Piles and Fistula
Your anal canal is a short, muscular tube with blood vessels that connects your rectum (back passage) with your anus. Piles can develop when this tissue becomes swollen, possibly as a result of straining on the toilet. Sometimes, piles can be painful and bleed if they become damaged.
Symptoms of Piles
Piles don’t always cause pain or other symptoms. If you do have symptoms, they can include:
• bleeding when you have a bowel movement – you may see blood on toilet paper or drips in the toilet or on your faeces.
• a lump in or around your anus.
• a slimy discharge of mucus from your anus, or leaking faeces.
• a feeling that your bowels haven’t emptied completely.
By making diet and lifestyle changes, you can often help to relieve your symptoms. For example, eating a high-fibre diet will make your stools softer and easier to pass. This is important for reducing the pressure on the veins in your anus caused by straining when you have a bowel movement. Examples of high-fibre foods are raw fruit and vegetables, cereals and fibre supplements. Drink enough fluid to keep hydrated, and don’t have too much caffeine.
Try not to strain when you’re passing a bowel movement. Afterwards, gently clean around your anus with moist wipes or baby wipes and pat it dry. Regular warm baths two or three times a day may relieve some of your symptoms. If you have trouble getting in and out the bath, you could try a sitz bath. This is a portable water basin you can sit your hips and buttocks in. Some experts think there isn’t enough proof that sitz baths help to treat piles though.
There are certain treatments that you’ll need to go into hospital for as an outpatient. You won’t usually have to stay overnight. These include the following.
• Banding. This involves placing a small elastic band around the pile, which cuts off the blood supply. This causes it to die and fall off after a few days. The area left behind will heal up naturally.
• Sclerotherapy. This involves having your piles injected with an oily solution, which makes them shrivel up.
• Infra-red coagulation or laser treatment. This uses infra-red light to seal the veins above the pile, which causes it to shrink.
• Bipolar diathermy and direct current electrotherapy treatment. This uses an electrical current to destroy the pile.
• Most people who have one of these procedures find that it helps. You may be offered a newer procedure called Doppler-guided haemorrhoidal artery ligation. This uses an ultrasound probe to find an artery in your anal canal that can be stitched up to limit the blood supply to your piles. Experts aren’t yet sure how well this procedure works.
An obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labor, leaving a woman incontinent of urine or feces or both.
For women with obstructed labor, labor that goes unattended, the labor can last up to six or seven days. The labor produces contractions that push the baby’s head against the mother’s pelvic bone. The soft tissues between the baby’s head and the pelvic bone are compressed and do not receive adequate blood flow. The lack of blood flow causes this delicate tissue to die, and where it dies holes are created between the laboring mother’s bladder and vagina and/or between the rectum and vagina. This is what produces incontinence in a fistula patient.