( By Dr. H.K.Bakhru )
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Piles or Haemorrhoids are among the most common ailments today, especially in the western world. They are a varicose and often inflamed condition of the veins inside or just outside the rectum. IN external piles, there is a lot of pain but not much bleeding. In the case of internal piles, there is discharge of dark blood.
Haemorrhoids are classified from mild to severe depending on the degree of prolapse, that is, how much they protrude from the anus. In some cases the veins burst and this results in what is known as bleeding piles.
Pain at passing stools, slight bleeding in the case of internal trouble, and a feeling of soreness and irritation after passing a stool are the usual symptoms of piles. The patient cannot sit comfortably due to itching, discomfort, and pain in the rectal region.
The primary cause of pile is chronic constipation and other bowel disorders. The pressure applied to pass a stool to evacuate constipated bowels and the congestion caused by constipation ultimately lead to piles. The use of purgatives to relieve constipation, by their irritating and weakening effect on the lining of the rectum, also result in enlargement and inflammation of veins and bleeding of mucus lining. Piles are more common during pregnancy and in conditions affecting the liver and upper bowel. Prolonged periods of standing or sitting, strenuous work, obesity and general weakness of the tissues of the body are the other contributory causes of piles.
Mental tension is also one of the main causes of haemorrhoids. Persons who are always in a hurry often strain while passing stools. They rush through defecation instead of making it a relaxed affair. The pressure thus exerted by the anal muscles affect the surrounding tissues. The extra rectal pressure and resultant congestion of veins ultimately lead to haemorrhoids. Hereditary factors also probably, involved in the development of piles.
There is no local treatment to cure piles. The treatment of the basic cause - namely, chronic constipationis the only way to get rid of the trouble. To begin the dietetic treatment, the whole digestive tract must be given a complete rest for a few days and the intestines thoroughly cleansed. For this purpose the patient should adopt an all -fruit diet for atleast seven days. He should have three meals a day of fresh juicy fruits such as grapes, apples, pears, peaches, oranges, pineapples and melons. For drinks, unsweetened lemon water or plain water either hot or cold may be taken.
In long-standing and stubborn cases, it will be advisable to have a short fast for four or five days before adopting an all-fruit diet. When on a short fast, the patient may have the juice of an orange in a glass of warm water, if desired. An enema with lukewarm water should be taken daily in the morning while fasting. This will cleanse the bowels and give much needed rest to the rectal tissues.
After the all-fruit diet, the patient may adopt a diet of neutral foods aimed at securing soft stools. The diet should be low in fat, it should not contain more than 50 grams of fat. Foods which contain less fat are skimmed milk, butter-milk, curd and cottage cheese made from skimmed milk ; all vegetables except cabbage, onions, dried beans and peas ; cooked and dried cereals, whole wheat chappatis and fruits and fruit juices.
The ideal diet for the patient with piles should consist of fruits like papaya, musk melon, apple and pear; green vegetables particularly spinach, cabbage and radish ; wheat, porridge, whole meal cereals and milk. Lentils and daals should be avoided, as they constipate the bowels. The patient should also abstain from meat, fish, eggs, cheese, white sugar, sweets, rice, all fried foods and all white flour products. Tea and coffee should be avoided. Dry fruits such as figs and raisins and coconuts should form part of the diet which could be on the following lines ;
Breakfast : Papaya, figs or prunes and milk.
Lunch : Raw vegetable salad, whole meal bread with a small quantity of butter and butter-milk.
Dinner : Two or three non-starchy steamed vegetables, nuts, curd, raisins and a fresh fruit.
Foods rich in vitamin C, bioflavonoids and vitamin E are essential in the treatment of haemorrhoids. Such foods include fresh raw vegetables and fruits, especially cabbage, citrus fruits, whole grains, seeds and nuts.
Vitamin B6 is also considered highly beneficial in the treatment of this disease. Piles have been produced in volunteers deficient in vitamin B6 and corrected when this vitamin was given. The patient with piles should supplement his diet with 10 mg. of B6 after each meal.
The patient should drink atleast six to eight glasses of water a day. He should avoid straining to pass stool. Cold water treatment helps the veins to shrink and tones up their walls. The treatment is done by sitting in a tub filled with cold water for two minutes with knees drawn up to your chin. The water level should cover the hips. This should be done twice a day. Cold compress applied to the rectal area for an hour before bedtime is also very helpful.
The patient with piles must make an all-out effort to tone up the entire system. Exercise plays an important corrective role in this condition. Movements which exercise the abdominal muscles will improve circulation in the rectal region and relieve congestion.