home remedies for hemorrhoids india

In India alone, 1 million new cases of piles are reported every year. Most people rely on home remedies to get cured of piles and the. Max Hospital is one of the top piles treatment hospitals in Delhi NCR, India with world class treatment facilities. Book an online appointment now at your. Dr. Piles Clinic is the best hospital in Pune and Mumbai provides one hour painless Only in ayurveda immunity boostup medicines and home remedies are.
home remedies for hemorrhoids india

Home remedies for hemorrhoids india -

Video: 7 effective home remedies using jeera

Benefit 1: To improve digestion
Cumin seeds are known to strengthen a sluggish digestive system. Due to the thymol compound and other important oils in cumin seeds, they help in stimulating salivary glands and, thus, aid digestion. So, if you are suffering from indigestion, try drinking jeera tea three times a day.

Recipe:Take 1 cup of water and add 1 tbsp of cumin seeds to it. Bring it to a boil. Strain and have it three times a day.

Jeera water

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Benefit 2: To beat constipation


Cumin seeds have high fibre content, which boost the activity of gastrointestinal tract. This in turn stimulates enzyme secretion. That is why cumin seeds are used as a natural laxative. Due to this property, cumin seeds are capable of healing severe digestive disorders, like piles.

Recipe: To get rid of constipation, roast 1 tbsp of cumin seeds till they turn deep brown and grind them into a fine powder. Then mix the powder with water and honey and consume it on an empty stomach everyday.


Cumin honey recipe

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Benefit 3: To relieve asthma and cold

Due to their anti-bacterial and anti-inflammatory properties, cumin seeds are an awesome home remedy for cold and cough. The compounds in cumin seeds help to soothe inflamed muscles and boost immunity to fight infections.

Recipe:Add 1 tbsp of cumin seeds to 1 glass of water. Bring it to a boil. Also add some chopped ginger to this. Boil properly. Strain and have this twice or thrice a day.


Jeera tea

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Benefit 4: For pregnant women

The properties of cumin seeds help in relieving constipation and improving digestion in pregnant women. The seeds also help in dealing with pregnancy symptoms like nausea and constipation. Along with aiding in better delivery, they also enhance lactation.

Recipe:Take a glass of warm milk and add half tbsp cumin powder and 1 tbsp honey to it. Mix well. Have it everyday.

For pregnant women

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Benefit 5: To deal with insomnia


Cumin seeds can help you if you are not able to sleep well. They contain a compound called melatonin, which when consumed with mashed bananas, increases the production of chemicals that induce sleep.

Recipe: Mix half tbsp of cumin powder with 1 tbsp of mashed banana. Have this paste before sleeping. This will help you have a good sleep.


Cumin banana paste

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Benefit 6: For glowing skin

A face pack containing honey and cumin seeds will make your skin glowy and smooth. Honey soothes inflamed tissues and this spice will prevent the skin from becoming too dry. Apply some jojoba oil after washing it off your face.

Recipe: To prepare this mask, mix one by four tbsp of turmeric powder, half tbsp of cumin powder and 1 tbsp of honey. After you apply this face mask, let it dry for 10 minutes and then wash it off with warm water. You can apply this face pack twice or thrice a week.


Face pack

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Benefit 7: For long and shiny hair

Cumin can also help you get long and lustrous tresses.

Recipe:For making this, take 150-200 ml of water (3/4 a glass), 1 tbsp cumin powder and 1 egg yolk. Mix them together and form a smooth paste. Apply it on hair and let it dry. Wash it off with water. You can do this once in a week or once in every two weeks.

Hair mask

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Источник: https://timesofindia.indiatimes.com/life-style/health-fitness/home-remedies/7-effective-jeera-home-remedies/articleshow/57424317.cms

Home Remedies for Piles

Home Remedies for Piles
Home Remedies for Piles
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January 28, 2021

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Piles is a condition in which the veins and tissues in the anal canal or around the anus become inflamed. Also known as haemorrhoids, piles may cause reddish-brown masses to grow inside and around the anus. These masses can sometimes bleed, leaving blood on the toilet paper. A person suffering from piles may experience a lot of pain, especially during defecation (passing stool).

The symptoms of piles can include:

  • Pain
  • Burning sensation in the anus
  • Feeling like you have to poo even after you've just defecated
  • Itchiness around the anus

These symptoms usually go away within a few days, and some simple home remedies can help to make them more bearable in the meantime. However, if the symptoms persist, consult a doctor for intervention: in case there's another reason for the anal bleeding.

  1. Turnip leaves for relief from piles
  2. Onions to reduce the symptoms of piles
  3. Aloe vera gel for relief from piles
  4. Oils for piles relief
  5. Sitz bath or warm water bath for relief from piles
  6. Ice packs for piles relief
  7. Root vegetables like radish for relief from piles
  8. Figs for relief from piles
  9. Mango give relief in piles
  10. Witch hazel for relief from piles
  11. Piles home remedy: horse chestnut extract
  12. How to get rid of piles: tips

Turnip leaves for relief from piles

Turnips are widely available in India in the wintertime. They are typically used in dishes such as curries, salads and pickles. However, most people discard the leaves while preparing the turnips. These leaves are a "phytomedicine" (plant-based medicine) for piles.

Turnip leaves (and also the stem) belong to the same family as kale, cabbage and broccoli. They are rich in fiber, vitamin C, vitamin K, vitamin B9 (folate), magnesium, phosphorus and potassium. They also have a high water content. The high fiber and water content helps in achieving smoother bowel movement and relieves some of the symptoms of piles. And the vitamin K - which regulates blood clotting - may help to reduce any bleeding associated with piles.

How to use turnip leaves:

  • You can blanch the leaves by placing them in boiling water for 30 seconds, and then add them to a salad.
  • You can also juice the leaves and consume 50-150 ml of this juice daily - however, taking the juice means taking out the fiber component.

Onions to reduce the symptoms of piles

Onions may help in symptomatic relief from piles, especially bleeding piles. Said to have anti-inflammatory and antioxidant properties that help in relieving swelling and burning sensation in inflamed haemorrhoids, red onions have also been found to contain active compounds known as saponins which help in relieving muscle spasms.

Consuming onions and sugar in a 1:2 ratio helps provide relief from bleeding piles. Other than bleeding piles, onions also help improve the symptoms of dry piles. Just cut the onion into fine slices and gently rub it locally: you might feel a slight burning sensation on its application, don't worry about that, it's an inherent property of raw onion. However, if burning intensifies, stop its application.

Aloe vera gel for relief from piles

When it comes to getting relief from the pain and burning sensation of piles, the soothing and cooling properties of aloe vera cannot be forgotten. It is like a wholesome package, which helps relieve almost all the symptoms of piles.

Aloe vera contains several bioactive compounds like vitamins, minerals, hormones, enzymes and fatty acids, which have antiseptic, analgesic (pain reliever), antioxidative, anti-inflammatory (reduce swelling) and healing effects. Not only will the aloe vera relieve your pain and burning sensation but also the pulp of this magical plant may promote the healing of your inflamed tissues, providing respite from the swelling.

In order to get the enormous benefits of aloe vera, take an aloe vera leaf, remove the pulp and apply the pulp directly on the affected areas.

If you don't have aloe vera growing in and around your house, you can also go for commercially available aloe vera gel - just make sure it is pure and free from additives.

Oils for piles relief

Various oils are traditionally used to alleviate the obvious symptoms of piles. According to the journal, Evidence-Based Complementary and Alternative Medicine, oils like sesame oil, olive oil and coconut oil are effective in the treatment of haemorrhoids. These oils are locally applied to the anal area to get relief from symptoms.

According to another study, topical application of olive oil, honey and beeswax on inflamed haemorrhoids can reduce the bleeding, pain and itching associated with piles. If the preparation and application of this mixture seem like a tedious task to you, you can simply opt for olive oil. Olive oil is commonly used nowadays to serve cosmetic and culinary purposes and is easily available in the market. Take a few drops of olive oil, rub it on your palm to heat it up slightly. Apply it to the anal area a few times a day until the symptoms subside.

Research done at the Harvard Medical School suggests that consumption of mineral oil with yoghurt as part of breakfast or lunch helps in the easy passage of stool through the lower part of the bowel. However, you should not take this home remedy for a prolonged period of time to avoid oil leakage.

Sitz bath or warm water bath for relief from piles

A warm water bath is one of the most popular remedies for piles. It is especially effective for people who suffer from constipation along with piles. Studies suggest that a warm water bath relieves pain by relaxing the anal sphincter, a muscle inside your rectum. And the best part is that it does not require much effort. All you need to do is sit in a tub filled with warm water (not hot).

Alternatively, you can use warm water in a “sitz bath”. This is a therapeutic procedure that is often used to relieve piles symptoms and involves sitting in a shallow water tub for 10 minutes, twice a day, without any additives in the water.

When done regularly, it can provide relief from pain, itching and burning along with relief from symptoms associated with thrombosed haemorrhoids.

Some people prefer adding anti-inflammatory additives like tea tree oil, chamomile, witch hazel or arnica in their warm baths. Although, there is not much research on the effectiveness of these additives in getting rid of apparent symptoms.

Ice packs for piles relief

If you are not fond of warm water baths you can always opt for cold compression. Just like warm baths, they are effective in reducing swelling in the haemorrhoid tissues. Ice packs slow down the inflammatory process in the affected area. They alleviate the burning sensation and contract local blood vessels in order to provide instant relief. The effects of an ice pack persist for 30 minutes even after cessation of application.

Application of ice packs also helps in reducing the size of the bulging growth temporarily and stops the leakage of blood from enlarged blood vessels (anal bleeding).

(Read more: Blood in stool symptoms, causes, treatment)

All you need to do in an attempt to bring all the above-mentioned effects is to wrap a few ice cubes in a soft, clean piece of cloth or wipes and apply it on the anal area. You can repeat this a few times a day to get symptomatic relief.

Root vegetables like radish for relief from piles

Root vegetables like radish and yams (called jimikand in Hindi) are nutrient-dense, in addition to being rich in fiber. They help to make the stool softer and improves the bowel movement.

Additionally, some root vegetables like potatoes and sweet potato (shakarkandi) contain resistant starch which is not absorbed in the small intestines. Instead, it ferments and improves gut flora, reducing the symptoms of digestive problems. This, in turn, makes it easier to pass stools.

Figs for relief from piles

If you have ever taken a few soaked figs with warm milk or water for relief from constipation in the past, then it might please you to know that this remedy is backed by science.

A study published in the International Journal of Drug Development and Research found that taking three to four soaked figs in water first thing in the morning daily also provides relief from piles symptoms. (You can also eat figs in the evening, if you like.) This may be due to the presence of dietary fiber in fig fruit. This fibre helps relieve constipation, which is one of the major reasons for the aggravation of piles symptoms.

Further, a study found that fig leaves can provide respite from piles due to their anti-inflammatory properties. Dried fig leaves can be brewed in hot water and consumed like green tea, without sugar or milk.

Mango give relief in piles

Mango contains lots of fibre - this is well-known. So consumption of mangoes may be effective in improving bowel movements and facilitating the easy passage of stools through the inflamed parts of your intestine.

But did you know mango seeds can also help provide respite from piles? Yes, the one you usually throw it away in the dustbin. Mango seeds contain various biological compounds that help heal bleeding piles. So, grab all the mango seeds you can during the season. Dry them and crush them to a powder and store in an airtight container as a medicine. Take 2 teaspoons of mango seed powder twice a day with or without honey to get the much-needed relief.

Witch hazel for relief from piles

Witch hazel is a herb that is widely used as a home remedy to treat haemorrhoids. Though this plant is native to North America and rarely found in the Indian subcontinent, it is available in the form of liquids and dried leaves. Witch hazel is also an important ingredient in many topical applications used for piles treatment.

Witch hazel contains 10% tannins, which makes it an effective astringent - that is, it helps constrict tissues. According to an article published in the Journal of Inflammation, witch hazel exhibits potent anti-inflammatory and antioxidant effects. You just need to apply the extract of its bark on the concerned area and let it do its work.

However, there are no studies that ascertain the safety of direct application of witch hazel for piles. Talk to your doctor before using this remedy. In case you experience discomfort, immediately terminate use.

Piles home remedy: horse chestnut extract

Medical researchers say that the extract of horse chestnut seeds helps to reduce inflammation and improve the health of our blood vessels. This is because of an organic compound called aescin in horse chestnuts which is said to be a "venotonic" - tonic for the veins. Aescin is also thought to reduce swelling as a result of oedema and have anti-inflammatory properties. For these reasons, horse chestnut extract is used in multiple alternative medicines and treatments for all kinds of haemorrhoids, including chronic venous insufficiency and varicose veins.

How to get rid of piles: tips

Home remedies will provide you symptomatic relief as well as help in improving inflammation associated with haemorrhoids or piles. But, a change in diet and lifestyle will be extremely helpful in easing the extent of your discomfort by eliminating some of the root causes of this condition. Here is a list of the things you should definitely consider doing to get rid of piles:

  • Eat fibre rich foods: Dietary fibre can help to prevent and alleviate piles symptoms. Eating a lot of fibre has dual benefits for your gut health. It helps provide bulk to stools and facilitates their easy passage through the alimentary canal and it also improves gut microflora, improving the process of digestion, thus making the whole process more efficient. So, try to increase the consumption of fibre-rich foods. You can also take psyllium husk (Isabgol) or nuts and seeds like flaxseed to get your daily dose of fibre.
    According to the American Society of Colon and Rectal Surgeons, daily dietary fibre intake should be 20 to 35 grams, which should include fruits and vegetables as a major source. Some other fibre rich foods include cereals, oats, quinoa, nuts, seeds and pulses.
  • Drink plenty of water: Not drinking enough water can cause many health conditions - from bad breath (halitosis) to fatigue and constipation. Sure, you might have to go to the washroom more often, but drinking 8-10 glasses of water a day has many benefits that outweigh the effort of going to the loo. Just like fibre, water helps in regulating bowel movement and helps the undigested food to flush out of the large intestine easily. In fact, excessive intake of fibre will only worsen your stomach health if you don’t combine it with enough water. Water also promotes detoxification of the body by improving the function of your liver and kidneys, thus promoting overall health. (Read more: Benefits of drinking water in the morning)
  • Clean anal area: After the passage of stool, clean your anal area with moist toilet paper or moistened pads like facial or baby wipes. This will prevent bacterial accumulation and infections and help to soothe the burning sensation and pain.
  • Don't delay nature's call: Whenever you feel an urge to go to the toilet, don't delay it by engaging in other activities. Your body needs to discard the waste and it is signalling the same to you. Ignoring the bowel process might worsen constipation, thereby inviting active symptoms of piles.
  • Avoid alcohol and spicy foods: Alcohol has a dehydrating effect on your system, which eventually hampers bowel movement. Eating spicy food may aggravate the symptoms of piles leading to increased bleeding, burning sensation and pain. A study done on 1,033 patients, revealed that alcohol, spicy foods and constipation are major risk factors for haemorrhoids.
  • Elevate your feet: Another tip you can try while passing stools is to elevate your feet to a height. If you have a Western-style toilet at home, try placing a footstool in front of the pot and place your feet on this. Following this, your rectum will be positioned in a way which will allow easy passage of stool.

References

  1. National Institutes of Health; [Internet]. U.S. National Library of Medicine. Hemorrhoids.
  2. National Health Portal [Internet] India; Bawaaseer-e- Daamiya (Bleeding Piles).
  3. Shafik A. Role of warm-water bath in anorectal conditions. The "thermosphincteric reflex". J Clin Gastroenterol. 1993 Jun;16(4):304-8. PMID: 8331263
  4. Herman Villalba,Maher A Abbas. Hemorrhoids: Modern Remedies for an Ancient Disease. Perm J. 2007 Spring; 11(2): 74–76. PMID: 21461099
  5. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Enlarged hemorrhoids: How can you relieve the symptoms yourself? 2014 Jan 29 [Updated 2017 Nov 2].
  6. A Hardy,CRG Cohen. The acute management of haemorrhoids. Ann R Coll Surg Engl. 2014 Oct; 96(7): 508–511. PMID: 25245728
  7. Jon E Block. Cold and compression in the management of musculoskeletal injuries and orthopedic operative procedures: a narrative review. Open Access J Sports Med. 2010; 1: 105–113. PMID: 24198548
  8. Mohammad Hashem Hashempur et al. An Evidence-Based Study on Medicinal Plants for Hemorrhoids in Medieval Persia. J Evid Based Complementary Altern Med. 2017 Oct; 22(4): 969–981. PMID: 29228790
  9. Al-Waili NS et al. The safety and efficacy of a mixture of honey, olive oil, and beeswax for the management of hemorrhoids and anal fissure: a pilot study. ScientificWorldJournal. 2006 Feb 2;6:1998-2005. PMID: 17369999
  10. Health Harvard Publishing. Harvard Medical School [Internet]. 6 self-help tips for hemorrhoid flare-ups. Harvard University, Cambridge, Massachusetts.
  11. Rajani Chauhan,Km. Ruby,Jaya Dwivedi. Golden Herbs used in Piles Treatment: A Concise Report. Int. J. Drug Dev. & Res., October-December 2012, 4(4): 50-68
  12. Tamsyn SA Thring,Pauline Hili,Declan P Naughton. Antioxidant and potential anti-inflammatory activity of extracts and formulations of white tea, rose, and witch hazel on primary human dermal fibroblast cells. J Inflamm (Lond). 2011; 8: 27. PMID: 21995704
  13. Health Harvard Publishing. Harvard Medical School [Internet]. Help for hemorrhoids. Harvard University, Cambridge, Massachusetts.
  14. Kellen V. Lambeau,Johnson W. McRorie Jr. Fiber supplements and clinically proven health benefits: How to recognize and recommend an effective fiber therapy. J Am Assoc Nurse Pract. 2017 Apr; 29(4): 216–223. PMID: 28252255
  15. American Society of Colon and Rectal Surgeons [internet]; Hemorrhoids: Expanded Version.
  16. Am Fam Physician. [Internet] American Academy of Family Physicians; Hemorrhoids.
  17. Pigot F,Siproudhis L,Allaert FA. Risk factors associated with hemorrhoidal symptoms in specialized consultation.. Gastroenterol Clin Biol. 2005 Dec;29(12):1270-4. PMID: 16518286
Источник: https://www.myupchar.com/en/disease/piles/home-remedies

Five excellent kitchen remedies for piles

Piles also known as hemorrhoids are the swollen and inflamed veins inside and outside the rectum. This problem is most frequently seen in people aged 45 to 65 years. Nowadays even the youth and children are found suffering from it due to the weakness of the digestive system.

Other than weakness in digestive system factors which contribute to piles are family history, constipation, pregnancy, sedentary lifestyle, and obesity.

Hemorrhoids are of two types depending on their position. Internal hemorrhoids develop inside the rectum whereas the external lie just below the skin around the anal region.

Most common symptoms of piles are,

  • Bleeding during defecation
  • Itching and soreness in the anus
  • A sensation of fullness of rectum after bowel movements
  • Pain and irritation in the anal region
  • If not treated the condition can worsen and lead to chronic blood loss, anemia, strangulated piles, and even cancer.

Many of us think than permanent treatment of piles is surgery, which is not true though (as there are chances of recurrence even after that). Ayurveda believes in removing the cause of the problem and has treatment plans based on it, which ensures complete and permanent relief and with negligible chances of recurrence.

Remedies from your own kitchen to get relief

Lemon juice

Nutrients present in lemon juice strengthens the capillaries and the blood vessels and can prove to be of immense help in treating hemorrhoids. Following are the ways a lemon can be helpful,

Squeeze a lemon and moisten a cotton ball in it and apply directly over the piles. It might irritate in the beginning but soon there will be relief from the pain.

A mixture of lemon juice, honey, ginger, mint juice can be taken every day once.

Whole grains

Rich in fiber, whole grains are highly effective in giving relief from bleeding and other hemorrhoidal symptoms. Fiber-rich foods include barley, lentils, beans, oats and brown rice.

Ice

It is a very easy and highly recommended home treatment, application of which constricts blood vessels, reduces inflammation and gives relief from pain.

Buttermilk

Bitter gourd mixed with buttermilk helps in treating hemorrhoids. Also, buttermilk mixed with rock salt, ginger, and pepper helps relieve hemorrhoid pain.

Radish juice

Radish juice twice in a day is a known common remedy for treating piles.

Why go under the knife for a not so sure treatment when the simple at home remedies can prove to be so beneficial.

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Источник: https://store.jiva.com/five-excellent-kitchen-remedies-for-piles/

Heparinoid

1. About heparinoid

Heparinoid is a medicine that reduces swelling and helps with healing.

It is used to treat:

Heparinoid comes as a cream or gel. The gel has an added cooling effect.

It also comes as an ointment for treating piles and itchy bottom. The ointment contains oxypolyethoxydodecane to soothe any itching.

Heparinoid is available on prescription and to buy from pharmacies and supermarkets.

2. Key facts

  • You'll usually use heparinoid 4 times a day.
  • It's a very safe medicine and does not usually cause any side effects.
  • Some people may get a rash but this is rare.
  • Do not use heparinoid to treat piles or itchy bottom in children younger than 12 years.
  • Brand names for the cream and gel include Hirudoid. The ointment is sold as Anacal.

3. Who can and can't use heparinoid

Most adults and children over the age of 12 years can use heparinoid to treat piles and itchy bottom.

It's used to treat bruises and phlebitis in adults and children over the age of 5 years.

Heparinoid is not suitable for some people. Tell your doctor or pharmacist if you:

  • are allergic to heparinoid or any other medicines
  • have had an allergic reaction to parabens (heparinoid treatments contain propyl parahydroxybenzoate or methyl parahydroxybenzoate as preservatives)
  • are constipated, due to taking other medicines such as codeine. Being constipated means you're more likely to get piles

4. How and when to use it

If you have bought heparinoid from a pharmacy or supermarket, follow the instructions that come with the packet, or ask your pharmacist for advice.

You can use it up to 4 times a day. For piles or an itchy bottom, it's usual to use heparinoid ointment several times a day - first thing in the morning, last thing at night and after having a poo. An ointment is thicker and greasier than a cream.

Always wash your hands after using the cream, gel or ointment.

For phlebitis, bruises and haematomas

You'll usually need to use 5cm to 15cm of cream or gel. It depends on how much skin you need to cover.

If the area you're treating is sore or tender, you can massage the cream or gel into the skin around it.

For external piles

  1. Squeeze a small amount of ointment onto your finger.
  2. Gently put the ointment onto the skin around your bottom (anus).

For internal piles

If you have piles inside your bottom, use the applicator that comes with the ointment. Read the instructions in the leaflet inside the packaging.

  1. Clean around your bottom (anus) with mild soap and water, rinse and pat dry.
  2. Squeeze some ointment into the applicator and spread a little ointment onto the end of the nozzle.
  3. Gently insert the nozzle into your bottom.
  4. Squeeze the tube so the ointment goes into your bottom and slowly pull the applicator out at the same time.
  5. Take the applicator apart and wash it when you've finished.

What if I forget to use it?

If you forget a treatment, do it as soon as you remember. If you do not remember until you are within a few hours of the next one, do not worry - just skip the missed treatment and go on with your usual treatment routine.

What if I use too much?

If you accidentally use too much, it's unlikely to cause any problems.

Non-urgent advice: Contact 111 for advice if:

  • you or your child swallow heparinoid cream, gel or ointment

Online

Go to 111.nhs.uk - for children aged 5 years and older

Telephone

Call 111

6. Pregnancy and breastfeeding

It's safe to use heparinoid while you're pregnant or breastfeeding.

However, always check with your doctor, midwife or a pharmacist first.

Here's more information on how to treat piles in pregnancy.

Important

Tell your pharmacist or doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

7. Cautions with other medicines

Using heparinoid will not usually affect how other medicines work. However, it might cause bleeding if you're taking other medicines that increase the risk of bleeding.

Tell your pharmacist or doctor if you're taking:

Mixing heparinoid with herbal remedies and supplements

There is very little information about using heparinoid together with complementary remedies, and vitamins or supplements.

Important

For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

8. Common questions

Источник: https://www.nhs.uk/medicines/heparinoid/

Piles (haemorrhoids) in pregnancy

What are piles?

Piles (haemorrhoids) are swollen blood vessels in the rectal area

They typically range in size from as small as a pea to as large as a grape, and they can develop inside the rectum or protrude through the anus. These swollen vessels may hang down during or after you've done potty. You may be able to feel them as small, soft lumps just inside or around the edge of your bottom, and they may be painful.

What are the symptoms of haemorrhoids?

Piles often don’t have any symptoms. You may be able to feel them as small, soft lumps just inside or around the edge of your bottom. Sometimes they can be painful. Other symptoms of piles you might or might not have are:
  • Soreness and inflammation around your anus, which can make going to the loo uncomfortable.
  • Mucus discharge after pooping.
  • Difficulty controlling your bowels, which you may notice if your underwear gets dirty.
  • Feeling like your bowels still need emptying after you've had a poo.
  • Itching around your bottom.
  • Bright red blood after you've been to the loo, which you may see when you wipe your bottom.
Piles won't affect your unborn baby, though having them may be annoying for you.

Why are piles more common during pregnancy?

When you're pregnant, you have more blood going around your body. At the same time, high levels of the hormone progesterone relax the walls of your blood vessels.

The weight of your growing babyputs pressure on these full veins making them prone to become swollen and stretched. This is why you're more prone to piles and varicose veinswhen you're pregnant. You can also get swollen veins on your vulva, called vulvar varicose veins.

Constipation, another pregnancy bugbear, can also cause piles. It's because you tend to strain when having a hard bowel movement, and straining leads to haemorrhoids.

Piles affect about a quarter of pregnant women by the third trimester.

Some women get them for the first time while they're pregnant. If you've had them before pregnancy, you're more likely to have them again now.

How can I avoid getting piles in pregnancy?

Here are some ways to prevent haemorrhoids when you're pregnant:
  • Prevent constipation. You can do this by eating a high-fibre diet (that includes plenty of whole grains, beans, fruits, and vegetables), drinking about 8-12 glasses of water a day, and getting regular exercise (as long as your doctor says it's okay). If you're already constipated, ask your doctor about taking a fibre supplement (like isabgol) or using a stool softener. See our slideshow of quick and easy constipation remedies.

  • Don't wait to go. When you feel the urge to have a bowel movement don't delay, and also try not to strain.

  • Don't sit on the toiletlonger than necessary. Sitting for a long time puts pressure on your rectal area.

  • Do Kegel exercises daily. Pelvic floor exercises (Kegels) increase circulation in the rectal area and strengthen the muscles around the anus, reducing the chance of haemorrhoids. They also strengthen and tone the muscles around the vagina and urethra, which can help your body recover after you give birth. How to do Kegels (pelvic floor exercises)

  • Don't sit or stand for long stretches of time. If your job involves sitting at a desk, get up and move around for a few minutes every hour or so. At home, lie on your side when sleeping, reading, or watching TV to take the pressure off your rectal veins and increase blood return from the lower half of your body.

  • Try squatting. If you have an Indian style toilet at home, use it to pass stool. The position of the squat might help you poo more easily and quickly, reducing the pressure on the anal blood vessels. If you don’t have an Indian toilet, use a small stool to raise your feet while sitting on the loo so that your knees are higher than your navel.

  • Massage the area. You could apply pressure with your fingers to the muscular area between your vagina and back passage (perineum) just before passing stools. This stimulates a reflex that increases muscle tone in your rectum, and may make pooing easier.

  • Don’t sleep on your back. Sleeping on your back can increase the pressure on the veins below your womb.

How can I treat haemorrhoids?

If you already have piles, there are a few things you can do to help yourself:
  • Use ice packs, or a cloth wrung out from iced water, to relieve the pain around your bottom.

  • Soak your bottom in a tub of warm water for 10 to 15 minutes a few times each day. You can also use a Sitz bath at the chemist or online. This is a small plastic basin that you fill with water and position over your toilet so you can sit down and submerge your rectal area.

  • Alternate. First, use cold then warm treatments, and repeat.

  • Gently and thoroughly clean the affected area after you've done a poo. Washing off with water or wiping with moist toilet wipes can be more comfortable than using toilet tissue. Pat rather than rub yourself dry.

  • Try pushing the piles gently back into your rectum with a clean finger when you are having a bath or shower. You could use a little lubricating jelly to help with this. They may pop out again at some point, so you may have to do this a few times during your pregnancy.

  • Take the pressure off the veins in your bottom to relieve the pain by sitting on a ring cushion. You can also roll a towel into a ring and sit on that if you don’t have ring cushion. Many new mothers find this solution a lifesaver. However, you should use it sparingly as it may reduce circulation in the affected area and prolong the healing process.

Consult your doctor before trying any over-the-counterhaemorrhoid-relief products. Your doctor will be able to recommend safe, topical anaesthetics, creams or medicated suppositories.

Also speak to your doctor if preventive efforts and home treatments don't help, or if you have severe pain or rectal bleeding.

In some cases, you may need to see a specialist for treatment to shrink your haemorrhoids. Rarely a minor surgery is necessary, though your doctor would prefer to schedule the surgery only after your delivery.

Do piles go away after birth?

In most cases, piles disappear or shrink as your body recovers after your baby’s birth. In some cases, you might have developed piles during labour, at the stage when you push out your baby. Or they may be a result of constipation in the weeks after giving birth, when your body is shedding the extra fluidneeded during pregnancy.

If you’re constipated and struggling with piles, speak to your doctor. She can give you advice about creams and laxatives, that might help.

Remember to always tell your doctor if you have bleeding from your anus. It might be hard to tell at first because of the lochia. But after passing stool and cleaning the area, apply soft tissue paper to your anus only and if it gets stained with blood, let your doctor know.

If you have severe, ongoing problems with piles, your doctor may recommend one of the following treatments:
  • Banding, where a type of rubber band is placed around the base of the haemorrhoid. This cuts off the circulation to it, making it shrivel and drop off.

  • Injection with chemicals, that cause the piles to shrink and drop off.

  • Electrotherapy, where a probe is used to apply an electric current to the haemorrhoid and make them shrivel and shrink.

  • Infrared coagulation (IRC), where the doctor uses an infrared beam light as a heat source to quickly coagulate, or clot, vessels supplying blood to the piles. This creates a scar tissue, which cuts off the blood supply to the haemorrhoid and makes it shrink.

  • Laser treatment, where laser beams are used to treat, dry up and shrink a haemorrhoid.

However, these procedures are usually advised if you have early piles. For late and prolapsed piles, surgery may be required. Your doctor will be in the best position to decide which treatment is best for your condition.


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References

Abbot R, Ayres I, Hui E, et al. 2015. Effect of perineal self-acupressure on constipation: a randomized controlled trial. J Gen Intern Med 30(4):434-9. www.ncbi.nlm.nih.gov

Arnouk A, De E, Rehfuss A, et al. 2017. Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders. Curr Urol Rep 18(6):47

Bick D, Hunter C. 2017. Content and organization of postnatal care. In: MacDonald S, Johnson G. eds. Mayes' midwifery. 15th ed. London: Elsevier, 695-704

Lohsiriwat V. 2015. Treatment of hemorrhoids: a coloproctologist's view. World J Gastroenterol 21(31):9245-52

Murray I, Hassall J. 2014. Change and adaptation in pregnancy. In: Marshall JE, Raynor MD. eds. Myles textbook for midwives. 16th ed. Edinburgh: Churchill Livingstone, 143-77

Nazik E, Eryilmaz G. 2013. Incidence of pregnancy-related discomforts and management approaches to relieve them among pregnant women. J Clin Nurs 23(11-12):1736-50

NCCWCH. 2008. Antenatal care: routine care for the healthy pregnant woman. National Collaborating Centre for Women's and Children's Health, Clinical guideline. www.nice.org.uk December

NHS. 2015a. Piles in pregnancy. NHS Choices, Health A-Z. www.nhs.uk

NHS. 2015b. Common pregnancy problems. NHS Choices, Health A-Z. www.nhs.uk

NHS. 2015c. Constipation. NHS Choices, Health A-Z. www.nhs.uk

NHS. 2015d. Rectal bleeding. NHS Choices, Health A-Z. www.nhs.uk

NHS. 2016. Haemorrhoids (piles). NHS Choices, Health A-Z. www.nhs.uk

NHS. 2017. Varicose veins. NHS Choices, Health A-Z. www.nhs.uk

NICE. 2016. Haemorrhoids. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.uk

Poskus et al. 2014. Haemmorhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. BJOG 30(4):434-9

Schytt E, Lindmark G, Waldenström U. 2005. Physical symptoms after childbirth: prevalence and associations with self-rated health. BJOG 112(2):210-7 < onlinelibrary.wiley.com

Tidy C. 2017. Piles (Haemorrhoids). Patient. patient.info

WaterUK. 2017. Flushability. Policy, Improving resilience. www.water.org.uk

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Top Herbs for Piles Treatment in Ayurveda

Nowadays many people have been complaining about piles, fistula or hemorrhoids in their 30s and 40s. It is also commonly seen in older people. 

Today's fast paced lifestyle with little attention to food and eating schedules along with the consumption of processed and junk foods has hampered the digestive capabilities of the individuals. One of the contributing factors is also stress, that has an adverse impact on digestion and can cause irritable bowel syndrome and other related irregularities.

If neglected, this could result in chronic constipation accompanied with tight stools and causing fissures and Hemorrhoids.

Some of the main symptoms of Piles are-

  • Blood in your stools.
  • An itchy anus.
  • Feeling like you still need to poop after going to the toilet.
  • Lumps around your anal area
  • Pain around the anal area

Let us find out the science behind this and herbs that can help in piles treatment in Ayurveda.

What Ayurveda says about Piles treatment?

Ayurveda aims at balancing the three doshas of the body- Vata, Pitta and Kapha.

In Ayurveda, it is said to balance the digestive system of the body. Good and proper digestion is based on digestive fire (agni) and its strength. It is also said that the digestive fire is strongest around noon. So, it is suggested that people should consume their heaviest meal at noon and keep their dinner and other meals lighter.

The excretion process in the body is governed by Vata Dosha, as it keeps the bowel movement proper and functioning.

Vata dosha when aggravated or  imbalanced can cause the bowel contents to get dried and hinders the proper bowel movement causing constipation. Imbalanced Vata Dosha also causes constipation along with painful hemorrhoids. 

An imbalance in Pitta Dosha can cause excessive diarrhea, excessive thirst, and inflamed hemorrhoids that bleed.

In addition to this, an imbalance in the Kapha Dosha, can cause light hemorrhoids.

So, it is necessary to bring all the three doshas in balance for complete treatment of piles.

Best Ayurvedic Herbs for Piles/ Hemorrhoids

Piles treatment in Ayurveda can be done with the help of some powerful herbs that can balance the doshas in the body and treat the root cause of the problem. These herbs can be helpful as there is no side effect that they cause. 

Haritaki is a fruit that can balance the three doshas in the body, improves digestion and helps in detoxifying the body. It has been used as an important ayurvedic herb for piles treatment as it eases the bowel movement and relieves pressure on the excretory system. 

Avipattikar churna is an ayurvedic herbal medicine for piles and other digestive problems.

Amalaki Rasayana or the Indian gooseberry is a common Ayurvedic medicine to balance all the three Doshas. It is used in traditional Ayurvedic medicine and acts as an antioxidant, immunomodulator, anti-inflammatory, astringent and laxative. 

Guggul is known for its anti-inflammatory properties in Ayurveda. It is one of the best herbs for piles as it reduces the inflammation in fistula-anorectal and hemorrhoidal conditions. Guggul is a laxative and astringent agent that helps in reducing the toxins (ama) and relieves pain and itching. It helps in balancing the body’s Kapha Dosha.

Turmeric or Curcuma offers anti-microbial and anti-inflammatory properties, that helps in controlling bleeding in hemorrhoids. It also helps reduce anal itching and shrink hemorrhoids. According to Ayurveda, Turmeric can strengthen the digestive fire and helps in balancing the doshas.

Triphala acts as a mild laxative and allows the deepest tissues and organs of the body to release toxins. Despite its powerful cleansing quality, it enhances absorption and balances the doshas in the body especially supporting the digestive system.

To Sum Up

I have summarized the list of various Ayurvedic herbs for piles or hemorrhoids. These can be taken to support the digestive system and balance the three doshas in the body and can be the best piles treatment in Ayurveda. These herbs offer no side effects and are not habit forming. Going for Ayurvedic treatment can prevent you from surgeries and you can get long term relief from piles.

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Источник: https://maharishiayurvedaindia.com/blogs/ayurveda-knowledge-center/piles-treatment-in-ayurveda

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Ageing has its own advantages and disadvantages. Included in the latter are piles, clinically known as haemorrhoids, which is a condition when veins in your rectum or under the skin around the anus swell. These swollen blood vessels can turn bowel movement into an intensely painful experience. According to research published in the year 2017 by The Indian Journal of Surgery, half the men and women in India above the age of 50 may develop the symptoms of haemorrhoids during their lifetime. Even though piles are rarely dangerous, if left ignored, they can lead to serious health complications. In this blog, let’s get a clear picture of the causes, types, symptoms and measures that can help prevent or cure haemorrhoids.

Causes

It is not established yet what actually causes the veins around your anus to swell and bulge, yet nearly two out of the four adults undergo the symptoms of haemorrhoids. Some of the common factors contributing to an increased risk of suffering from piles are constipation, sedentary lifestyle, bad diet, smoking and alcohol, family history, being pregnant or obese, regular heavy eating, and stress.

Types

Hemorrhoids are classified into 4 different categories Internal, Prolapsed, External and Thrombosed.

  • Internal Hemorrhoids: They lie deep inside the rectum and so, are not visible to the naked eye. They might not cause any pain but their presence is marked with the symptom of bleeding through the anus.
  • External Hemorrhoids: They are formed in the outer lining of the anal creating extreme discomfort and pain. They are sometimes invisible and the other times develop as a lump. These can also form blood clots within the mass that slips down.
  • Prolapsed Hemorrhoids: When internal haemorrhoids swell and sticks outside your anus the situation is coined as prolapsed haemorrhoids. These lumps cause discomfort or pain along with itchiness and burning.
  • Thrombosed Hemorrhoids: These swollen bulges around your anus are blood clots within the haemorrhoid tissue. Due to lack of blood supply to your rectal tissue, thrombosed haemorrhoids need to be attended to urgently to prevent severe complications.

Signs and symptoms

The symptoms of piles subside on their own in a few days. However, in some cases, these must not be ignored. Since ignoring the initial symptoms can lead to serious complications, keep a check on these symptoms:

  • Rectal pain
  • Itching
  • Bleeding
  • Sore and redness in the anus area
  • Mucus discharge

It is strongly suggested that if you are bleeding during defecation or your haemorrhoids don’t improve after a week of home care, consult a doctor.

Treatment

The treatment for piles may vary depending on the type, degree of prolapse or the severity of the situation. However, these self-help tips may ease haemorrhoid pain and promote healing:

Drink plenty of water

Drinking 2 liters of water daily reduces the risk of piles, as it helps to keep the stool soft.

Fibrous foods

Including fibre-rich foods in your diet tends to improve the overall symptoms and bleeding from haemorrhoids. A healthy diet should contain the recommended amount of 20-30 grams of fibre a day.

Don’t hold back

Rush towards the toilet when you feel the urge, don’t wait for a convenient time. Delaying or waiting puts on more pressure on the rectum veins, which can worsen constipation thus aggravating haemorrhoid.

Exercise

Staying active prevents and eases constipation, thus reducing the pressure on the veins. It can also help you lose weight which is another major contributor to piles.

Avoid self medication

In case you feel your symptoms are worsening, consult a doctor immediately. Some over the counter medicines may give you temporary relief but for an effective treatment reach out to an expert medical practitioner.

Don’t exert pressure

Don’t force your bowel movement, pushing and straining can make haemorrhoids worse. If you are not relieved within 2 minutes then get up and try again later.

Disclaimer: The information included at this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.

Источник: https://pharmeasy.in/blog/piles-causes-types-symptoms-and-treatment/

By Turgut Bora Cengiz, MD, and Emre Gorgun, MD, FACS, FASCRS

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Aspects of modern life that may promote hemorrhoids include increased consumption of processed foods, a sedentary lifestyle and using cell phones while defecating, which translates to much more time spent on the toilet.

Hemorrhoids accounted for more than 3.5 million U.S. outpatient visits in 2010, and they were the third leading cause of hospital admissions related to gastrointestinal disease.1

Here, we review the process for diagnosing and grading hemorrhoids, as well as for selecting the appropriate medical or surgical treatment based on the most recent clinical evidence.

Diagnosing and classifying hemorrhoids

Hemorrhoids are the distal prolapse of the arteriovenous bundle, muscle fibers and surrounding connective tissue as an envelope below the dentate line in the anal canal. They usually present with painless rectal bleeding.2

The diagnosis of hemorrhoids relies on history and physical examination rather than on laboratory testing or imaging studies. Typically, the presenting symptom is painless rectal bleeding associated with bowel movements, usually appearing as bright red blood on the toilet paper or coating the stool. Severe itching and anal discomfort also are common, especially with chronic hemorrhoids.

Detailed patient history

A detailed patient history is important. It should include the extent, severity and duration of symptoms, frequency of bowel movements, associated symptoms (e.g., constipation, fecal incontinence), daily dietary habits and details of bowel movements (e.g., time spent during each bowel movement and concomitant cell phone use).3

Regarding bowel habits, some patients experience lifelong constipation or diarrhea. Therefore, what a patient considers a normal bowel habit may not be normal and should be investigated.4 Also, it is important to exclude external thrombosed hemorrhoids, anal fissure, anal abscess and Crohn’s disease.5

Physical examination

A digital rectal examination is the second step. During the examination, look for skin tags, sphincter tone, perianal hygiene and synchronous anal lesions.3 Of note, the Valsalva maneuver can be performed during the digital rectal examination.

Red flags for colorectal cancer on the digital rectal examination include a mass with or without presence of hemorrhoidal sacs and a bleeding source above the level of internal hemorrhoids.

Patients with recurrent abscesses, fistulas or skin tags (especially cauliflower-type skin tags) should be investigated for Crohn’s disease (Figure 1).

Figure 1. Patient with Crohn’s disease. Note the fistula orifices and skin tag.

Endoscopy

Since rectal bleeding can be a sign of several diseases, including colorectal cancer, it is important to review any previous endoscopic results. Patients at high risk of colon cancer should undergo rigid proctoscopy, flexible sigmoidoscopy or colonoscopy.3,4 In our practice, we recommend endoscopic evaluation for patients older than  age 40 with rectal bleeding, especially if they have a family history of colorectal cancer.

External or internal (grades I–IV)

Hemorrhoids can be categorized as either external or internal.

External hemorrhoids are distinguished by their outer covering with perianal skin and anoderm and their location inferior to the dentate line. They are painful if the hemorrhoidal sac is occluded by a thrombotic clot.

Internal hemorrhoids are above the dentate line and covered with rectal columnar and transitional mucosa. They are further graded on a 4-point scale3:

  • Grade I—Visible hemorrhoids that do not prolapse.
  • Grade II—Hemorrhoids that prolapse during the Valsalva maneuver but spontaneously reduce.
  • Grade III—Hemorrhoids that prolapse during the Valsalva maneuver and need manual reduction.
  • Grade IV—Nonreducible hemorrhoids.

A range of treatments

In choosing the treatment for hemorrhoids, one should consider the disease grade and severity, its impact on the quality of life, the degree of pain it causes, the patient’s likelihood of adhering to treatment and the patient’s personal preference.

Regardless of severity, treatment almost always starts with a high-fiber diet and other lifestyle modifications that include bowel movement behaviors. This requires practitioners to spend significant time on patient education, regardless of the type or severity of the disease.

Treatments can be grouped in three categories: conservative, office-based and surgical. Practitioners should thoroughly discuss the options with the patient, emphasizing the pros and cons of each.

Conservative measures

Conservative measures are aimed at softening the stool, relieving pain and correcting bad toileting habits. In most cases, the primary precipitating factor is lifestyle, and unless patients change it, they are more likely to have recurrent symptoms in the long term.

No phone in the bathroom

People take their phones into the bathroom, and this habit is blamed for increasing the time on the toilet and leading to increased pressure on the anal region and straining during defecation. Some research points to a direct correlation between the time spent on the toilet and hemorrhoidal disease, although the exact cause-and-effect relationship with cell phone use has not been determined. In general, spending excessive time on the commode, including reading, should be discouraged.

Less time in the bathroom

Johannsson et al6 reported that patients with hemorrhoids spent more time on the toilet and had to strain harder and more often than controls in the community and hospital.

Garg and Singh7 and Garg8 use the mnemonic “TONE” for appropriate defecation habits:

  • Three minutes during defecation.
  • Once-daily defecation.
  • No straining and no cell phone use during defecation.
  • Enough fiber.

More fiber

Fiber draws water into the lumen of the colon, increasing the water content of the stool. Recommended daily fiber intake is about 28 g for women and 38 g for men.9 This high level of intake is hard to achieve without supplements for someone who consumes a classic American diet with a lot of fast food.

Fiber supplements are strongly recommended in the American Society of Colon and Rectal Surgeons (ASCRS) practice guidelines3 based on a Cochrane review.10 In this meta-analysis, with fiber supplements the relative risk of persisting or nonimproving symptoms was 0.53 (95% confidence interval [CI] 0.38-0.73) and the relative risk of bleeding was 0.50 (95% CI 028-0.89). Psyllium husk is an inexpensive bulk-forming fiber supplement; the optimal daily dosage is not known.

We recommend at least 28 g of daily fiber intake for women and 38 g for men, for which psyllium husk can be used to complement the diet.

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Laxatives for some

Laxatives such as docusate are used to change the stool consistency when there is an organic bowel problem rather than a dietary issue. They can be used as a complementary treatment to enhance the effect of the fiber treatment.

Other measures

Topical anesthesia (e.g., 5% lidocaine) is commonly used to treat pain from low-grade lesions, but no reliable data have been published. As most cases of hemorrhoids tend to progress over time, one should not expect long-term improvement with topical anesthesia. Nevertheless, it can be used as an ancillary treatment in select cases when short-term improvement is the main goal, and we recommend it based on our own experience.

Hygiene. Bidet use or cleaning the perianal area with water is recommended.

Phlebotonics contain a variety of ingredients including natural plant extracts such as flavonoids and synthetic products. Even though the exact mechanism of action is not known, phlebotonics are thought to increase venous and lymphatic drainage, normalize capillary permeability and decrease inflammation in the hemorrhoidal cushions.4,11–13

In a Cochrane review of 24 randomized controlled trials, Perera et al14 found that phlebotonics improved the outcomes of:

  • Bleeding (odds ratio [OR] 0.21, number needed to treat [NNT] 4.8, p = .0002).
  • Pruritus (OR 0.23, NNT 9.1, p = .02).
  • Discharge or leakage (OR 0.12, NNT 5, p = .0008).
  • Overall symptoms (OR 15.99, NNT 2.7, p < .00001). Overall symptoms  also improved in the subgroup of pregnant patients.

Although phlebotonics give better results than placebo in the short-term management of hemorrhoids, there is a paucity of long-term data. Thus, the ASCRS clinical practice guidelines give the regular use of these agents only a weak recommendation.3

Flavonoids (diosmin, hesperidin, rutoside), in a meta-analysis vs. placebo in 1,514 patients, showed a beneficial response in terms of bleeding (relative risk [RR] 0.33), pruritus (RR 0.65) and recurrences (RR 0.53).15

Although Preparation H is commonly used as an over-the-counter medication, there are no good data on it and it is not considered a phlebotonic.

Office-based treatments

Office-based treatments — rubber band ligation, infrared photocoagulation, and sclerotherapy — are commonly used for grade I, II and III hemorrhoids that have not responded to conservative management. The primary goal of these treatments is to decrease blood flow into the hemorrhoidal sac.

Even though office-based treatments are highly effective and major complications are uncommon, recurrence rates can be high, requiring patients to undergo additional treatments. Moreover, septic complications can occur so patients should be closely observed for fever and urinary problems. Pain is a common symptom after office-based treatments, and bleeding may also occur.

The ASCRS guidelines strongly recommend office-based treatments for patients with grade I and II hemorrhoids, and for some with grade III hemorrhoids.3

Rubber band ligation

Ligating the apex of the hemorrhoidal cushion stops the arterial flow and causes the hemorrhoidal tissue to undergo necrosis (Figure 2). The ligation is performed above the dentate line, where the sensory nerve fibers differ from those found below the line; therefore, the operation causes less pain than one would expect. One or more hemorrhoidal cushions can be ligated at the same time, although increased pain, bleeding and vasomotor reactions have been reported with multiple banding during a single procedure.16,17

Figure 2. In rubber band ligation, an internal hemorrhoid is grasped with a forceps (A) and drawn into the cylinder of the ligator (B). A band is deployed around the base of the hemorrhoid (C), cutting off its blood supply and causing it to fall off within a few days.

Iyer et al18 reported that patients on warfarin therapy had as much as nine times higher risk of postprocedural bleeding, and patients on aspirin had a risk as much as three times higher. Therefore, whether patients on anticoagulant therapy should undergo this procedure is unclear.

A Cochrane database review19 found this technique effective for hemorrhoid grades I through III, although some patients with grade III hemorrhoids may benefit more from excisional hemorrhoidectomy, which is associated with a lower recurrence rate than rubber band ligation.

Brown et al20 performed a randomized controlled trial comparing hemorrhoidal artery ligation and rubber band ligation for symptomatic hemorrhoids in 372 patients with grade II and III hemorrhoids. Postprocedural pain scores on days one and seven were significantly lower with rubber band ligation, but recurrences were more common (49% vs 30%, p = .0005, respectively).

Overall, rubber band ligation is an excellent option for grade II hemorrhoids, as it is easy to perform, is associated with low pain scores and can be used to treat recurrences.

Infrared photocoagulation

In this procedure, an infrared probe produces heat to induce coagulation, fibrosis and ultimately necrosis of the protruding tissue in the hemorrhoidal cushions.21 Even though its use was initially directed at grade I and II hemorrhoids, recent reports showed acceptable results for grades III and IV.22,23 A randomized controlled trial comparing infrared photocoagulation and rubber band ligation in 94 patients found that both procedures were well accepted and highly effective; however, patients had better pain scores with photocoagulation in the first 24 hours after the procedure (p < .05).24

Sclerotherapy

Sclerotherapy involves injection of a sclerotic agent into the submucosa of the hemorrhoidal sac (Figure 3), which causes an inflammatory reaction and eventually forms fibrotic tissue that stops the blood flow to the hemorrhoid. Many sclerotic agents are available, including 5% phenol in almond or vegetable oil, quinine, ethanolamine, and hypertonic saline.21

Figure 3. Sclerotherapy involves injecting an irritating solution into the hemorrhoid, reducing its blood supply and causing it to shrink.

The injection can cause prostatic abscess and sepsis, although this is rare.25 Nevertheless, high fever and postprocedural pain should be carefully evaluated.

There have been few randomized trials of sclerotherapy, but success rates so far have been higher for grade I hemorrhoids than for grades II and III.26–28 It is the preferred method for patients who have bleeding abnormalities caused by medications or other diseases (e.g., cirrhosis).

Surgery

Although nonsurgical treatments have substantially improved, surgery is the most effective and strongly recommended treatment for patients with high-grade internal hemorrhoids (grades III and IV), external and mixed hemorrhoids, and recurrent hemorrhoids.

The most popular surgical options are open or closed hemorrhoidectomy, stapled hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation. Each has different success rates and different complication profiles, which need to be discussed with the patient.

Overall, surgery is associated with more adverse effects than office-based treatments or medical management. Postoperative pain is the most common complaint, but anal stricture (rare) or incontinence may occur due to excessive tissue excision and damage to the sphincter muscles. These can be avoided by maintaining the normal anoderm between excisions, by not excising all hemorrhoid sacs at once if the patient has extensive lesions and by performing a careful dissection in the submucosal plane.

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Patients with profuse bleeding or an underlying bleeding abnormality are best managed with surgical approaches performed in an operating room.

Excisional surgical hemorrhoidectomy

Excision of the hemorrhoidal sac, the most conventional surgical technique, is generally reserved for prolapsing disease. The recurrence rate after excisional hemorrhoidectomy is significantly lower than with any other approach.29

Excisional hemorrhoidectomy can be performed using either an open approach, in which the edges of the mucosal defect are not reapproximated, or a closed approach, in which they are. In a systematic review, Bhatti et al30 compared open vs. closed techniques and found that the closed technique resulted in less postoperative pain, better wound healing and less bleeding. Rates of recurrence, postoperative complications and surgical site infection and lengths of stay were comparable with either procedure.

Overall, excisional hemorrhoidectomy is associated with higher pain scores than any other surgical method.29 Recently, the use of electrodiathermy energy devices, also described as electrosurgical vessel-sealing devices, have further improved overall patient satisfaction.31

Multiple painful hemorrhoidal sacs require a careful surgical approach, as extensive resection may cause widespread fibrosis and stricture. As with anal stricture, fecal incontinence can be prevented by careful dissection. However, already existing incontinence is not a contraindication for the surgery.

Doppler-guided hemorrhoidal artery ligation

Doppler-guided hemorrhoidal artery ligation involves using a Doppler probe to find and ligate individual hemorrhoidal arteries. Additionally, mucopexy (transanal rectoanal repair) is performed to relocate the prolapsing tissue. Avital et al32 reported that at one year after this procedure, recurrence rates were 5.3% for grade II hemorrhoids and 13% for grade III hemorrhoids. At five years, recurrence rates were 12% for grade II and 31% for grade III.

To date, this procedure appears to be suitable for grade I, II, and III hemorrhoids, especially for grade II, but more studies are needed to prove its efficacy and recurrence rates for more advanced lesions. Although this technique has a high morbidity rate (18%), primarily pain or tenesmus, it causes less postoperative pain than other surgical methods.33 Overall, it has the potential to become a favored treatment.

Stapled hemorrhoidopexy

In this procedure, the prolapsing part of the internal hemorrhoidal cushion is moved upward by stapling the rectal mucosa just above the hemorrhoid (Figure 4). This is not an option for patients with thrombosed internal hemorrhoids or with external hemorrhoids.

Figure 4. In stapled hemorrhoidopexy, a special tool is inserted (A). Excess tissue is excised (B), and the remaining tissue is drawn up to its normal position and fastened in place, yielding the result pictured in panel C.

Although pain scores are lower with stapled hemorrhoidopexy than with excisional hemorrhoidectomy, this procedure is not superior in terms of recurrences.34,35 Also, practitioners should be careful about specific complications of stapled hemorrhoidopexy, such as rectovaginal fistula, anal stenosis or sphincter injuries. These specific complications should be clearly explained to patients, and necessary information should be given to patients upon discharge. The primary care physician should also be careful about fistulas and stenoses in this particular patient population.

No best treatment

There is no best treatment for hemorrhoids. Every patient is different, and the physician and patient need to understand each other’s expectations, weigh the risks and benefits and arrive at a mutual decision. A good patient-doctor relationship is essential.

A thorough history and physical examination will enable the practitioner to understand the patient’s problem (Figure 5).

Figure 5. Algorithm for hemorrhoid management.

Given the variety of available treatments, head-to-head comparisons are difficult. Moreover, the efficacy and applicability of each technique changes with the grade of the lesion or lesions and the skill of the practitioner. Lacking comprehensive studies comparing conservative, office-based and surgical management, no decisive statements can be made based on current evidence.

Patients with compounding conditions

Pregnant patients often develop hemorrhoids as intra-abdominal pressure increases, particularly during the third trimester.36 Also, acute episodes of pain and bleeding are common in pregnant women with preexisting hemorrhoids.

Conservative treatment is the main approach in pregnant patients because most hemorrhoids regress after childbirth. This includes increased dietary fiber, stool softeners and sitz baths, which are safe to use for external hemorrhoids. Any office-based or surgical intervention should be postponed until after childbirth, if possible. Kegel exercises and lying on the left side are also recommended to relieve symptoms. In cases of severe bleeding, anal packing appears to be useful.

Immunosuppressed patients and those on anticoagulant therapy are more prone to serious complications such as sepsis and profuse bleeding. Thus, conservative management should be used in these patients as well. Injection sclerotherapy may be beneficial, as it has been shown to decrease bleeding. Of note, patients on immunosuppressive agents should stop taking them and start taking an antibiotic, and patients on anticoagulant or antiplatelet medications should be instructed to stop them one week before any intervention.

Crohn’s disease. Some patients with Crohn’s disease may have hemorrhoids, though this is rare. Eglinton et al,37 in a series of 715 patients with Crohn’s disease, reported that 190 (26.6%) had symptomatic perianal disease. Of these, only 3 (1.6%) had hemorrhoids. Treatment is always conservative and directed at the Crohn’s disease rather than the hemorrhoids.

Patients with portal hypertension (e.g., due to cirrhosis) are prone to have anorectal varices that may resemble hemorrhoids. Anorectal varices can be treated with vascular ligation, whereas sclerotherapy is the preferred method for hemorrhoids in this group, in whom coagulopathy is common.

Take-home messages

Hemorrhoidal disease is common in the United States, and with our diet and lifestyle, the incidence is likely to increase. (A national survey found that overall dietary quality improved modestly in children and adolescents in the United States from 1999 to 2012 but remained far below optimal.38) Practitioners need to carefully assess hemorrhoidal symptoms and complete any necessary screening tests before establishing a diagnosis. This helps to avoid missing any underlying disease.

Fiber supplements along with dietary and lifestyle changes constitute the baseline of the management, regardless of the disease grade. Office-based interventions are beneficial for grade I and II hemorrhoids and for some grade III hemorrhoids. Repeated interventions can increase the success rate. In patients with high-grade, symptomatic hemorrhoids, surgical hemorrhoidectomy is the most effective modality with the lowest recurrence rates, although it causes more pain than conservative methods.

Dr. Cengiz is a resident in Cleveland Clinic Digestive Disease & Surgery Institute’s Department of General Surgery. Dr. Gorgun is Director for Lower GI of the Digestive Disease & Surgery Institute’s Endoluminal Surgery Center.

Note: This article originally was published in the Cleveland Clinic Journal of Medicine (2019 September;86(9):612-620).

References

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  4. Lohsiriwat V. Treatment of hemorrhoids: a coloproctologist’s view. World J Gastroenterol 2015; 21(31):9245–9252.
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  7. Garg P, Singh P. Adequate dietary fiber supplement and TONE can help avoid surgery in most patients with advanced hemorrhoids. Minerva Gastroenterol Dietol 2017; 63(2):92–96.
  8. Garg P. Conservative treatment of hemorrhoids deserves more attention in guidelines and clinical practice [letter]. Dis Colon Rectum 2018; 61(7):e348.
  9. Rakinic J, Poola VP. Hemorrhoids and fistulas: new solutions to old problems. Curr Probl Surg 2014; 51(3):98–137.
  10. Alonso-Coello P, Guyatt G, Heels-Ansdell D, et al. Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev 2005;(4):CD004649.
  11. Struckmann JR. Clinical efficacy of micronized purified flavonoid fraction: an overview. J Vasc Res 1999; 36(suppl 1):37–41.
  12. Shoab SS, Porter J, Scurr JH, Coleridge-Smith PD. Endothelial activation response to oral micronised flavonoid therapy in patients with chronic venous disease — a prospective study. Eur J Vasc Endovasc Surg 1999; 17(4):313–318.
  13. Meyer OC. Safety and security of Dafl on 500 mg in venous insufficiency and in hemorrhoidal disease. Angiology 1994; 45(6 pt2):579–584.
  14. Perera N, Liolitsa D, Iype S, et al. Phlebotonics for haemorrhoids. Cochrane Database Syst Rev 2012;(8):CD004322.
  15. Alonso-Coello P, Zhou Q, Martinez-Zapata MJ, et al. Meta-analysis of flavonoids for the treatment of haemorrhoids. Br J Surg 2006;93(8):909–920.
  16. Lee HH, Spencer RJ, Beart RW Jr. Multiple hemorrhoidal bandings in a single session. Dis Colon Rectum 1994; 37(1):37–41.
  17. Law WL, Chu KW. Triple rubber band ligation for hemorrhoids: prospective, randomized trial of use of local anesthetic injection. Dis Colon Rectum 1999; 42(3):363–366.
  18. Iyer VS, Shrier I, Gordon PH. Long-term outcome of rubber band ligation for symptomatic primary and recurrent internal hemorrhoids. Dis Colon Rectum 2004; 47(8):1364–1370.
  19. Shanmugam V, Thaha MA, Rabindranath KS, Campbell KL, Steele RJ, Loudon MA. Rubber band ligation versus excisional haemorrhoidectomy for haemorrhoids. Cochrane Database Syst Rev 2005;(3):CD005034.
  20. Brown SR, Tiernan JP, Watson AJM, et al; HubBLe Study team. Haemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree haemorrhoids (HubBLe): a multicentre, open-label, randomized controlled trial. Lancet 2016; 388(10042):356–364.
  21. ASGE Technology Committee; Siddiqui UD, Barth BA, Banerjee S, et al. Devices for the endoscopic treatment of hemorrhoids. Gastrointest Endosc 2014; 79(1):8–14.
  22. Ahmad A, Kant R, Gupta A. Comparative analysis of Doppler guided hemorrhoidal artery ligation (DG-HAL) & infrared coagulation (IRC) in management of hemorrhoids. Indian J Surg 2013; 75(4):274–277.
  23. Poen AC, Felt-Bersma RJ, Cuesta MA, Devillé W, Meuwissen SG. A randomized controlled trial of rubber band ligation versus infra-red coagulation in the treatment of internal haemorrhoids. Eur J Gastroenterol Hepatol 2000; 12(5):535–539.
  24. Marques CF, Nahas SC, Nahas CS, Sobrado CW Jr, Habr-Gama A, Kiss DR. Early results of the treatment of internal hemorrhoid disease by infrared coagulation and elastic banding: a prospective randomized cross-over trial. Tech Coloproctol 2006; 10(4):312–317.
  25. Madoff RD, Fleshman JW; Clinical Practice Committee, American Gastroenterological Association. American Gastroenterological Association technical review on the diagnosis and treatment of hemorrhoids. Gastroenterology 2004; 126(5):1463–1473.
  26. Yano T, Yano K. Comparison of injection sclerotherapy between 5% phenol in almond oil and aluminum potassium sulfate and tannic acid for grade 3 hemorrhoids. Ann Coloproctol 2015; 31(3):103–105.
  27. Kanellos I, Goulimaris I, Vakalis I, Dadoukis I. Long-term evaluation of sclerotherapy for haemorrhoids. A prospective study. Int J Surg Investig 2000; 2(4):295–298.
  28. Moser KH, Mosch C, Walgenbach M, et al. Effi cacy and safety of sclerotherapy with polidocanol foam in comparison with fluid sclerosant in the treatment of first-grade haemorrhoidal disease: a randomised, controlled, single-blind, multicentre trial. Int J Colorectal Dis 2013; 28(10):1439–1447.
  29. MacRae HM, McLeod RS. Comparison of hemorrhoidal treatments: a meta-analysis. Can J Surg 1997; 40(1):14–7.
  30. Bhatti MI, Sajid MS, Baig MK. Milligan-Morgan (open) versus Ferguson haemorrhoidectomy (closed): a systematic review and meta-analysis of published randomized, controlled trials. World J Surg 2016; 40(6):1509–1519.
  31. Nienhuijs S, de Hingh I. Conventional versus LigaSure hemorrhoidectomy for patients with symptomatic hemorrhoids. Cochrane Database Syst Rev 2009; (1):CD006761.
  32. Avital S, Inbar R, Karin E, Greenberg R. Five-year follow-up of Doppler-guided hemorrhoidal artery ligation. Tech Coloproctol 2012; 16(1):61–65.
  33. Ratto C, Parello A, Veronese E, et al. Doppler-guided transanal haemorrhoidal dearterialization for haemorrhoids: results from a multicentre trial. Colorectal Dis 2015; 17(1):010–019.
  34. Senagore AJ, Singer M, Abcarian H, et al; Procedure for Prolapse and Hemorrhoids (PPH) Multicenter Study Group. A prospective, randomized, controlled multicenter trial comparing stapled hemorrhoidopexy and Ferguson hemorrhoidectomy: perioperative and one-year results. Dis Colon Rectum 2004; 47(11):1824–1836.
  35. Jayaraman S, Colquhoun PH, Malthaner RA. Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev 2006;(4):CD005393.
  36. Poskus T, Buzinskiene D, Drasutiene G, et al. Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. BJOG 2014; 121(13):1666–1671.
  37. Eglinton TW, Barclay ML, Gearry RB, Frizelle FA. The spectrum of perianal Crohn’s disease in a population-based cohort. Dis Colon Rectum 2012; 55(7):773–777.
  38. Gu X, Tucker KL. Dietary quality of the US child and adolescent population: trends from 1999 to 2012 and associations with the use of federal nutrition assistance programs. Am J Clin Nutr 2017;105(1):194–202.
Источник: https://consultqd.clevelandclinic.org/hemorrhoids-the-definitive-guide-to-medical-and-surgical-treatment/

Heparinoid

1. About heparinoid

Heparinoid is a medicine that reduces swelling and helps with healing.

It is used to treat:

Heparinoid comes as a cream or gel. The gel has an added cooling effect.

It also comes as an ointment for treating piles and itchy bottom. The ointment contains oxypolyethoxydodecane to soothe any itching.

Heparinoid is available on prescription and to buy from pharmacies and supermarkets.

2. Key facts

  • You'll usually use heparinoid 4 times a day.
  • It's a very safe medicine and does not usually cause any side effects.
  • Some people may get a rash but this is rare.
  • Do not use heparinoid to treat piles or itchy bottom in children younger than 12 years.
  • Brand names for the cream and gel include Hirudoid. The ointment is sold as Anacal.

3. Who can and can't use heparinoid

Most adults and children over the age of 12 years can use heparinoid to treat piles and itchy bottom.

It's used to treat bruises and phlebitis in adults and children over the age of 5 years.

Heparinoid is not suitable for some people. Tell your doctor or pharmacist if you:

  • are allergic to heparinoid or any other medicines
  • have had an allergic reaction to parabens (heparinoid treatments contain propyl parahydroxybenzoate or methyl parahydroxybenzoate as preservatives)
  • are constipated, due to taking other medicines such as codeine. Being constipated means you're more likely to get piles

4. How and when to use it

If you have bought heparinoid from a pharmacy or supermarket, follow the instructions that come with the packet, or ask your pharmacist for advice.

You can use it up to 4 times a day. For piles or an itchy bottom, it's usual to use heparinoid ointment several times a day - first thing in the morning, last thing at night and after having a poo. An ointment is thicker and greasier than a cream.

Always wash your hands after using the cream, gel or ointment.

For phlebitis, bruises and haematomas

You'll usually need to use 5cm to 15cm of cream or gel. It depends on how much skin you need to cover.

If the area you're treating is sore or tender, you can massage the cream or gel into the skin around it.

For external piles

  1. Squeeze a small amount of ointment onto your finger.
  2. Gently put the ointment onto the skin around your bottom (anus).

For internal piles

If you have piles inside your bottom, use the applicator that comes with the ointment. Read the instructions in the leaflet inside the packaging.

  1. Clean around your bottom (anus) with mild soap and water, rinse and pat dry.
  2. Squeeze some ointment into the applicator and spread a little ointment onto the end of the nozzle.
  3. Gently insert the nozzle into your bottom.
  4. Squeeze the tube so the ointment goes into your bottom and slowly pull the applicator out at the same time.
  5. Take the applicator apart and wash it when you've finished.

What if I forget to use it?

If you forget a treatment, do it as soon as you remember. If you do not remember until you are within a few hours of the next one, do not worry - just skip the missed treatment and go on with your usual treatment routine.

What if I use too much?

If you accidentally use too much, it's unlikely to cause any problems.

Non-urgent advice: Contact 111 for advice if:

  • you or your child swallow heparinoid cream, gel or ointment

Online

Go to 111.nhs.uk - for children aged 5 years and older

Telephone

Call 111

6. Pregnancy and breastfeeding

It's safe to use heparinoid while you're pregnant or breastfeeding.

However, always check with your doctor, midwife or a pharmacist first.

Here's more information on how to treat piles in pregnancy.

Important

Tell your pharmacist or doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

7. Cautions with other medicines

Using heparinoid will not usually affect how other medicines work. However, it might cause bleeding if you're taking other medicines that increase the risk of bleeding.

Tell your pharmacist or doctor if you're taking:

Mixing heparinoid with herbal remedies and supplements

There is very little information about using heparinoid together with complementary remedies, and vitamins or supplements.

Important

For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

8. Common questions

Источник: https://www.nhs.uk/medicines/heparinoid/

Video: 7 effective home remedies using jeera

Benefit 1: To improve digestion
Cumin seeds are known to strengthen a sluggish digestive system. Due to the thymol compound and other important oils in cumin seeds, they help in stimulating salivary glands and, thus, aid digestion. So, if you are suffering from indigestion, try drinking jeera tea three times a day.

Recipe:Take 1 cup of water and add 1 tbsp of cumin seeds to it. Bring it to a boil. Strain and have it three times a day.

Jeera water

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Benefit 2: To beat constipation


Cumin seeds have high fibre content, which boost the activity of gastrointestinal tract. This in turn stimulates enzyme secretion. That is why cumin seeds are used as a natural laxative. Due to this property, cumin seeds are capable of healing severe digestive disorders, like piles.

Recipe: To get rid of constipation, roast 1 tbsp of cumin seeds till they turn deep brown and grind them into a fine powder. Then mix the powder with water and honey and consume it on an empty stomach everyday.


Cumin honey recipe

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Benefit 3: To relieve asthma and cold

Due to their anti-bacterial and anti-inflammatory properties, cumin seeds are an awesome home remedy for cold and cough. The compounds in cumin seeds help to soothe inflamed muscles and boost immunity to fight infections.

Recipe:Add 1 tbsp of cumin seeds to 1 glass of water. Bring it to a boil. Also add some chopped ginger to this. Boil properly. Strain and have this twice or thrice a day.


Jeera tea

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Benefit 4: For pregnant women

The properties of cumin seeds help in relieving constipation and improving digestion in pregnant women. The seeds also help in dealing with pregnancy symptoms like nausea and constipation. Along with aiding in better delivery, they also enhance lactation.

Recipe:Take a glass of warm milk and add half tbsp cumin powder and 1 tbsp honey to it. Mix well. Have it everyday.

For pregnant women

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Benefit 5: To deal with insomnia


Cumin seeds can help you if you are not able to sleep well. They contain a compound called melatonin, which when consumed with mashed bananas, increases the production of chemicals that induce sleep.

Recipe: Mix half tbsp of cumin powder with 1 tbsp of mashed banana. Have this paste before sleeping. This will help you have a good sleep.


Cumin banana paste

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Benefit 6: For glowing skin

A face pack containing honey and cumin seeds will make your skin glowy and smooth. Honey soothes inflamed tissues and this spice will prevent the skin from becoming too dry. Apply some jojoba oil after washing it off your face.

Recipe: To prepare this mask, mix one by four tbsp of turmeric powder, half tbsp of cumin powder and 1 tbsp of honey. After you apply this face mask, let it dry for 10 minutes and then wash it off with warm water. You can apply this face pack twice or thrice a week.


Face pack

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Benefit 7: For long and shiny hair

Cumin can also help you get long and lustrous tresses.

Recipe:For making this, take 150-200 ml of water (3/4 a glass), 1 tbsp cumin powder and 1 egg yolk. Mix them together and form a smooth paste. Apply it on hair and let it dry. Wash it off with water. You can do this once in a week or once in every two weeks.

Hair mask

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Источник: https://timesofindia.indiatimes.com/life-style/health-fitness/home-remedies/7-effective-jeera-home-remedies/articleshow/57424317.cms

Piles or haemorrhoids are basically swollen veins around the anus or in the lower rectum. They occur internally (within the rectum) or more commonly; externally (outside the rectum). A fairly common disease with around fifty percent of all adults reportedly experiencing some form of symptoms before the age of fifty, India reports about twenty million cases a year. Piles can cure on their own within two weeks in most cases and are treatable through a host of options; ranging from medication (even Ayurvedic) to surgery (in case the case is severe). Piles do not pose a threat to life. 

Medical experts are divided over the exact cause of piles but fairly agree on a few causes such as over exertion during bowel movement, persistent constipation, long stints on the toilet seat and familial predisposition to piles. 

The symptoms range from extreme pain and difficulty while sitting, unrelenting itchiness around the anus, a painful and irritating lump (cyst like) near the anus, faecal leakages, painful stool and bowel movement, bloody stool. Internal piles do not cause discomfort generally and bleed painlessly during bowel movement. They become problematic in case there is heavy bleeding or if they pop out (prolapse). External piles develop blood clots (called thrombosed haemorrhoids) which can cause severe itching and pain; this can be done away with through fairly simple treatment called a “drainage and incision” procedure. 

Even though simple measures like a well-balanced, high fibre diet accompanied by consuming about four to five litres of water or taking stool softeners are enough to treat the symptoms; at times piles can cause complications. For instance, external piles can develop painful blood clots called thrombosed haemorrhoids. Internal piles may move through the anus and protrude from the anus, these are called prolapsed haemorrhoids. Both prolapsed and thrombosed haemorrhoids can develop further infections that might require surgical removal. 

There are certain factors that increase the risk of developing piles. They can be genetically passed down from one generation to the next, children whose parents have had piles are more likely to have them at some stage in their lives. Strain on the body plays a major role, for instance if there is constant lifting of heavy objects in the gym or at work; the chances of developing piles are higher. Obesity also exerts strain on the body and is known to cause piles. People who stand for long spells of time without seating themselves in the middle or those who have prolonged diarrhoea or partake in anal intercourse are at increased risk. Pregnancy also increases the risk of developing piles as the uterus is enlarged and naturally exerts more pressure on the vein in the colon, causing it to protrude. 

Diagnosis can be done simply by visually examining the area around the anus to check for any bulging cyst like formations. Thereafter, a doctor may conduct further tests to reveal any other abnormality inside the anus; this is called a Digital Rectal Exam. A lubricated and gloved finger is used to probe and seek any swelling within the anus. A Sigmoidoscopy may be conducted in case any abnormalities are discovered, this is done using a tiny fibre optic camera called a Sigmoidoscope, which is inserted via a small tube. 

Treatment for piles can be done at home and naturally at a clinic or hospital. Home remedies include using simple over the counter medicines like haemorrhoid creams and hydrocortisone which ease the itching and spin piles cause. A warm water sitz bath may be prepared to soak the anus for ten to fifteen minutes in order to bring relief and comfort. Good hygiene, ample amounts of water and a high fibre diet will also help. The swelling caused by piles can also be reduced by applying a cold compress to the area. Pain relief medicines like ibuprofen or acetaminophen can help in stemming the pain caused by piles. 

Medical procedures will be needed in case home remedies fail. A rubber band ligation, wherein a rubber band is placed around the haemorrhoid; is used to cut off circulation and in turn shrink the haemorrhoid. This is the most common and simple procedure for doing away with haemorrhoids but must be done only by a medical professional. In case ligation doesn’t work or is not an option; sclerotherapy may be used, this involves injecting a chemical into the blood vessel directly, causing it to shrink. 

Treatment options are conventional haemorrhoidectomy by open and closed methods – Stapler haemorrhoidectomy & Laser haemorrhoidectomy

In some cases, piles are recurrent and never truly get cured. Prevention is the best option naturally. Some things to keep in mind: 

- Do not strain too hard during bowel movement or sit too long on the toilet. 

- Increase fibre (oats, bran) and water intake, have loads of vegetables like carrots. 

- Regular exercise will keep constipation at bay.

- Do not wait to use the toilet if bowel pressure is developing; go as soon as possible.

Dr. Nikhil Yadav
Senior Consultant
General and Minimal Access Surgery

Источник: https://aakashhealthcare.com/piles-treatment

Five excellent kitchen remedies for piles

Piles also known as hemorrhoids are the swollen and inflamed veins inside and outside the rectum. This problem is most frequently seen in people aged 45 to 65 years. Nowadays even the youth and children are found suffering from it due to the weakness of the digestive system.

Other than weakness in digestive system factors which contribute to piles are family history, constipation, pregnancy, sedentary lifestyle, and obesity.

Hemorrhoids are of two types depending on their position. Internal hemorrhoids develop inside the rectum whereas the external lie just below the skin around the anal region.

Most common symptoms of piles are,

  • Bleeding during defecation
  • Itching and soreness in the anus
  • A sensation of fullness of rectum after bowel movements
  • Pain and irritation in the anal region
  • If not treated the condition can worsen and lead to chronic blood loss, anemia, strangulated piles, and even cancer.

Many of us think than permanent treatment of piles is surgery, which is not true though (as there are chances of recurrence even after that). Ayurveda believes in removing the cause of the problem and has treatment plans based on it, which ensures complete and permanent relief and with negligible chances of recurrence.

Remedies from your own kitchen to get relief

Lemon juice

Nutrients present in lemon juice strengthens the capillaries and the blood vessels and can prove to be of immense help in treating hemorrhoids. Following are the ways a lemon can be helpful,

Squeeze a lemon and moisten a cotton ball in it and apply directly over the piles. It might irritate in the beginning but soon there will be relief from the pain.

A mixture of lemon juice, honey, ginger, mint juice can be taken every day once.

Whole grains

Rich in fiber, whole grains are highly effective in giving relief from bleeding and other hemorrhoidal symptoms. Fiber-rich foods include barley, lentils, beans, oats and brown rice.

Ice

It is a very easy and highly recommended home treatment, application of which constricts blood vessels, reduces inflammation and gives relief from pain.

Buttermilk

Bitter gourd mixed with buttermilk helps in treating hemorrhoids. Also, buttermilk mixed with rock salt, ginger, and pepper helps relieve hemorrhoid pain.

Radish juice

Radish juice twice in a day is a known common remedy for treating piles.

Why go under the knife for a not so sure treatment when the simple at home remedies can prove to be so beneficial.

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Источник: https://store.jiva.com/five-excellent-kitchen-remedies-for-piles/

Piles foreclosed homes for sale tulsa in pregnancy

What are piles?

Piles (haemorrhoids) are swollen blood vessels in the rectal area

They typically range in size from as small as a pea to as large as a grape, and they can develop inside the rectum or protrude through the anus. These swollen vessels may hang down during or after you've done potty. You may be able to feel them as small, soft lumps just inside or around the edge of your bottom, and they may be painful.

What are the symptoms of haemorrhoids?

Piles often don’t have any symptoms. You may be able to feel them as small, soft lumps just inside or around the edge of your bottom. Sometimes they can be painful. Other symptoms of piles you might or might not have are:
  • Soreness and inflammation around your anus, discover bank cd can make going to the loo uncomfortable.
  • Mucus discharge after pooping.
  • Difficulty controlling your bowels, which you may notice if your underwear gets dirty.
  • Feeling like your bowels still need emptying after you've had a poo.
  • Itching around your bottom.
  • Bright red blood after you've been to the loo, which you may see when you wipe your bottom.
Piles won't affect your unborn baby, though having them may be annoying for you.

Why are piles more common during pregnancy?

When you're pregnant, you have more blood going around your body. At the same time, high levels of the hormone progesterone relax the walls of your blood vessels.

The weight of your growing babyputs pressure on these full veins making them prone to become swollen and stretched. This is why you're more prone to piles and varicose veinswhen you're pregnant. You can also get swollen veins on your vulva, called vulvar varicose veins.

Constipation, another pregnancy bugbear, can also cause piles. It's because you tend to strain when having a hard bowel movement, and straining leads to haemorrhoids.

Piles affect about a quarter of pregnant women by the third trimester.

Some women get them for the first time while they're pregnant. If you've had them before pregnancy, you're more likely to have them again now.

How can I avoid getting piles in pregnancy?

Here are some ways to prevent haemorrhoids when you're pregnant:
  • Prevent constipation. You can do this by eating a high-fibre diet (that includes plenty of whole grains, beans, fruits, and vegetables), drinking about 8-12 glasses of water a day, and getting regular exercise (as long as your doctor says it's okay). If you're already constipated, ask your doctor about taking a fibre supplement (like isabgol) or using a stool softener. See our slideshow of quick and easy constipation remedies.

  • Don't wait to go. When you feel the urge to have a bowel movement don't delay, and also try not to strain.

  • Don't sit on the toiletlonger than necessary. Sitting for a long time puts pressure on your rectal area.

  • Do Kegel exercises daily. Home remedies for hemorrhoids india floor exercises (Kegels) increase circulation in the rectal area and strengthen the muscles around the anus, reducing the chance of haemorrhoids. They also strengthen and tone the muscles around the vagina and urethra, which can help your body recover home remedies for hemorrhoids india you give birth. How to do Kegels (pelvic floor exercises)

  • Don't sit or stand for long stretches of time. If your job involves sitting at a desk, get up and move around for a few minutes every hour or so. At home, lie on your side when sleeping, reading, or watching TV to take the pressure off your rectal veins and increase blood return from the lower half of your body.

  • Try squatting. If you have an Indian style toilet at home, use it to pass stool. The position of the squat might help you poo more easily and quickly, reducing the pressure on the anal blood vessels. If you don’t have an Indian toilet, use a small stool to raise your feet while sitting on the loo so that your knees are higher than your navel.

  • Massage the area. You could apply pressure with your fingers to the muscular area between your vagina and back passage (perineum) just before passing stools. This stimulates a reflex that increases muscle tone in your rectum, and may make pooing easier.

  • Don’t sleep on your back. Sleeping on your back can increase the pressure on the veins below your womb.

How can I treat haemorrhoids?

If you already have piles, there are a few things you can do to help yourself:
  • Use ice packs, or a cloth wrung out from iced water, to relieve the pain around your bottom.

  • Soak your bottom in a tub of warm water for 10 to 15 minutes a few times each day. You can also use a Sitz bath at the chemist or online. This is a small plastic basin that you fill with water and position over your toilet so you can sit down and submerge your rectal area.

  • Alternate. First, use cold then warm treatments, and repeat.

  • Gently and thoroughly clean the affected area after you've done a poo. Washing off with water or wiping with moist toilet wipes can be more comfortable than using toilet tissue. Pat rather than rub yourself dry.

  • Try pushing the piles gently back into your rectum with a clean finger when you are having a bath or shower. You could use a little lubricating jelly to help with this. They may pop out again at some point, so you may have to do this a few times during your pregnancy.

  • Take the pressure off the veins in your bottom to relieve the pain by sitting on a ring cushion. You can also roll a towel into a ring and sit on that if you don’t have ring cushion. Home remedies for hemorrhoids india new mothers find this solution a lifesaver. However, you should use it sparingly as it may reduce circulation in the affected area and prolong the healing process.

Consult amazon driver jobs ct doctor before trying any over-the-counterhaemorrhoid-relief products. Your doctor will be able to recommend safe, topical anaesthetics, creams or medicated suppositories.

Also speak to your doctor if preventive efforts and home treatments don't help, or if you have severe pain or rectal bleeding.

In some cases, you may need to see a specialist for treatment to shrink your haemorrhoids. Rarely a minor surgery is necessary, though your doctor would prefer to schedule the surgery only after your delivery.

Do piles go away after birth?

In most cases, piles disappear or shrink as your body recovers after your baby’s birth. In some cases, you might have developed piles during labour, at the stage when you push out your baby. Or they may be a result of constipation in the weeks after giving birth, when your body is shedding the extra fluidneeded during pregnancy.

If you’re constipated and struggling with piles, speak to your doctor. She can give you advice about creams and laxatives, that might help.

Remember to always tell your doctor if you have bleeding from your anus. It might be hard to tell at first because of the lochia. But after passing stool and cleaning the area, apply soft tissue paper to your anus only and if it gets stained with blood, let your doctor know.

If you have severe, ongoing problems with piles, your doctor may recommend one of the following treatments:
  • Banding, where a type of rubber band is placed around the base of the haemorrhoid. This cuts off the circulation to it, making it shrivel and drop off.

  • Injection with chemicals, that cause the piles to shrink and drop off.

  • Electrotherapy, where a probe is used to apply an electric current to the haemorrhoid and make them shrivel and shrink.

  • Infrared coagulation (IRC), where the doctor uses an infrared beam light as a heat source to quickly coagulate, or clot, vessels supplying blood to the piles. This creates a scar tissue, which cuts off the blood supply to the haemorrhoid and makes it shrink.

  • Laser treatment, where laser beams are used to treat, dry up and shrink a haemorrhoid.

However, these procedures are usually advised if you have early piles. For late and prolapsed piles, surgery may be required. Your doctor will be in the best position to decide which treatment is best for your condition.


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Read more best budget m 2 ssd Abbot R, Ayres I, Hui E, et al. 2015. Effect of perineal self-acupressure on constipation: a randomized controlled trial. J Gen Intern Med 30(4):434-9. www.ncbi.nlm.nih.gov

Arnouk A, De E, Rehfuss A, et al. 2017. Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders. Curr Urol Rep 18(6):47

Bick D, Hunter C. 2017. Content and organization of postnatal care. In: MacDonald S, Johnson G. midwest one bank dyersville. Mayes' midwifery. 15th ed. London: Elsevier, 695-704

Lohsiriwat V. 2015. Treatment of hemorrhoids: a coloproctologist's view. World J Gastroenterol 21(31):9245-52

Murray I, Hassall J. 2014. Change and adaptation in pregnancy. In: Marshall JE, Raynor MD. eds. Myles textbook for midwives. home remedies for hemorrhoids india ed. Edinburgh: Churchill Livingstone, 143-77

Nazik E, Eryilmaz G. 2013. Incidence of pregnancy-related discomforts and management approaches to relieve them among pregnant women. J Clin Nurs 23(11-12):1736-50

NCCWCH. 2008. Antenatal care: routine care for the healthy pregnant woman. National Collaborating Centre for Women's and Children's Health, Clinical guideline. www.nice.org.uk December

NHS. 2015a. Piles in pregnancy. NHS Choices, Health A-Z. www.nhs.uk

NHS. 2015b. Common pregnancy problems. NHS Choices, Health A-Z. www.nhs.uk

NHS. 2015c. Constipation. NHS Choices, Health A-Z. www.nhs.uk

NHS. 2015d. Rectal bleeding. NHS Choices, Health A-Z. www.nhs.uk

NHS. 2016. Haemorrhoids (piles). NHS Choices, Health A-Z. www.nhs.uk

NHS. 2017. Varicose veins. NHS Choices, Health A-Z. www.nhs.uk

NICE. 2016. Haemorrhoids. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.uk

Poskus et al. 2014. Haemmorhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. BJOG 30(4):434-9

Schytt E, Lindmark G, Waldenström U. 2005. Physical symptoms after childbirth: prevalence and associations with self-rated health. BJOG 112(2):210-7 < onlinelibrary.wiley.com

Tidy C. 2017. Piles (Haemorrhoids). Patient. patient.info

WaterUK. 2017. Flushability. Policy, Improving resilience. www.water.org.uk

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Five excellent kitchen remedies for piles

Piles also known as hemorrhoids are the swollen and inflamed veins inside and outside the rectum. This problem is most frequently seen in people aged 45 to 65 years. Nowadays even the youth and children are found suffering from it due to the weakness of the digestive system.

Other than weakness in digestive system factors which contribute to piles are family history, constipation, pregnancy, sedentary lifestyle, and obesity.

Hemorrhoids are of two types depending on their position. Internal hemorrhoids develop inside the rectum whereas the external lie just below the skin around the anal region.

Most common symptoms of piles are,

  • Bleeding during defecation
  • Itching and soreness in the anus
  • A sensation of fullness of rectum after bowel movements
  • Pain and irritation in the anal region
  • If not treated the condition can worsen and lead to chronic blood loss, anemia, strangulated piles, and even cancer.

Many of us think than permanent treatment of piles is surgery, which is not true though (as there are chances of recurrence even after that). Ayurveda believes in removing the cause of the problem and has treatment plans based on it, which ensures complete and permanent relief and with negligible chances of recurrence.

Remedies from your own kitchen to get relief

Lemon juice

Nutrients present in lemon juice strengthens the capillaries and the blood vessels and can prove to be of immense help in treating hemorrhoids. Following are the ways a lemon can be helpful,

Squeeze a lemon and moisten a cotton ball in it and apply directly over the piles. It might irritate in the beginning but soon there will be relief from the pain.

A mixture of lemon juice, honey, ginger, mint juice can be taken every day once.

Whole grains

Rich in fiber, whole grains are highly effective in giving relief from bleeding and other hemorrhoidal symptoms. Fiber-rich foods include barley, lentils, beans, oats and brown rice.

Ice

It is a very easy and highly recommended home treatment, application of which constricts blood vessels, reduces inflammation and gives relief from pain.

Buttermilk

Bitter gourd mixed with buttermilk helps in treating hemorrhoids. Also, buttermilk mixed with rock salt, ginger, and pepper helps relieve hemorrhoid pain.

Radish juice

Radish juice twice in a day is a known common remedy for treating piles.

Why go under the knife for a not so sure treatment when the simple at home remedies can prove to be so beneficial.

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Источник: https://store.jiva.com/five-excellent-kitchen-remedies-for-piles/

Top Herbs for Piles Treatment in Ayurveda

Nowadays many people have been complaining about piles, fistula or hemorrhoids in their 30s and 40s. It is also commonly seen in older people. 

Today's fast paced lifestyle with little attention to food and eating schedules along with the consumption of processed and junk foods has hampered the digestive capabilities of the individuals. One of the contributing factors is also stress, that has an adverse impact on digestion and can cause irritable bowel syndrome and other related irregularities.

If neglected, this could result in chronic constipation accompanied with tight stools and causing fissures and Hemorrhoids.

Some of the main symptoms of Piles are-

  • Blood in your stools.
  • An itchy anus.
  • Feeling like you still need to poop after going to the toilet.
  • Lumps around your anal area
  • Pain around the anal area

Let us find out the science behind this and herbs that can help in piles treatment in Ayurveda.

What Ayurveda says about Piles treatment?

Ayurveda aims at balancing the three doshas of the body- Vata, Pitta and Kapha.

In Ayurveda, it is said to balance the digestive system of the body. Good and proper digestion is based on digestive fire (agni) and its strength. It is also said that the digestive fire is strongest around noon. So, it is suggested that people should consume their heaviest meal at noon and keep their dinner and other meals lighter.

The excretion process in the body is governed by Vata Dosha, as it keeps the bowel movement proper and functioning.

Vata dosha when aggravated or  imbalanced heritage near me cause the bowel contents to get dried and hinders the proper bowel movement causing constipation. Imbalanced Vata Dosha also causes constipation along with painful hemorrhoids. 

An imbalance in Pitta Dosha can cause excessive diarrhea, excessive thirst, and inflamed hemorrhoids that bleed.

In addition to this, an imbalance in the Kapha Dosha, can cause light hemorrhoids.

So, it is necessary to bring all the three doshas in balance for complete treatment of piles.

Best Ayurvedic Herbs for Piles/ Hemorrhoids

Piles treatment in Ayurveda can be done with the help of some powerful herbs that can balance the doshas in the body and treat the root cause of the problem. These herbs can be helpful as there is no side effect that they cause. 

Haritaki is a fruit that can balance the three doshas in the body, how to close out pnc bank account digestion and helps in detoxifying the body. It has been used as an important ayurvedic herb for piles treatment as it eases the bowel movement and relieves pressure on the excretory system. 

Avipattikar churna is an ayurvedic herbal medicine for piles and other digestive problems.

Amalaki Rasayana or the Indian gooseberry is a common Ayurvedic medicine to balance all the three Doshas. It is used in traditional Ayurvedic medicine and acts as an antioxidant, immunomodulator, anti-inflammatory, astringent and laxative. 

Guggul is known for its anti-inflammatory properties in Ayurveda. It is one of the best herbs for piles as it reduces the inflammation in fistula-anorectal and hemorrhoidal conditions. Guggul is a laxative and astringent agent that helps in reducing the toxins (ama) and relieves pain and itching. It helps in balancing the body’s Kapha Dosha.

Turmeric or Curcuma offers anti-microbial and anti-inflammatory properties, that helps in controlling bleeding in hemorrhoids. It also helps reduce anal itching and shrink hemorrhoids. According to Ayurveda, Turmeric can strengthen the digestive fire and helps in balancing the doshas.

Triphala acts as a mild laxative and allows the deepest tissues and organs of the body to release toxins. Despite its powerful cleansing quality, it enhances absorption and balances the doshas in the body especially supporting the digestive system.

To Sum Up

I have summarized the list of various Ayurvedic herbs for piles or hemorrhoids. These can home remedies for hemorrhoids india taken to support the digestive system and balance the three doshas in the body and can be the best piles treatment in Ayurveda. These herbs offer no side effects and are not habit forming. Going for Ayurvedic treatment can prevent you from surgeries and you can get long term relief from piles.

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Источник: https://maharishiayurvedaindia.com/blogs/ayurveda-knowledge-center/piles-treatment-in-ayurveda

By Turgut Bora Cengiz, MD, and Emre Gorgun, MD, FACS, FASCRS

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Aspects of modern life that may promote hemorrhoids include increased consumption of processed foods, a sedentary lifestyle and using cell phones while defecating, which translates to much more time spent on the toilet.

Hemorrhoids accounted for more than 3.5 million U.S. outpatient visits in 2010, and they were the third leading cause of hospital admissions related to gastrointestinal disease.1

Here, we review the process for diagnosing and grading hemorrhoids, as well as for selecting the appropriate medical or surgical treatment based on the most recent clinical evidence.

Diagnosing and classifying hemorrhoids

Hemorrhoids are the distal prolapse of the arteriovenous bundle, muscle fibers and surrounding connective tissue as an envelope below the dentate line in the anal canal. They usually present with painless rectal bleeding.2

The diagnosis of hemorrhoids relies on history and physical examination rather than on laboratory testing or imaging studies. Typically, the presenting symptom is painless rectal bleeding associated with bowel movements, usually appearing as bright red blood on the toilet paper or coating the stool. Severe itching and anal discomfort also are common, especially with chronic hemorrhoids.

Detailed patient history

A detailed patient history is important. It should include the extent, severity and duration of symptoms, frequency of bowel movements, associated symptoms (e.g., constipation, fecal incontinence), daily dietary habits and details of bowel movements (e.g., time spent during each bowel movement and concomitant cell phone use).3

Regarding bowel habits, some patients experience lifelong constipation or diarrhea. Therefore, what a patient considers a normal bowel habit may not be normal and should be investigated.4 Also, it is important to exclude external thrombosed hemorrhoids, anal fissure, anal abscess and Crohn’s disease.5

Physical examination

A digital rectal examination is the second step. During the examination, look for skin tags, sphincter tone, perianal hygiene and synchronous anal lesions.3 Of note, the Valsalva maneuver can be performed during the digital rectal examination.

Red flags for colorectal cancer on the digital rectal examination include a mass with or without presence of hemorrhoidal sacs and ally bank close account bleeding source above the level of internal hemorrhoids.

Patients with recurrent abscesses, fistulas or skin tags (especially cauliflower-type skin tags) should be investigated for Crohn’s disease (Figure 1).

Figure 1. Patient with Crohn’s disease. Note the fistula orifices and skin tag.

Endoscopy

Since rectal bleeding can be a sign of several diseases, including colorectal cancer, it is important to review any previous endoscopic results. Patients at high risk of colon cancer should undergo rigid proctoscopy, flexible sigmoidoscopy or colonoscopy.3,4 In our practice, we recommend endoscopic evaluation for patients older than  age 40 with rectal bleeding, especially if they have a family history of colorectal cancer.

External or internal (grades I–IV)

Hemorrhoids can be categorized as either external or internal.

External hemorrhoids are distinguished by their outer covering with perianal skin and anoderm and their location inferior to the dentate line. They are painful if the hemorrhoidal sac is occluded by a thrombotic clot.

Internal hemorrhoids are above the dentate line and covered with rectal columnar and transitional mucosa. They are further graded on a 4-point scale3:

  • Grade I—Visible hemorrhoids that do not prolapse.
  • Grade II—Hemorrhoids that prolapse during the Valsalva maneuver but spontaneously reduce.
  • Grade III—Hemorrhoids that prolapse during the Valsalva maneuver and need manual reduction.
  • Grade IV—Nonreducible hemorrhoids.

A range of treatments

In choosing the treatment for hemorrhoids, one should consider the disease grade and severity, its impact on the quality of life, the degree of pain it causes, the patient’s likelihood of adhering to treatment and the patient’s personal preference.

Regardless of severity, treatment almost always starts with a high-fiber diet and other lifestyle modifications that include bowel movement behaviors. This requires practitioners to spend significant time on patient education, regardless of the type or severity of the disease.

Treatments can be grouped in three categories: conservative, office-based and surgical. Practitioners should thoroughly discuss the options with the patient, emphasizing the pros and cons of each.

Conservative measures

Conservative measures are aimed at softening the stool, relieving pain and correcting bad toileting habits. In most cases, the primary precipitating factor is lifestyle, and unless patients change it, they are more likely to have recurrent symptoms in the long term.

No phone in the bathroom

People take their phones into the bathroom, and this habit is blamed for increasing the time on the toilet and leading to increased pressure on the anal region and straining during defecation. Some research points to a direct correlation between the time spent on the toilet and hemorrhoidal disease, although the exact cause-and-effect relationship with cell phone use has not been determined. In general, spending excessive time on the commode, including reading, should be discouraged.

Less time in the bathroom

Johannsson et al6 reported that patients with hemorrhoids spent how do i apply for amazon prime credit card time on the toilet and had to strain harder and more often than controls in the community and hospital.

Garg and Singh7 and Garg8 use the mnemonic “TONE” for appropriate defecation habits:

  • Three minutes during defecation.
  • Once-daily defecation.
  • No straining and no cell phone use during defecation.
  • Enough fiber.

More fiber

Fiber draws water into the lumen of the colon, increasing the water content of the stool. Recommended daily fiber intake is about 28 g for women and 38 g for men.9 This high level of intake is hard to achieve without supplements for someone old national bank online sign in consumes a classic American diet with a lot of fast food.

Fiber supplements are strongly recommended in the American Society of Colon and Rectal Surgeons (ASCRS) practice guidelines3 based on a Cochrane review.10 In this meta-analysis, with fiber supplements the relative risk of persisting or nonimproving symptoms was 0.53 (95% confidence interval [CI] 0.38-0.73) and the relative risk of bleeding was 0.50 (95% CI 028-0.89). Psyllium husk is an inexpensive bulk-forming fiber supplement; the optimal daily dosage is not known.

We recommend at least 28 g of daily fiber intake for women and 38 g for men, for which psyllium husk can be used to complement the diet.

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Laxatives for some

Laxatives such as docusate are used to change the stool consistency when there is an organic bowel problem rather than a dietary issue. They can be used as a complementary treatment to enhance the effect of the fiber treatment.

Other measures

Topical anesthesia (e.g., 5% lidocaine) is commonly used to treat pain mortgage down payment loan low-grade lesions, but no reliable data have been published. As most cases of hemorrhoids tend to progress over time, one should not expect long-term improvement with topical anesthesia. Nevertheless, it can be used as an ancillary treatment in select cases when short-term improvement is the main goal, and we recommend it based on our own experience.

Hygiene. Bidet use or cleaning the perianal area with water is recommended.

Phlebotonics contain a variety of ingredients including natural plant home remedies for hemorrhoids india such as flavonoids and synthetic products. Even though the exact mechanism of action is not known, phlebotonics how long does chime direct deposit take thought to increase venous and lymphatic drainage, normalize capillary permeability and decrease inflammation in the hemorrhoidal cushions.4,11–13

In a Cochrane review of 24 randomized controlled trials, Perera et al14 found that phlebotonics improved the outcomes of:

  • Bleeding (odds ratio [OR] 0.21, number needed to treat [NNT] 4.8, p = .0002).
  • Pruritus (OR 0.23, NNT 9.1, p = .02).
  • Discharge or leakage (OR 0.12, NNT 5, p = .0008).
  • Overall symptoms (OR 15.99, NNT 2.7, p < .00001). Overall symptoms  home remedies for hemorrhoids india improved in the subgroup of pregnant patients.

Although phlebotonics give better results than placebo in the short-term management of hemorrhoids, there is a paucity of long-term data. Thus, the ASCRS clinical practice guidelines give the regular use of these agents only a weak recommendation.3

Flavonoids (diosmin, hesperidin, rutoside), in a meta-analysis vs. placebo in 1,514 patients, showed a beneficial response in terms of bleeding (relative risk [RR] 0.33), pruritus (RR 0.65) and recurrences (RR 0.53).15

Although Preparation H is commonly used as an over-the-counter medication, there are no good data on it and it is not considered a phlebotonic.

Office-based treatments

Office-based treatments — rubber band ligation, infrared photocoagulation, and sclerotherapy — are commonly used for grade I, II and III hemorrhoids that have not responded to conservative management. The primary goal of these treatments is to decrease blood flow into the hemorrhoidal sac.

Even though office-based treatments are highly effective and major complications are uncommon, recurrence rates can be high, requiring patients to undergo additional treatments. Moreover, septic complications can occur so patients should be closely observed for fever and urinary problems. Pain is a common symptom after office-based treatments, and bleeding may also occur.

The ASCRS guidelines strongly recommend office-based treatments for patients with grade I and II hemorrhoids, and for some with grade III hemorrhoids.3

Rubber band ligation

Ligating the apex of the hemorrhoidal cushion stops the arterial flow and causes the hemorrhoidal tissue to undergo necrosis (Figure 2). The ligation is performed above the dentate line, where the sensory nerve fibers differ from those found below the line; therefore, the operation causes less pain than one would expect. One or more hemorrhoidal cushions can be ligated at the same time, although increased pain, bleeding and vasomotor reactions have been reported with multiple banding during a san jose city college canvas procedure.16,17

Figure 2. In rubber band ligation, an internal hemorrhoid is grasped with a forceps (A) and drawn into the cylinder of the ligator (B). A band is deployed around the base of the hemorrhoid (C), cutting off its blood supply and causing it to fall off within a few days.

Iyer et al18 reported that patients book about trump and deutsche bank warfarin therapy had as much as nine times higher risk of postprocedural bleeding, and patients on aspirin had a risk as much as three times higher. Therefore, whether patients on anticoagulant therapy should undergo this procedure is unclear.

A Cochrane database review19 found this technique effective for hemorrhoid grades I through III, although some patients with grade III hemorrhoids may benefit more from excisional hemorrhoidectomy, which is associated with a lower recurrence rate than rubber band ligation.

Brown et al20 performed a randomized controlled trial comparing hemorrhoidal artery ligation and rubber band ligation for symptomatic hemorrhoids in 372 patients with grade II and III hemorrhoids. Postprocedural pain scores on days one and seven were significantly lower with rubber band ligation, but recurrences were more common (49% vs 30%, p = .0005, respectively).

Overall, rubber band ligation is an excellent option for grade II hemorrhoids, as it is easy to perform, is associated with low pain scores and can be used to treat recurrences.

Infrared photocoagulation

In this procedure, an infrared probe produces heat to induce coagulation, fibrosis and ultimately necrosis of the protruding tissue in the hemorrhoidal cushions.21 Even though its use was initially directed at grade I and II hemorrhoids, recent reports showed acceptable results for grades III and IV.22,23 A randomized controlled trial comparing infrared photocoagulation and rubber band ligation in 94 patients found that both procedures were well accepted and highly effective; however, patients had better pain scores with photocoagulation in the first 24 hours after the procedure (p < .05).24

Sclerotherapy

Sclerotherapy involves injection of a sclerotic agent into the submucosa of the hemorrhoidal sac (Figure 3), which causes an inflammatory reaction and eventually forms fibrotic tissue that stops the blood flow to the hemorrhoid. Many sclerotic agents are available, including 5% phenol in almond or vegetable oil, quinine, ethanolamine, and hypertonic saline.21

Figure 3. Sclerotherapy involves injecting an irritating solution into the hemorrhoid, reducing its blood supply and causing it to shrink.

The injection can cause prostatic abscess and sepsis, although this is rare.25 Nevertheless, high fever and postprocedural pain should be carefully evaluated.

There have been few randomized trials of sclerotherapy, but success rates so far have been higher for grade I hemorrhoids than for grades II and III.26–28 It is the preferred method for patients who have bleeding abnormalities caused by medications or other diseases (e.g., cirrhosis).

Surgery

Although nonsurgical treatments have substantially improved, surgery is the most effective and strongly recommended treatment for patients with high-grade internal hemorrhoids (grades III and IV), external and mixed hemorrhoids, and recurrent hemorrhoids.

The most popular surgical options are open or closed hemorrhoidectomy, stapled hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation. Each has different success rates and different complication profiles, which need to be discussed with the patient.

Overall, surgery is associated with more adverse effects than office-based treatments or medical management. Postoperative pain is the most common complaint, but anal stricture (rare) or incontinence may occur due to excessive tissue excision and damage to the sphincter muscles. These can be avoided by maintaining the normal anoderm between excisions, by not excising all hemorrhoid sacs at once if the patient has extensive lesions and by performing a careful dissection in the submucosal plane.

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Patients with profuse bleeding or an underlying bleeding abnormality are best managed with surgical approaches performed in an operating room.

Excisional surgical hemorrhoidectomy

Excision of the hemorrhoidal sac, the most conventional surgical technique, is generally reserved for prolapsing disease. The recurrence rate after excisional hemorrhoidectomy is significantly lower than with any other approach.29

Excisional hemorrhoidectomy can be performed using either an open approach, in which the edges of the mucosal defect are not reapproximated, or a closed approach, in which they are. In a systematic review, Bhatti et al30 compared open vs. closed techniques and found that the closed technique resulted in less postoperative pain, better wound healing and less bleeding. Rates of recurrence, postoperative complications and surgical site infection and lengths of stay were comparable with either procedure.

Overall, excisional hemorrhoidectomy is associated with higher pain scores than any other surgical method.29 Recently, the use of electrodiathermy energy devices, also described as electrosurgical vessel-sealing devices, have further improved overall patient satisfaction.31

Multiple painful hemorrhoidal sacs require a careful surgical approach, as extensive resection may cause widespread fibrosis and stricture. As with anal stricture, fecal incontinence can be prevented by careful dissection. However, already existing incontinence is not a contraindication for the surgery.

Doppler-guided hemorrhoidal artery ligation

Doppler-guided hemorrhoidal artery ligation involves using a Doppler probe to find and ligate individual hemorrhoidal arteries. Additionally, mucopexy (transanal rectoanal repair) is performed to relocate the prolapsing tissue. Avital et al32 reported that at one year after this procedure, recurrence rates were 5.3% for grade II hemorrhoids and 13% for grade III hemorrhoids. At five years, recurrence rates were 12% for grade II and 31% for grade Home remedies for hemorrhoids india date, this procedure appears to be suitable for grade I, II, and III hemorrhoids, especially for grade II, but more studies are needed to prove its efficacy and recurrence rates for more advanced lesions. Although this technique has a high morbidity rate (18%), primarily pain or tenesmus, it causes less postoperative pain than other surgical methods.33 Overall, it has the potential to become a favored treatment.

Stapled hemorrhoidopexy

In this procedure, the prolapsing part of the internal hemorrhoidal cushion is moved upward by stapling the rectal mucosa just above the hemorrhoid (Figure 4). This is not an option for patients with thrombosed internal hemorrhoids or with external hemorrhoids.

Figure 4. In stapled hemorrhoidopexy, a special tool is inserted (A). Excess tissue is excised (B), and the remaining tissue is drawn up to its normal position and fastened in place, yielding the result pictured in panel C.

Although pain scores are lower with stapled hemorrhoidopexy than with excisional hemorrhoidectomy, this procedure is not superior in terms of recurrences.34,35 Also, practitioners should be careful about specific complications of stapled hemorrhoidopexy, such as rectovaginal fistula, anal stenosis or sphincter injuries. These specific complications should be clearly explained to patients, and necessary information should be given to patients upon discharge. The primary care physician should also be careful about fistulas and stenoses in this particular patient population.

No best treatment

There is no best treatment for hemorrhoids. Every patient is different, and the physician and patient need to understand each other’s expectations, weigh the risks and benefits and arrive at a mutual decision. A good patient-doctor relationship is essential.

A thorough history and physical examination will enable the practitioner to understand the patient’s problem (Figure 5).

Figure 5. Algorithm for hemorrhoid management.

Given the variety of available treatments, head-to-head comparisons are difficult. Moreover, the efficacy and applicability of each technique changes with the grade of the lesion or lesions and the skill of the practitioner. Lacking comprehensive studies comparing conservative, office-based and surgical management, no decisive statements security first federal credit union locations be made based on current evidence.

Patients with compounding conditions

Pregnant patients often develop hemorrhoids as intra-abdominal pressure increases, particularly during the third trimester.36 Also, acute episodes of pain and bleeding are common in pregnant women with preexisting hemorrhoids.

Conservative treatment is the main approach in pregnant patients because most hemorrhoids regress after childbirth. This includes increased dietary fiber, stool softeners and sitz baths, which are safe to use for external hemorrhoids. Any office-based or surgical intervention should be postponed until after childbirth, if possible. Kegel exercises and lying on the left side are also recommended to relieve symptoms. In cases of severe bleeding, anal packing appears to be useful.

Immunosuppressed patients and those on anticoagulant therapy are more prone to serious complications such as sepsis and profuse bleeding. Thus, conservative management should be used in these patients as well. Injection sclerotherapy may be beneficial, as it has been shown to decrease bleeding. Of note, patients on immunosuppressive agents should stop taking them and start taking an antibiotic, and patients on anticoagulant or antiplatelet medications should be instructed to stop them one week before any intervention.

Crohn’s disease. Some patients with Crohn’s disease may have hemorrhoids, though this is rare. Eglinton et al,37 in a series of 715 patients with Crohn’s disease, reported that 190 (26.6%) had symptomatic perianal disease. Of these, only 3 (1.6%) had hemorrhoids. Treatment is always conservative and directed at the Crohn’s disease rather than the hemorrhoids.

Patients with portal hypertension (e.g., due to cirrhosis) are prone to have anorectal varices that may resemble hemorrhoids. Anorectal varices can be treated with vascular ligation, whereas sclerotherapy is the preferred method for hemorrhoids in this group, in whom coagulopathy is common.

Take-home messages

Hemorrhoidal disease is common in the United States, and with our diet and lifestyle, the incidence is likely to increase. (A national survey found that overall dietary quality improved modestly in children and adolescents in the United States from 1999 to 2012 but remained far below optimal.38) Practitioners need to carefully assess hemorrhoidal symptoms and complete any necessary screening tests before establishing a diagnosis. This helps to avoid missing any underlying disease.

Fiber supplements along with dietary and lifestyle changes constitute the baseline of the management, regardless of the disease grade. Office-based interventions are beneficial for grade I and II hemorrhoids and for some grade III hemorrhoids. Repeated interventions can increase the success rate. In patients with high-grade, symptomatic hemorrhoids, surgical hemorrhoidectomy is the most effective modality with the lowest recurrence rates, although it causes more pain than conservative methods.

Dr. Cengiz is a resident in Cleveland Clinic Digestive Disease & Surgery Institute’s Department of General Surgery. Dr. Gorgun is Director for Lower GI of the Digestive Disease & Surgery Institute’s Endoluminal Surgery Center.

Note: This article originally was published in the Cleveland Clinic Journal of Medicine (2019 September;86(9):612-620).

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  19. Shanmugam V, Thaha MA, Rabindranath KS, Campbell KL, Steele RJ, Loudon MA. Rubber band ligation versus excisional haemorrhoidectomy for haemorrhoids. Cochrane Database Syst Rev 2005;(3):CD005034.
  20. Brown SR, Tiernan JP, Watson AJM, et al; HubBLe Study team. Haemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree haemorrhoids (HubBLe): a multicentre, open-label, randomized controlled trial. Lancet 2016; 388(10042):356–364.
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Источник: https://consultqd.clevelandclinic.org/hemorrhoids-the-definitive-guide-to-medical-and-surgical-treatment/

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Ageing has its own advantages and disadvantages. Included in the latter are piles, clinically known as haemorrhoids, which is a condition when veins in your rectum or under the skin around the anus swell. These swollen blood vessels can turn bowel movement into an intensely painful experience. According to research published in the year 2017 by The Indian Journal of Surgery, half the men and women in India above the age of 50 may develop the symptoms of haemorrhoids during their lifetime. Even though piles are rarely dangerous, if left ignored, they can lead to serious health complications. In this chase bill pay check not received, let’s get a clear picture of the causes, types, symptoms and measures that can help prevent or cure haemorrhoids.

Causes

It is not established yet what actually causes the veins around your anus to swell and bulge, yet nearly two out of the four adults undergo the symptoms of haemorrhoids. Some of the common factors contributing to an increased risk of suffering from piles are constipation, sedentary lifestyle, bad diet, smoking and alcohol, family history, being pregnant or obese, regular heavy eating, and stress.

Types

Hemorrhoids are classified into 4 different categories Internal, Prolapsed, External and Thrombosed.

  • Internal Hemorrhoids: They lie deep inside the rectum and so, are not visible to the naked eye. They might not cause any pain but their presence is marked with the symptom of bleeding through the anus.
  • External Hemorrhoids: They are formed in the outer lining of the anal creating extreme discomfort and pain. They are sometimes invisible and the other times develop as a lump. These can also form blood clots within the mass that slips down.
  • Prolapsed Hemorrhoids: When internal haemorrhoids swell and sticks outside your anus the situation is coined as prolapsed haemorrhoids. These lumps cause discomfort or pain along with itchiness and burning.
  • Thrombosed Hemorrhoids: These swollen bulges around your anus are blood clots within the haemorrhoid tissue. Due to lack of blood supply to your rectal tissue, thrombosed haemorrhoids need to be attended to urgently to prevent severe complications.

Signs and symptoms

The symptoms of piles subside on their own in a few days. However, in some cases, these must not be ignored. Since ignoring the initial symptoms can lead to serious complications, keep a check on these symptoms:

  • Rectal pain
  • Itching
  • Bleeding
  • Sore and redness in the anus area
  • Mucus discharge

It is strongly suggested that if you are bleeding during defecation or your haemorrhoids don’t improve after a week of home care, consult a doctor.

Treatment

The treatment for piles may vary depending on the type, degree of prolapse or the severity of the situation. However, these self-help tips may ease haemorrhoid pain and promote healing:

Drink plenty of water

Drinking 2 liters of water daily reduces the risk of piles, as it helps to keep the stool soft.

Fibrous foods

Including fibre-rich foods in your diet tends to improve the overall symptoms and bleeding from haemorrhoids. A healthy diet should contain the recommended amount of 20-30 grams of fibre a day.

Don’t hold back

Rush towards the toilet when you feel the urge, don’t wait for a convenient time. Delaying or waiting puts on more pressure on the rectum veins, which can worsen constipation thus aggravating haemorrhoid.

Exercise

Staying active prevents and eases constipation, thus reducing the pressure on the veins. It can also help you lose weight which is another major contributor to piles.

Avoid self medication

In case you feel your symptoms are worsening, consult a doctor immediately. Some over the counter medicines may give you temporary relief but for an effective treatment reach out to an expert medical practitioner.

Don’t exert pressure

Don’t force your bowel movement, pushing and straining can make haemorrhoids worse. If you are not relieved within 2 minutes then get up and try again later.

Disclaimer: The information included at this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.

Источник: https://pharmeasy.in/blog/piles-causes-types-symptoms-and-treatment/
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