BRIEF IDEA ABOUT PILES (Hemorrhoids)

What is piles ?

Dilatation of radicles of rectal veins within the anal canal is called piles.The medical term for piles is hemorrhoids.Compared to arteries veins are weak due to thin walls and hence any backpressure in the veins can make them tortuous.There are three rectal veins namely superior, middle and inferior rectal veins.Any obstructions or increase of pressure in these veins can predispose piles.

Depending upon the situation there are two types of piles.

1) External piles. 2) Internal piles.

1) External piles:-

This type of piles is seen outside the anal opening and is covered by skin.It is black or brown in colour.This type of piles is very painful due to rich nerve supply in this area.

2) Internal piles:-

It is inside the anal canal and internal to the anal orifice.It is covered by mucous membrane and is red or purple in colour.These piles are painless.

Some times internal and external piles occure in same individual.

Factors responsible for piles:–

1) This is a familial disease.

2) Piles is seen only in animals maintain an erect posture. This is due to congestion in the rectal veins due to the effect of gravity.

3) It is common in individuals having chronic constipation.Those who have a habit of visiting the toilet due to frequent urge for stool may develop piles in future.

4) Piles is common in those who take excess of chicken, prawns, spicy food ect.Those who take vegetables and fibrous food are rarely affected.

5) Some ladies get piles during pregnancy due to compression of rectal veins by the uterus.

6) Cancerous lesions in the rectum can obstruct blood flow and result in piles.

Signs and symptoms of piles:–

1) Pain:-

Pain is common in external piles which will be worse while straining at stool.

2) Bleeding:-

Bleeding comes in splashes while pressing for stool.Bleeding may be profuse in some cases.

3) Protruding mass:-

In external piles the swelling can be felt around the anal orifice.In case of internal piles initially it can not be felt.When the disease progresses the piles protrude during stool and will go inside automatically.When the condition becomes worse the protruded piles will not go back in to the anus.

4) In some cases there will be discharge of mucus with itching around the anal orifice.

Complications of piles:–

1,Infection: The infection can spread to deep veins resulting in septicaemia.
2,Fibrosis: Here the piles become fibrosed with hardening of anal orifice.
3,Thrombosis: Here the blood inside the piles will form clots and can obstruct blood flow.
4,Gangrene: Here the tissues in the piles and nearby skin die due to lack of blood supply.
5,Suppuration: When the piles suppurate it can produce abscess with discharge of pus.

Treatment of piles:–

Initially it is treated on the basis of symptoms.Constipation should be treated.If there is anaemia iron should be give.Homoeopathic medicines can give good results. If medicinal treatment is not giving any result the following can be tried.

1) The thrombosed external pile is excised under local anaesthesia.

2) Sclerosant injection therapy can reduce the size of piles.

3) Rubber band ligation around the neck of piles is useful in some cases.

4) Cryosurgery is very effective.

5) Anal dilatation can reduce constipation and pain.

6) Haemorrhoidectomy is the surgical removal of piles.

How to prevent piles?

1) Eat plenty of fruits and vegetables.

2) Take fibrous food.

3) Avoid excess intake of meat,prawns,crabs ect.

4) Keep a regular timing for food.

6) Drink sufficient quantity of water.

7) Keep a regularity in bowel habits.

8) Take treatment for constipation.

THE ENTRANCE INTO SOCIETY.

The desire of pleasing is, of course, the basis of social connexion. Persons who enter society with the intention of producing an effect, and of being distinguished, however clever they may be, are never agreeable. They are always tiresome, and often ridiculous. Persons, who enter life with such pretensions, have no opportunity for improving themselves and profiting by experience. They are not in a proper state to observe: indeed, they look only for the effect which they produce, and with that they are not often gratified. They thrust themselves into all conversations, indulge in continual anecdotes, which are varied only by dull disquisitions, listen to others with impatience and heedlessness, and are angry that they seem to be attending to themselves. Such men go through scenes of pleasure, enjoying nothing. They are equally disagreeable to themselves and others. Young men should, therefore, content themselves with being natural. Let them present themselves with a modest assurance: let them observe, hear, and examine, and before long they will rival their models.

The quality which a young man should most affect in intercourse with gentlemen, is a decent modesty: but he must avoid all bashfulness or timidity. His flights must not go too far; but, so far as they go, let them be marked by perfect assurance.

Among persons who are much your seniors behave with the utmost respectful deference. As they find themselves sliding out of importance they may be easily conciliated by a little respect.

By far the most important thing to be attended to, is ease of manner. Grace may be added afterwards, or be omitted altogether: it is of much less moment than is commonly believed. Perfect propriety and entire ease are sufficient qualifications for standing in society, and abundant prerequisites for distinction.

There is the most delicate shade of difference between civility and intrusiveness, familiarity and common-place, pleasantry and sharpness, the natural and the rude, gaiety and carelessness; hence the inconveniences of society, and the errors of its members. To define well in conduct these distinctions, is the great art of a man of the world. It is easy to know what to do; the difficulty is to know what to avoid.

Long usage a sort of moral magnetism, a tact acquired by frequent and long associating with others alone give those qualities which keep one always from error, and entitle him to the name of a thorough gentleman.

A young man upon first entering into society should select those persons who are most celebrated for the propriety and elegance of their manners. He should frequent their company and imitate their conduct. There is a disposition inherent, in all, which has been noticed by Horace and by Dr. Johnson, to imitate faults, because they are more readily observed and more easily followed. There are, also, many foibles of manner and many refinements of affectation, which sit agreeably upon one man, which if adopted by another would become unpleasant. There are even some excellences of deportment which would not suit another whose character is different. For successful imitation in anything, good sense is indispensable. It is requisite correctly to appreciate the natural differences between your model and yourself, and to introduce such modifications in the copy as may be consistent with it.

Let not any man imagine, that he shall easily acquire these qualities which will constitute him a gentleman. It is necessary not only to exert the highest degree of art, but to attain also that higher accomplishment of concealing art. The serene and elevated dignity which mark that character, are the result of untiring and arduous effort.