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HAEMORRHOIDS, or HEMORRHOIDS (from Gr...
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See also:HAEMORRHOIDS, or HEMORRHOIDS (from Gr. aiµa, See also:blood, and bap, to flow) , commonly called piles, swellings formed by the See also:dilatation of See also:veins of the lowest See also:part of the bowel, or of those just outside the margin of its See also:aperture. The former, See also:internal piles, are covered by mucous membrane; the latter, See also:external piles, are just beneath the skin. As the veins of the lining of the bowel become dilated they See also:form definite bulgings within the bowel, and, at last increasing in See also:size, See also:escape through the anus when a See also:motion is being passed. Growing still larger, they may come down spontaneously when the individual is See also:standing or walking, and they are See also:apt to be a See also:grave source of See also:pain or annoyance. Eventually they may remain constantly protruded—nevertheless, they are still internal piles because they arise from the interior of the bowel. Though a See also:pile is sometimes solitary, there are usually several of them. They are apt to become inflamed, and the inflammation is associated with See also:heat, pain, See also:discharge and See also:general uneasiness; ulceration and bleeding are also See also:common symptoms, hence the See also:term " bleeding piles." The external pile is covered by the thin dark-coloured skin of the anal margin. Severe pressure upon the large abdominal veins may retard the upward flow of blood to the See also:heart and so give rise to piles; this is apt to happen in the See also:case of disease of the See also:liver, See also:malignant and other tumours, and pregnancy. General weakness of the constitution or of the blood-vessels and habitual See also:constipation may be predisposing causes of piles. The exciting cause may be vigorous straining at See also:stool or exposure to See also:damp, as from sitting on the wet ground. Piles are often only a symptom, and in their treatment this fact should be kept in view; if the cause is removed the piles may disappear. But in some cases it may be impossible to remove the cause, as when a widely-spreading cancerous growth of the rectum, or of the interior of the See also:pelvis or See also:abdomen, is blocking the upward flow of blood in the veins. Sometimes when a pile has been protruded, as during defaecation, it is tightly grasped by spasmodic contraction of the circular See also:muscular See also:fibres which guard the outlet of the bowel, and it then becomes swollen, engorged and extremely painful; the strangulation may be so severe that the blood in the vessels coagulates and the pile mortifies. This, indeed, is nature's See also:attempt at curing a pile, but it is distressing, and, as a See also:rule, it is not entirely successful. The palliative treatment of piles consists in obtaining a daily and easy See also:action of the bowels, in See also:rest, See also:cold bathing, astringent injections, lotions and ointments. The See also:radical treatment consists in their removal by operation, but this should not be contemplated until palliative treatment has failed. The operation consists in See also:drawing the pile well down, and strangling the vessels entering and leaving its See also:base, either by a strong ligature tightly applied, by crushing, or by cautery. Before dealing with the pile the anus is vigorously dilated in See also:order that the pile may be dealt with with greater precision, and also that the temporary See also:paralysis of the sphincter muscle, which follows the stretching, may prevent the occurrence of painful and spasmodic contractions subsequently. The ligatures by which the base of the piles are strangulated See also:slough off with the pile in about ten days, and in about ten days more the individual is, as a rule, well enough to return to his See also:work. If, for one See also:reason or another, no operation is to be under-taken, and the piles are troublesome, See also:relief may be afforded by warm sponging and by sitz-See also:baths, the pile being gently dried afterwards by a piece of soft See also:linen, smeared with See also:vaseline, and carefully returned into the bowel. Under surgical See also:advice, See also:cocaine or morphia may be brought in contact with the See also:tender parts, either in the form of lotion, suppository or ointment. In operating upon internal piles it is undesirable to remove all the external piles around the anus, lest the contraction of the circumferential scar should cause permanent narrowing of the orifice. If, as often happens, blood clots in the vein of an external pile, the small, hard, tender swelling may be treated with See also:anodyne fomentations, or it may be rendered insensitive by the See also:ether spray and opened by a small incision, the See also:clot being turned out. (E. Additional information and CommentsThere are no comments yet for this article.
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