How Piles Can Be Prevented?

Hemorrhoids in their natural anatomical state are cushions of submucosal tissue containing venules, arterioles, and smooth muscle fibers in the anal canal. But when they cause severe discomfort, pain, inflammation, itching & bleeding due to the varicosities of the veins of the arterial & venous plexus, usually presumed to be caused by repeated pressure in the anal and rectal veins by certain factors like constipation, excessive straining during bowel movements, loss of muscle tone due to old age, rectal surgery etc lead to haemorrhoidal disease. 

Ayurveda encompasses on ‘ nidana parivarjana’ i.e. to avoid the known disease-causing factors in diet and lifestyle & also refrain from precipitating factors of the piles is most important. 

A: Precipitating Factors of Piles

Usually, the cause of the piles lies in the excessive pressure on blood vessels that are located inside and around the anus. Piles generally occur to those people who are suffering from long term constipation. Several risk factors can be listed that should be kept in mind because these risk factors can increase the piles problem in a person.

I: Faulty dietary habits

• Persistent depletion of food lacking fiber, excessive meat consumption
• Consuming incompatible food combinations (Virudhha-aahar)
• Taking food when the previous meal is not digested well
• Regular intake of dry vegetables, dry meat & spicy fried junk food items

II: Prolonged constipation

• Habitual straining in a constipated state
• Irrational use of stool softeners worsening constipation
• Hereditary history of piles aggravates this factor

III: Faulty habits of defecation

• Forceful suppression or expulsion of natural urges of defecation, flatus and micturition
• Too much straining during defecation
• Sitting in a squatting position for a longer time
• Continued excessive strain

IV: Psychological factors

• Eating unwholesome food reflects a state of despair
• Stress, worry & depression
• Eating meals in a hurry

V: Physical injury or trauma

• Injury to the anal area might result in painful defecation letting the person avoid defecation, which will worsen the condition by leading to chronic constipation.

• The pressure of the pregnant uterus, repeated miscarriage, abnormal or complicated delivery, type of child-birth result in varicosity in the anal area & venous supply.
• Obstetric injuries such as sphincter tear lead to pain & discomfort while defecating.

B: Preventive Measures

A healthy diet and a healthy lifestyle help to maintain the overall health of the body. Lifestyle modification should be a part of treatment as a preventive measure for any degree of hemorrhoids. Some treatments help relieve symptoms right away while others involve making changes in the diet & lifestyle regime to help ease constipation and prevent hemorrhoid symptoms from coming back.

The following measures help to prevent the pile’s occurrence & worsening further;

I: Fill Up On The Fibre-rich Diet

Dietary habit is the key link as shearing action of passing hard stool on the anal mucosa results in damage to the anal cushions leading to hemorrhoids. Thus increasing the intake of fiber and providing added bulk in the diet might help eliminate straining during defecation by softening hard stools & reducing the frequency of constipation. People who prefer a high fiber diet are at lower risk of piles as compared to those who prefer a diet rich in processed foods. 

• Adequate fibers aid in thickening the stools & make bowel movements less traumatic.
• Fibers cause absorption of water in the stools within the colon making the stools softer with increased volume. 
• Include legumes, such as split peas, lentils, black beans, lima beans, and baked beans, whole grains, such as barley, bran flakes, oatmeal, and brown rice, vegetables, such as carrots, artichoke, green peas, broccoli, and Brussels sprouts and fruits, such as pomegranate, raspberries, pears, apples, and bananas
• Females having painful stools around the time of menstruation should start taking extra dietary fiber and fluids a couple of days prior to periods. 

II: Stay Hydrated

Drinking enough water helps prevent constipation and thus decreases the need for straining by aiding in running the digestive system smoothly.

• Drink at least 6-8 glasses of water daily to keep the stools lubricated.
• Alcohol and caffeine-containing drinks like tea, coffee and colas should be avoided.
• Include fresh fruit juices, such as prune, apple, cranberry, and pomegranate to prevent constipation.

III: Get Plenty of Exercises

Physical exercise helps to stimulate the lymphatic system and aids in keeping the colon in check and also relieves pressure on the rectal muscle thus lowering the burden. 

• A regular physical workout helps in weight management and also aids in regular bowel movements thus keep the colon contractions more regular.
• Include low-impact activities, such as swimming or a 30-minute brisk walk, yoga asanas and breathing exercises by taking it easy at first.
• Avoid sitting for long hours and move more by having a 5-minute walk after every 20 minutes sitting in between working hours.
• Manage weight to help overcome obesity the leading risk factor for piles.

IV: Be Careful With Stool Softeners

Stool softeners are medications that may be used in people with constipation to correct constipation before it can predispose to piles. The safest stool softeners & laxatives help to work in harmony with the body rather than those that stimulate or simulate normal physiological activities, worsening the condition even more.

• Opt for the herbal stool softeners that work by increasing the amount of water in the digestive tract helping in the smooth evacuation.
• Use them wisely, without getting habitual to their usage.
• Isabgol husk, Haritaki powder, Triphala powder, and Avipattikar powder are certain Ayurvedic formulations effective in treating constipation & hard stools without many side effects & are not moreish.

V: Don’t Hold The Urge

Ignoring natural urges of defecation, micturition and even flatus results in the damaging of the nerves in the rectal area & thus responds inappropriately to the stool in the rectum as the brain stops responding to the stimulus of urge. It is advisable not to fight the urge & need to pass stool since it can worsen the piles by putting pressure on the veins in the rectum. 

• Don’t hold bowel movements as waiting may harden the stools.
• Do not sit on the toilet for more than 5-minutes, if there is no urge then the person should get up.
• It is advisable to wait until one really feels the need to go to the toilet and then spend no more than a minute or two in the lavatory. 
• Avoid sitting and waiting to pass that last little piece of the stool.

VI: Avoid Excess Straining

Good bowel habits should be practiced as being aware of the excessive strain while defecating.

• Avoid any activity which leads to an increase in the pressure in the lower rectum. 
• Avoid straining for more than a few seconds while having a motion.
• Don’t strain or hold your breath during bowel movements. 
• Go to the bathroom as soon as one feels the urge to defecate.
• Abstain from both straining and reading on the toilet.
• The rectum empties better when in a squatting position. Hence when using a Western toilet, place a stool under the feet and lean forward to mimic that position.

VII: Maintain Anal Hygiene

The anal area & lower rectum should be treated with as much care as other sensitive areas of the body.  It is crucial to keep the anal area clean with self-cleaning anal hygiene tips mentioned as follows; 

• Use lukewarm water preferably to clean the skin around the anal area gently.
• Avoid usage of any alcohol-based or rough tissue wipes.
• Strictly avoid vigorous wiping, especially with dry toilet paper, as it irritates the skin around the anus.
• One should avoid wearing tight clothing and underwear garments as they contribute to irritation and poor muscle tone in the anal region. So wear loose-fitting dresses and undergarments for comfort.

VIII: Ayurvedic Herbal Remedies

The healing action of natural Ayurveda herbs helps to identify pain points in patients suffering from piles & nurture them on their journey to wellness. Along with dietary & lifestyle management, correction of metabolic errors with natural herbs is the key to curing piles effectively. Ayurveda has innumerable herbs to help cure piles;

• Applying coconut oil to the affected area in the anal region helps to reduce swelling, irritation and urge to scratch the region. 
• A warm Hot sitz bath with lukewarm water and spahtika powder, after each time of defecation, reduces discomfort and calms spasm of inner sphincter & thus helps to ease the pain of anorectal conditions.
• Take 1 tbsp of Triphala powder every night before going to bed, with hot water for smooth bowel evacuation.
• Castor oil with its properties like anti-oxidant rich, anti-bacterial and anti-inflammatory can be used in two ways to heal piles. Either apply locally over the anal area after hot sitz bath or take 3ml of castor oil with warm milk at night to alleviate the pain and symptoms of piles.
•  Use a cold compress or ice pack to soothe the large & painful piles as it helps reduce the swelling and inflammation. 

The improved awareness of a healthy diet & lifestyle and hygienic bathroom behavior modifications on the patient’s part, can help in complete resolution of the pile’s symptoms. Ayurvedic herbs balance the doshas with a combination of diet, lifestyle modifications, and herbal remedies.