HOMOEOPATHIC MANAGEMENT FOR HEMORRHOIDS
Introduction
Piles, also known as hemorrhoids. There are swollen and inflamed veins around anus or in anal canal.
Hemorrhoids (Piles) are blood vessels located in the smooth muscles of the walls of the rectum and anus. They are a normal part of the anatomy and are located at the junction where small arteries merge into veins.
They are cushioned by smooth muscles and connective tissue and are classified by where they are located in relationship to the pectinate line, the dividing point between the upper 2/3 and lower 1/3 of the anus. This is an important anatomic distinction because of the type of cells that line the hemorrhoid, and the nerves that provide sensation.
Internal hemorrhoids are located above the pectinate line and are covered with cells that are the same as those that line the rest of the intestines. External hemorrhoids arise below the line and are covered with cells that resemble skin.
Pathophysiology of hemorrhoids
Constipation/prolong straining
Several enzymes or mediators like MMP (metalloproteinase) zinc-dependant protinase collagen is one of the most potent enzymes capable degrading extracellular protein, like elastin.
So increased Microvacular density,and increased Neovacularazation.(Profilaration of blood vessels)
So abnormal and distortion of the vascular channel, together with destructive changes in supporting connective tissue within anal cushion.
Than abnormal downward displacement of cushions take place which causes venous dilation.
Develop piles.
Etiology
Hemorrhoid swelling occurs when there is an increase in the pressure in the small vessels that make up the hemorrhoid causing them to swell and engorge with blood. This causes them to increase in size leading to symptoms. Increased pressure may be caused by a variety of factors:
Low fiber diet and smaller caliber stool causes a person to strain when having a bowel movement, increasing the pressure within the blood vessels.
Pregnancy is associated with hemorrhoid swelling and is likely due to increased pressure of the enlarged uterus on the rectum and anus. In addition, hormonal changes with pregnancy may weaken the muscles that support the rectum and anus.
Prolonged sitting on the toilet may increase pressure within the hemorrhoid blood vessels
Obesity
Diarrhea, both acute and chronic
Colon cancer
Previous rectal surgery
Spinal cord injury, lack of erect position
Hypertension.
Types of piles
Internal piles develop inside your anal canal, but they can hang down outside your anus. Internal piles can be graded according to how far they protrude, if at all, from your anus.
First degree piles are swellings on the inside lining of your anal canal. They may bleed but can’t be seen from outside your anus.
Second degree piles are larger than first degree piles. They come out of your anus when you have a bowel movement, but go back inside on their own afterwards.
Third degree piles hang down from your anus and only go back inside when you push them in.
Fourth degree piles permanently hang down from your anus and you can’t push them back in. They may become very swollen and painful if the blood inside them clots.
External piles are swellings that develop further down your anal canal, closer to your anus. They can be more painful than internal types of piles.
Sign and symptoms
Hemorrhoids are the most common cause of rectal and anal complaints. The most common complaint symptoms are:
-A lump in or around anus
-A slimy discharge of mucus.
-A feeling that bowels haven’t emptied completely.
-Painless bleeding.
-Itchy swelling around anus
-Pain and discomfort after a bowel movement (if you have external piles)
Diagnosis
The diagnosis is made by history taking and physical examination. The history may focus on the associated symptoms including constipation
Physical examination is performed to confirm the diagnosis and includes a rectal examination where a finger is used to feel for abnormal lumps or masses. Interestingly, internal hemorrhoids cannot usually be felt. The rectal exam may be deferred if there is intense pain or swelling.
Sigmoidoscopy or colonoscopy.
Treatment
How can homeopathy help?
A combination lifestyle changes and homeopathic treatment can be a great relief to a person suffering from piles, as it eliminates the possibility of surgery. Moreover, a thorough homeopathic treatment can remove the tendency and thereby prevent its recurrence with help of constitution medicine and other following medicine.
Other specific medicines- acid mur, aesculus hip, alumina, ars.alb, barayta.carb, carbo.veg, caust, collinsonia,graph, hamamelis, ignatia, kali.carb, lycopodium, lycopus, millifolium, nat.mur,negundo, nit.acid, nux.vomica, paeonia,puls, phos, ratanhia, sulphur,thuja.
Aesculus hip and Hamamelis virginica Use externally for pain , swelling.
Collinsonia – Said to be of special value when given before operations, for rectal diseases.
Biochemical treatment of piles-
Tissue salts can be used with constitution medicine.
Cal .flour, cal.phos, ferrum phos- for strengthening of the vessels wall against bleding.
Nat .mur – piles and stubborn constipation
Sil –suppuration of internal hemorrhoids.
Bleeding piles – kali.mur can be applied externally.
1.Cal flour-
Bleeding hemorrhoids , internal or blind piles frequently with pain in back. Piles with pressure of blood to the head. hemorrhoids with bleeding and itching in the anal region, or internal hemorrhoids causing soreness in the very low back and sacrum. The person may also have problems with flatulence and constipation.
2.Ferrum .phos-
Constipation with heat in lower bowel, associated with prolapsed and hemorrhoids and aversion to meat diet.
3.Kali.mur-
Hemorrhoids, bleeding piles, blood dark and thick, fibrious, clotted.
4.Kali.phos-
Hemorrhoids , sore, painful and itching.
5.Kali.sulph-
Internal and external hemorrhoids, with characteristic tongue and secretion.
6.Mag.phos-
Cutting, lightning – like pains in hemorrhoids, so severe as to cause fainting , most severe in rectum and abdomen.
7.Nat.mur-
Stubborn constipation. Stinging pain in hemorrhoids.
SOME INDIAN DRUGS FOR PILES
1.AEGLE – MARMELOS and AEGLE- FOLIA(Bel fruit) – bleeding piles.
2.FICUS RELIGIOSA(Ashwattha) – bleeding piles, dysentery.
3.FICUS INDICA(Bot) – successfully arrest haemorrhage from piles.
4.JANOSIA ASOKA(The Asoka Tree) – blind or bleeding piles with itching and smarting.
5.LUFFA BINDAL(Ghosalata) – it controls piles successfully, useful for externally.
6.TERMINALIA CHEBULA(Haritaki) – billiary colic, bleeding piles.
Refrences –
1.Boricke material medica
2.Schussler’s biochemic medicine
3.Beliy and love textbook of surgery
4.Harrison’s textbook of medicine
5.www.ncbi.nih.gov/med/1169085
