Are you tired of the discomfort and pain that comes with piles? You’re not alone. Many people struggle with this common condition, but there is a natural and effective way to find relief. Fibre, a humble nutrient found in everyday foods, plays a very important role in preventing and managing piles. In this blog, you will learn how adding more fibre to your diet can make a significant difference in your digestive health and overall well-being.

What is the Role of Fibre in Piles?^[1]

Fibre adds bulk to the stool and helps it pass more easily through the intestines. There are two types of fibre: soluble and insoluble.

• Soluble fibre dissolves in water and forms a gel-like substance, which slows down digestion.
• Insoluble fibre does not dissolve in water and adds bulk to the stool, aiding in its movement through the digestive tract.

Sources of Dietary Fibre^[2]

Incorporating fibre into your diet is simple and can be achieved through a variety of foods. Here are some excellent sources of dietary fibre:

• Fruits: Apples, bananas, oranges, and berries.
• Vegetables: Carrots, broccoli, spinach, and sweet potatoes.
• Whole Grains: Brown rice, oatmeal, and whole wheat bread.
• Legumes: Lentils, beans, and chickpeas.
• Nuts and Seeds: Almonds, chia seeds, and flaxseeds.

Preventing Piles with Fibre^[3]

• Regular Bowel Movements: One of the primary benefits of fibre is its ability to promote regular bowel movements. Regular bowel movements prevent the build-up of pressure in the rectal veins, reducing the risk of developing piles. A fibre-rich diet ensures that your digestive system works efficiently, making it less likely for you to experience constipation, a major contributing factor to piles.
• Softens Stool: Fibre helps soften the stool by absorbing water, making it easier to pass. Hard, dry stools can lead to straining during bowel movements, which can cause or worsen piles. By consuming enough fibre, you can maintain soft, easily passable stools, reducing the strain on your rectal veins.

Managing Piles with Fibre^[3]

If you are already experiencing piles, making dietary adjustments to include more fibre can help manage the condition. A high-fibre diet can alleviate symptoms such as pain, itching, and bleeding. Here are some tips to increase your fibre intake:

• Start your day with a high-fibre breakfast, such as oatmeal topped with fruits and nuts.
• Include plenty of vegetables in your meals, aiming for a variety of colours and types.
• Snack on fruits, nuts, and seeds instead of processed snacks.
• Choose whole grains over refined grains.

Fibre Supplements

In addition to dietary changes, fibre supplements can be helpful in managing piles. Supplements can provide the necessary fibre intake if you are unable to get enough from your food alone. However, it is always recommended to consult your healthcare provider before consuming these supplements.

Recommended Fibre Intake for Piles

The recommended daily intake of fibre varies depending on age and gender. On average, adult women should aim for about 25 grams of fibre per day, while adult men should aim for about 38 grams^[4]. These recommendations can serve as a guideline for adjusting your diet to ensure adequate fibre intake.

Sample High-Fibre Diet Plan^[5]

To help you add more fibre into your diet, here’s a sample high-fibre diet plan:

Breakfast:

• Oatmeal cooked with milk, topped with chopped apples, almonds, and a sprinkle of chia seeds.
• A glass of freshly squeezed orange juice.

Mid-Morning Snack:

• A bowl of mixed fruits such as papaya, guava, and pomegranate.

Lunch:

• Brown rice or whole wheat roti.
• A serving of dal (lentil soup) and a vegetable curry made with spinach, carrots, and peas.
• A side salad with cucumbers, tomatoes, and a lemon dressing.

Afternoon Snack:

• A handful of roasted chickpeas or a small bowl of yoghurt with flaxseeds.

Dinner:

• Quinoa or whole wheat pulao.
• A serving of mixed vegetable curry with beans, cauliflower, and sweet potatoes.
• A side of sautéed greens such as spinach or methi (fenugreek leaves).

Before Bed:

• A small bowl of fruit salad or a few pieces of dried figs.

Conclusion

Incorporating more fibre into your diet is a natural and effective way to prevent and manage piles. Start making these changes today to experience the benefits of a healthier, more comfortable life.

Reference Links:

[1] https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983#:~:text=Soluble%20fiber.,%2C%20carrots%2C%20barley%20and%20psyllium.
[3] https://www.news-medical.net/health/Prevention-of-piles-(Haemorrhoids).aspx
[4] https://www.medicinenet.com/how_can_i_eat_25_grams_of_fiber_a_day/article.htm#:~:text=According%20to%20the%20American%20Heart,may%20need%2030%2D38%20grams.
[5] https://www.healthifyme.com/blog/high-fibre-diet/
https://www.lybrate.com/topic/high-fiber-diet
https://www.prevention.com/food-nutrition/a20516445/high-fiber-diet-plan/
https://www.medicalnewstoday.com/articles/hemorrhoids-high-fiber-diet#foods-to-eat
https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/eating-diet-nutrition
https://www.guysandstthomas.nhs.uk/health-information/piles-haemorrhoids/lifestyle-changes#:~:text=Eat%20a%20high%20fibre%20diet&text=Eating%20lots%20of%20high%2Dfibre,muesli%2C%20oats%20and%20bran%20flakes

Introduction

When two body cavities or a body cavity and skin connect abnormally, they form a fistula. A fistula can be formed in many parts of the body, namely between the cervix and vagina, the neck and the throat, an artery, and a vein, the bowel and vagina, stomach and skin surface, anus and skin surface, skull space, and nasal sinus. These fistulas could be open (one end open), complete (both ends open), incomplete (closed inside), or horseshoe (connecting the anus to the skin surface). Some fistulas may heal on their own, while some may not. The treatment depends on the type, location, cause, and severity of the condition.

An anal fistula is one such types of fistula that most commonly affect men. Following an infected anal gland that does not heal, it needs surgical treatment for its cure.

The present blog provides insight into the meaning, causes, symptoms, diagnosis, and treatment of anal fistula for a better understanding of the condition.

What is an Anal Fistula?

An anal fistula, also known as a Fistula-in-Ano, is an abnormal connection between the surface of the skin of the bullock and the anal canal in the colon. It is a tunnel running from inside the anus to the skin surface around it. An anus is an opening at the end of the digestive tract that gets rid of the solid waste of the body. Anal fistula affects the internal and/or external anal sphincters (muscles).

What Causes Anal Fistula?

An infection in the anal gland is the primary cause of anal fistula. This infection causes an abscess. An abscess is a tender mass over skin filled with pus and bacteria, painful and warm to feel.

The other cause of anal fistula includes –

• an injury or surgery in the anus,
• radiation therapy in the pelvic region,
• tuberculosis (infection in the lungs),
• Crohn’s disease (inflammation of the digestive tract),
• ulcerative colitis (inflammation of the large intestine) or
• sexually transmitted diseases.

Symptoms of Anal Fistula?

Anal fistula symptoms require immediate medical consultation and intervention for its treatment. Some of the symptoms of anal fistula are-

• Fever
• Swelling and redness around the anus,
• Pain during bowel movement or urination
• Fowl smelling pus or watery discharge from the abscess
• Bleeding

How is Anal Fistula Diagnosed?

The diagnosis of anal fistula starts with medical history and physical examination of the patient. Some fistulas can be easily spotted, and the doctor may examine through the oozing blood fluid.

For those that are closed, the doctor may need to find the inside source of the fistula. For this, they may use an anoscope or a proctoscope to examine the anal canal. The patient is put on anesthesia during the examination. 

The use of special dye to find the internal source of the anal fistula is also resorted to by the doctor. For this, the doctor injects a special dye that would react with the infection, creating bubbles at the injection site.

Ultrasound and MRI are some of the imaging studies that the healthcare provider may conduct for the diagnosis of anal fistula.

Treating Anal Fistula

The treatment for anal fistula depends on the severity of the condition and the type of fistula. Before arriving at the decision for anal fistula surgery, the healthcare provider may try to treat it with medications. However, spontaneous healing may cause the fistulas to reopen if there is infection again. The treatment varies depending on whether the fistula is simple or complex. Simple fistula has less muscle involved that needs to be treated. Complex fistula treatment requires addressing more muscle damage. The treatment options for fistula are-

• Fistulotomy– Fistulotomy is the most common one-time surgery for simple fistulas. The surgeon cuts through the fistula, opens the infected area, and removes the damaged muscle.
• Seton drain– For complex fistulas, the surgeon uses a surgical thread called the seton that keeps the fistula open and helps drain the infection. The seton is passed from the opening of the fistula through its track out to the anus with a loop at the end. It acts as a wick to drain the infection and heal the fistulas. Later, it may be closed with a fistulotomy. A seton is generally required to be removed; however, in some cases, it might be placed for an indefinite time.
• Endorectal advancement flap– The infection is accessed through the inside opening of the fistula and cut out. The opening is then covered with healthy tissue from the inside of the rectum above it. This flap of the healthy tissue is pulled down from the rectum to fill the opening. The infection drains out from the outside of the fistula opening. In some cases, there are chances of reoccurrence of infection and fistula, along with the risk of damaging the muscles.
• LIFT- The procedure is known as the Ligation of the Intersphinteric Fistula Tract. It avoids cutting the sphincter muscles. The surgeon accesses the fistula between the internal and external muscles through an incision at the anal track opening and treats the infection, and then closes the incision with stitches.

Conclusion

Fistulas are not life-threatening; however, they may become life-challenging, affecting the patient’s quality of life. Anal fistulas usually need to be treated surgically depending on the severity and location of the fistula. A timely address requires an informed decision based on the risk assessment and successful surgical outcomes of the various treatment options. Living with a fistula is challenging, and its treatment varies depending on its severity and complexity. Immediate and timely medical intervention is the only way to treat it, enabling quality and healthy living.

References

https://my.clevelandclinic.org/health/diseases/14466-anal-fistula
https://www.mayoclinic.org/diseases-conditions/anal-fistula/symptoms-causes/syc-20352871
https://www.webmd.com/digestive-disorders/anal-fistula-overview
https://www.hopkinsmedicine.org/health/conditions-and-diseases/anal-fistula
https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/fistula

Ever felt like stress has a way of making everything worse? From sleepless nights to headaches, stress can creep into all parts of life. But did you know it could also be affecting your digestive health and even making piles more severe? If you are dealing with piles, understanding how stress ties into this common condition might be the missing piece in managing it better.

What are Piles?

Piles are swollen veins in the lower rectum or anus that can cause discomfort, itching, pain, and bleeding. They are classified into two main types: internal piles, which occur inside the rectum, and external piles, which develop under the skin around the anus. Internal piles are generally less painful but can bleed, while external piles can be more painful and irritating .

Causes of Piles

• Chronic constipation
• Prolonged sitting
• A low-fibre diet
• Obesity
• Pregnancy
• Heavy lifting
• Straining during bowel movements

Although these physical factors are well-known causes of piles, emotional and psychological factors like stress can also play a crucial role ^[1].

The Connection Between Stress and Piles

Stress and Digestive Health
When a person is stressed, the body’s natural “fight or flight” response is activated, leading to a series of physiological changes, including the slowing down of digestion. This can cause changes in digestive system leading to constipation, which is one of the primary triggers for piles. The longer food remains in the digestive tract, the more water is absorbed, making the stool harder and more difficult to pass. This leads to increased straining, which can aggravate or even cause piles^[2] .

The Role of Cortisol
When stressed, the body releases cortisol, a hormone that activates body’s stress response. Elevated cortisol levels can have various negative effects on the body that weakens the immune system, increases inflammation, and affects blood flow. In the context of piles, heightened cortisol levels can exacerbate inflammation and swelling, making the condition more painful and harder to manage^[3] .

Behavioural Impact of Stress
Stress can also lead to unhealthy behaviours that may worsen piles. People under stress often neglect their diet, opting for comfort foods that are low in fibre and high in fat and sugar. These dietary choices can lead to constipation and poor digestive health, directly impacting the severity of piles. Moreover, stress can cause people to skip meals, avoid drinking enough water, or neglect exercise—all of which can contribute to the development and worsening of piles.

Tips for Managing Piles and Stress Simultaneously

Eat a High-Fibre Diet: Including plenty of high-fibre vegetables and fruits in your diet along with whole grains can prevent constipation.

Stay Hydrated: Drinking at least 8-10 glasses of water daily can keep stools soft and easier to pass, preventing strain on the rectal veins.

Practice Mindfulness: Mindful activities such as deep breathing exercises, meditation, and yoga can reduce stress and improve overall mental health, aiding in better digestive health.

Stay Active: Physical activity, such as walking, swimming, or cycling, can reduce stress and improve bowel movements, helping prevent and manage piles.

Avoid Prolonged Sitting: Long periods of sitting can increase pressure on the rectal area, worsening piles. Take frequent breaks to stand and stretch.

Use Relaxation Techniques: Stress-relieving practices such as progressive muscle relaxation, guided imagery, and aromatherapy can help manage stress levels effectively.

Conclusion

Managing piles is more than just dealing with the physical symptoms—it is about taking care of your overall well-being. Ready to take a step toward a healthier life? Start today with these simple tips, and feel the relief and comfort you deserve!

Reference Links:

[1] https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268
[2] https://www.henryford.com/blog/2021/07/how-stress-affects-digestion#:~:text=That%20includes%20digestion.,experience%20bowel%20urgency%20or%20diarrhea.
[3] https://my.clevelandclinic.org/health/articles/22187-cortisol

What is Stapled Hemorrhoidopexy?
Also known as the Procedure for Prolapse and Hemorrhoids (PPH), stapled hemorrhoidopexy is a technique that uses a circular stapler to reposition and remove excess tissue in the rectum, which is causing the prolapse. At the same time, the procedure also lifts the prolapsed tissue back into the anal canal. 

The procedure is typically completed within an hour. First, the surgeon will insert a proctoscope, a specialised instrument fitted with a light, to view the insides of the rectum and anus. The stapling device is inserted through the proctoscope and positioned around the prolapsed hemorrhoid tissue. Once the device is in place, the surgeon will fire it, creating a circular staple line that removes the excess tissue and lifts the prolapsed tissue back into place.

The stapled hemorrhoidopexy technique most effectively treats grade III and IV hemorrhoids. However, it may also be used to treat grade II hemorrhoids in some instances.

Benefits of Stapled Hemorrhoidopexy
Stapled hemorrhoidopexy offers several benefits for patients compared to traditional hemorrhoidectomy procedures. Some of these benefits include:

• Reduced pain and discomfort: Since the procedure removes less tissue than traditional hemorrhoidectomy surgeries, patients generally experience less postoperative pain and discomfort.
• Faster recovery times and shorter hospital stays: Patients typically require less recovery time and can return to work and normal activities sooner than with traditional hemorrhoidectomy procedures. Hospital stays are also shorter, typically ranging from 24-48 hours.
• Lower risk of bleeding and other complications: The stapling device creates a circular staple line that seals the tissue, reducing the risk of bleeding and other complications that can occur with traditional hemorrhoidectomy procedures.
• Improved cosmetic outcomes: As the procedure removes less tissue, there is less scarring and better cosmetic outcomes than traditional hemorrhoidectomy surgeries.
• Prevents of Stenosis of anal canal

Recovery and Aftercare for Stapled Hemorrhoidopexy
After the stapled hemorrhoidopexy procedure, patients will be monitored in a recovery room before being discharged home. Patients may experience discomfort and pain after the procedure, which can typically be managed with pain medications prescribed by the surgeon. Patients should also expect bleeding and discharge for a few days after the procedure.

Patients must follow specific instructions for wound care and activity restrictions during recovery. These instructions may include avoiding strenuous activity, drinking more water, and following a soft, fibrous diet to avoid constipation. Patients should also avoid lifting heavy objects and straining during bowel movements to prevent damage to the surgical site.

Patients typically have a follow-up appointment with their surgeon within a few weeks after the procedure to monitor the healing process and address any concerns or complications.

Conclusion
Stapled hemorrhoidopexy is a safe and effective procedure for treating prolapsed hemorrhoids. Patients should undergo a thorough preoperative evaluation and follow specific instructions for preparation and aftercare to ensure the best possible outcomes. While there are risks associated with any surgical procedure, the stapled hemorrhoidopexy technique is a valuable treatment option for patients suffering from severely prolapsed hemorrhoids. If you are experiencing symptoms of hemorrhoids, it is essential to speak with your doctor to determine the best treatment for your specific needs.

FAQs

Q: What is the difference between stapled hemorrhoidopexy and traditional hemorrhoidectomy surgery?
A: Stapled hemorrhoidopexy is a less invasive technique that uses a special circular stapler to reposition and remove excess tissue in the rectum. Traditional hemorrhoidectomy involves the complete removal of hemorrhoids using surgical instruments.

Q: What is the typical recovery time for stapled hemorrhoidopexy?
A: Recovery times can vary depending on the individual patient and the extent of the procedure. However, many patients can return to normal activities within a week or two after the surgery.

Q: What are the benefits of stapled hemorrhoidopexy?
A: The benefits of this surgery include reduced pain and discomfort, faster recovery times, shorter hospital stays, lower risk of bleeding, and improved cosmetic outcomes.

References
https://ales.amegroups.com/article/view/3596/html
https://www.tgh.org/institutes-and-services/treatments/hemorrhoidopexy#:~:text=Complete%20recovery%20from%20stapled%20hemorrhoidopexy,Consuming%20a%20high%2Dfiber%20diet
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4775568/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780042/
https://emedicine.medscape.com/article/1829854-overview