Piles to Smiles – A better understanding.
There is a lot of misunderstanding when it comes to a common problem encountered by most human beings in their lifetime. Piles or Hemorrhoids as it known in medical terms, Fissure and Fistula form a triad of afflictions related to the ano-rectum. It would be prudent to remember that most of these above problems are invariably related to passing hard stools or constipation.
Piles/Haemorrhoids
Symptoms:
- Bright-red, painless bleeding
- Mucus discharge
- Prolapse
Common Causes:
- Constipation
- Hard stools
- Straining while passing stools
Treatment:
Non-operative:
- Normalizing bowel and defaecatory habits: only evacuating when the natural desire to do so arises.
- Defaecatory position to minimize straining, Stool softeners and bulking agents.
- Adequate water intake.
Operations:
- Sclerotherapy
- Banding
- Haemorrhoidectomy
- Stapled
- Laser
Anal fissure/ Fissure in ano
A longitudinal split in the anoderm of the distal anal canal.
Acute anal fissures:
Due to trauma caused by the strained passage of a hard stool or, less commonly, from the repeated diarrhea.
Chronic fissures:
Hypertrophied anal papilla internally and a sentinel tag externally between which lies the slightly indurated anal ulcer overlying the fibers of the internal sphincter.
Symptoms:
- Pain on defecation
- Bright-redbleeding
- Mucousdischarge
- Constipation
Treatment:
- Addition of fiber in diet
- Stool softeners
- Adequate water intake
- Warm Sitz baths
- Topical local anesthetic agents
Operative treatment:
- Lateral anal sphincterotomy
- A simple day care or hospital procedure gives good results
Fistula-in-ano (anal fistula)
Chronic abnormal communication, from the anorectal lumen the internal opening to an external opening on the skin around the anus.
Symptoms:
- Intermittent pus discharge from an opening around the anus – may be bloody.
- Severe pain which reduces after discharge of pus.
Diagnosis:
- Clinical examination
- Transrectal ultrasound scan
- MRI scan
Treatment: - Antibiotics for infection.
IT IS IMPORTANT TO REMEMBER FISTULA IN ANO ALWAYS NEEDS SOME FORM OF SURGERY FOR CURE
Operations:
- Fistulotomy
- Fistulectomy
- Setons
- Laser fistulotomy and others