What are Different Piles/Haemorrhoids

Recently, one of my medical representative  friends talked about his suffering from piles and termed that he suffers from 4th degree piles; when he was promoting one of his products for hemorrhoids.
When I enquired about the rational behind his thinking of piles in 4th stage, he very confidently tried to establish that as his suffering is for more than 5 to 7 years that is why is in 4th stage.
Actually, assigning a degree to piles or haemorrhoid has nothing do do with the duration of suffering; rather the classification of degree done seeing other features of piles.

Piles (Latin: Pila=a ball) or Haemorrhoids (Greek: haima= blood, rhoos= flowing) is a bunch of dilated veins present in anal canal or external to it. likewise, those are termed as either external or internal piles. Another term, sentinel pile is used in case of a fissure-in-ano, to guard the fissure as sentry (Sentinel= Sentry, to guard).
Internal piles starts from the inside the anal canal, so first degree piles are those which can not be seen or felt out side; but can only bleed to show its presence.
Second degree piles are those which come out of anal opening during defecation and reduce automatically; whereas third degree piles does not reduce, remain prolapsed or may show up at any other time besides during defecation; to be reduced manually.
External piles are those which remain outside the anal margin and can be readily seen and felt.
Another variety of piles named interno-external piles, where both external and internal components of piles co-exist.

Piles as such is not painful, unless thrombosed; and so also not felt on digital examination, unless otherwise thrombosed.
Commonly, piles are located in at 3, 7 or 11 O’clock position; where the branches of superior rectal vein are present. Ancillary positions are 5 and 9 O’clock positions. 
Haemorrhoids may be a manifestation of a colorectal cancer inside. Digital and sigmoidoscopic examination rectum and colon is a must to rule out the possibility of colorectal cancer.

read more...

All Those Diseases Presenting as Piles

Piles called hemorrhoid, in medical languages is a very common disease. It is seen more often in female than male. It is probably the reward to human race for adaption of erect posture, as quadrupeds do not suffer from this disease. Piles, as such occurs due to various local factors, mainly a cushion defect in the vascular bed of rectum and anal canal. But, there are some diseases which present as piles. Common amongst those are:

• Cancer rectum and Colon
• Portal hypertension

Cancer of rectum and colon: Many times the clinicians avoid digital rectal examination and presume that the bleeding from anus is from the simple piles. That is why, it is said that” If the clinician has not put his finger inside, he may put his foot in it”. This shows how much vexing the problem is, if  not properly examined. Many great surgeons have missed the diagnosis and operated as simple piles leaving the underlying disease intact. Rectal cancer may present as painless bleeding from anus. As the tumor grows there occurs some obstruction to the venous flow resulting in engorged anal veins, apart from it there may be direct bleeding from the tumor itself. Multiple polyposis is precursor of cancer rectum and colon. Non-vegetarian diet, especially meat consumption is associated with colon cancer. Vegetarian diet, fiber rich diet, aspirin, metformin and regular exercise may have some protective effect.
Portal Hypertension: This disease is rather a complication of cirrhosis of liver. Here, there is obstruction to free flow of blood from lower extremities through the liver; and alternative channels open up for the flow of blood to the heart. In that way an alternative channel opens up in the rectum and anal canal, in addition to other sites; the veins become engorged resulting in bleeding from the anus. Cirrhosis of liver may result from chronic hepatitis, commonly hepatitis B and C; besides this alcoholic cirrhosis, biliary cirrhosis and aflatoxin poisoning are some other causes.
So, for any bleeding from anus a simple examination like digital examination should not be skipped.

Related articles by Zemanta

• Aspirin use from Headache to Cancer (clinispot.blogspot.com)

read more...