Are You Plagued with Piles?
ACCORDING to historians, piles (or hemorrhoids, as the doctors call them) have changed the course of history. Thus Rudolph Marx tells that Napoleon failed to exploit a gap in the flank of Wellington’s army because of his being groggy owing to a lack of sleep as well as opiate medication taken to ease the pain caused by his hemorrhoids.
Piles are swellings or dilatations of the veins in the anus; actually varicose veins at the lower end of the large bowel or rectum. Basically, there are two kinds—internal and external piles. When complications arise, they may be quite painful and perhaps may rupture, causing bleeding. According to some authorities, one third, if not more, of all adults have piles in one form or another. In many cases, however, the situation is not such that the person is aware of having them.
The affliction of piles goes back as far as written history. Ancient records of both Egypt and Babylon show that doctors were familiar with this malady, and in particular does the Bible tell about them.—Deut. 28:15, 27; 1 Sam. 5:6-12.
Causes
As to the causes of piles—it has long been stressed that among the main causes of piles are sedentary occupations and poor bowel habits. But today we are told that piles are found among heavy laborers, military personnel and many others whose work is not sedentary.
Among the factors charged by some with bringing on piles are excess use of spices, vinegar and coffee. A most likely basic cause is a hereditary weakness that makes one a good candidate for piles.
It is believed that constipation and straining when having bowel movements are to blame in a large measure for the prevalence of piles. But, conversely, an acute case of diarrhea can bring on an attack of complicated hemorrhoids. Inability to relax the muscles in the anus may also bring them on, and this, in turn, may well be caused by modern man’s improper eating habits. Additionally, piles are one of the common complications of pregnancy, due apparently to increased intra-abdominal pressure brought on by the enlarged uterus.
Thus an article in the American Heart Journal, April 1973, showed the relationship between deep vein thrombosis or clotting, varicose veins and hemorrhoids. It put forward this hypothesis: “A high residue diet promotes rapid transit of intestinal content with the passage of large unformed stools. In contrast, the low residue diet . . . of modern western civilization results in prolonged intestinal transit times with the passage of small, firm, formed stools. In the latter situation not only are [certain] pressures in the colon greatly raised, with resultant appendicitis and [bowel] disease, but the intra-abdominal pressures are also greatly raised during straining at constipated stools.” The article concludes by noting that “if this hypothesis proves correct even in part,” hemorrhoids and related ills “in the western world could be greatly reduced by a return to a higher residue diet.”
Making similar observations is an article that appeared in the New Zealand Medical Journal, November 1972. It called attention to a noted surgeon’s view that “the low residue diet of western society is the major factor in the high incidence of haemorrhoids . . . in our communities [as] compared with that obtaining in the native populations of Africa and India.” No wonder that hemorrhoids have been called “a disease of civilization.”
Preventing and Curing Piles
To avoid having piles, the recommendation is to exercise if yours is a sedentary occupation and to be sure to eat plenty of food that has high residues. Foods that do not have high residues are those largely made with white flour, also white or polished rice, spaghetti and chocolate. Eat sparingly of these foods but plenty of those having high residues, such as bran muffins, whole wheat bread and whole grain cereals. Also, eat plenty of leafy and other vegetables, especially celery and cabbage. Eat baked potatoes with the “jackets,” and fruits with their peelings—apples, peaches and suchlike fruits.
Hypocrates, the noted Greek physician of the fifth century B.C.E., as well as the twelfth-century Jewish scholar and philosopher Maimonides, gave some practical advice regarding the treatment of piles, much in line with what is here noted.
If you already have piles, what can you do about them? Just returning to a natural diet as noted above may relieve you of the problem if it is not severe or complicated. But you may need more definitive treatment. What is known in the medical profession as “ligature and excision” is the most common surgical treatment, although only about 10 percent of those afflicted need such surgery. Some types of uncomplicated internal hemorrhoids are successfully treated by one of several injection techniques.
Still another procedure employs the use of elastic bands, which are placed so as simply to strangulate the mass of involved venous tissue. Such methods of treatment are done as office procedures under local anesthesia and without much postoperative disability for the patient.
A more recent innovation is the “freezing” method, also known as cryosurgery. Surgeons employing this method use “Kryostik” in destroying hemorrhoidal tissue by freezing. It is a relatively painless and nondisabling procedure.
Some authorities stress the importance of dilatation (stretching the opening of the anus) as a means of avoiding a narrowing of the anal opening. This may be part of the surgical procedure itself or it may be advised as postoperative management to be carried out by the patient at home.
So there are a number of ways in which piles can be dealt with. However, as is obvious, the type of treatment may be determined to a large extent by the type of the problem and the presence of complications such as blood clotting, fissures or fistula.
But let it be noted that in the case of piles as in the case of so many other afflictions that plague mankind the rule applies that “an ounce of prevention is worth a pound of cure.” Learn to relax the muscles of the anus, get more exercise if you are a sedentary worker and, above all, watch your diet and eat the foods that will help you to keep “regular” and avoid constipation.