High fibre diet keeps haemorrhoids at bay

Though it is a condition associated with the elderly, experts say that of late they are seeing a number of youngsters suffering from the condition. Haemorrhoids, a common anorectal disorder is expected to affect at least five per cent of the population at any given time. Haemorrhoids are swollen veins in the lowest part of your rectum and anus. Some of the symptoms may be pain in the rectum, anal discomfort, itchiness, or swelling or blood in stool or constipation Dr B Mahadevan, consultant, gastroenterology, Global Hospitals, says, “Lack of sleep, inadequate intake of water and diet imbalance are the biggest reasons for the condition to surface among youngsters. 

With long working schedules, many skip the morning routine of passing motion in a hurry and over a period of time, constipation acts as a huge trigger.” Stress is also an underlying factor, points out Dr Deepak Subramanian, Consultant – Minimal Access & Bariatric Surgery. He says, “This when coupled with lifestyle issues like smoking and poor intake of fibre lead to haemorrhoids.” Dr Subramanian adds that with haemorrhoids it is essential to rule of cancer. “I get a colonoscopy done in that case, to catch the disease early,” he adds. 

Experts say that in India with a limited access to toilet facilities in public places, women are more likely to skip using toilets due to hygiene issues. “Therefore, they are likely to be constipated more than the men,” says Dr Patta Radhakrishna, director of surgical services, SIMS Hospital. He adds, “In women, during pregnancy there is a thrust on the pelvic veins. This is likely to sort out after pregnancy and in some, the condition can surface soon after delivery,” he says. However, Dr Mahadevan says that women tend to hide it. He says, “Especially if it is asymptomatic; they are more likely to live with it, partly out of embarrassment. 

Early diagnosis, better treatment Among the biggest problems that experts face while managing haemorrhoids is late diagnosis. Dr Subramanian says, “Most of them who come to us are in either grade or three. Early presentation is rare due to lack of symptoms.” However, scope or recovery is highest during early stages. In the earlier stages, they can be treated through medications, especially when it is grade one and grade 2. “The other options are conventional haemorrhoidectomy to remove the haemorrhoids, or stapled haemorrhoidectomy. a surgical procedure that involves the removal of abnormally enlarged haemorrhoidal tissue. A laser procedure is also an option that causes less pain during surgery and while recovering,” says Dr Subramanian.

External haemorrhoids originate distal to the dentate line, arising from the inferior hemorrhoidal plexus. They are sometimes painful as they are lined with modified squamous epithelium, which is richly innervated with somatic pain fibres (delta type, unmyelinated), and often accompanied by swelling and irritation. External haemorrhoids are prone to thrombosis, they become thrombosed when the vein ruptures and/or a blood clot develop. 

Internal haemorrhoids are symptomatic and can be classified into four cartegories

They are those that are permanently prolapsed and irreducible despite attempts at manual reduction 

They protrude at the time of bowel movement and reduce spontaneously

These are a combination of internal and external haemorrhoids

They are those that protrude spontaneously or at the time of bowel movement and require manual reduction