motion and from heat, warmth, any motion, morning, eating, hot weather, exertion, touch.
- Symptoms Better by: While lying down or getting warm in bed, pressure, rest, cold things.
- Dosage: Bryonia 200, 3 times a day for 3 days.
4. Antimonium crud
Copious haemorrhoidal hemorrhage accompanying a stool of solid fecal matter, there is pricking burning, continuous mucous discharge, staining yellow. There is a feeling of soreness in the rectum as if an ulcer had been torn open, and alternate diarrhea and constipation, increased and frequent discharge of urine at night with the discharge of mucus, burning in the urethra, and pain in the back. There anal itching. Diarrhea alternates with constipation, especially in old people. Diarrhea after acids, sour wine, baths, overeating, slimy, flatulent stools, there are hard lumps mixed with watery discharge. Stools composed entirely of mucus.
- Symptoms Worse by In the evening, from heat, acids, wine water, and washing.
- Symptoms Better by: -in the open air, during rest, warmth.
- Dosage: Antimonium crud 200, 3 times a day for 3 days.
5. Apis Mel
There are small protruding hemorrhoids, which sting, burn, and smart tolerably, there is prolapsus ani with hemorrhage from the bowels, burning pain in the anus. Constipation, feeling in the rectum as if it were stuffed full, with heat and throbbing, scanty urine due to hemorrhoids. Involuntary stools on every motion. There is bloody, painless. Anus feels raw. Hemorrhoids, with stinging pain. Diarrhea watery, yellow. Cannot urination without passing stool. Dark, fetid, worse after eating.
- Symptoms Worse by heat, touch, pressure, late in the afternoon, after sleeping, in closed and heated rooms.
- Symptoms Better by in open air, uncovering, and cold bathing.
- Dosage: Apis Mel 30, 4 pills 3 times a day for 1 week