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SANTHOSH HOSPITAL
PILES &

PROCTOLOGY

SANTHOSH HOSPITAL
PESEAKH FOUNDATION For PILES
TELLICHERRY-1.

(N. Home 702
Phone < Personal 480
(.Resi.
429-

Dr. V. BHARATHAN
M.B.B.S., F.C.G.P., F.I.C.A.

Consultant Specialist,
Consultation by appointment.

COMMUNITY HEALTH CELL
'’■--'-.4- r,os>H

Bangalore - cr''

THE PROBLEM OF PILES-PILES A NATIONAL PROBLEM
Dr. V. BHARATHAN
The problem of Piles has been pestering the
mankind ever since man started walking on two legs.
It is the penalty man has to pay for adopting the erect
posture, as it is practically unknown in the four legged
animals. It is caused mainly by the incessant pulling
of gravity and the intermittent pushing during the act
of defecation. So the ultimate eradication of Piles can
be achieved only when man settles down on the moon,
where there is no force of gravity to pull on his anal
canal or he has to adopt the four-legged posture of his
fore-fathers. Both these solutions are only of theoretical
importance without much practical implication. We can
imagine about a Piles-free society probably in the next
century when man settles down in some of the celestial
planets. Till then we have to face this universal malady
which causes a lot of untold miseries and mental suf­
ferings for the afflicted victim.
Piles is a very common condition, almost as
common as the Common Cold. According to authori­
tative medical literature, it affects about 50% of the
adult population. At this rate, the number of Piles
patients in our country will come to millions and milli­
ons and the important aspect is that most of these
people are in the working age group. So the national

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loss in productivity in the farm and field and other
fields of activity is colossal and unimaginable. More­
over the amount of absenteeism due to Piles disease
cannot be assessed properly, as the Piles patient, due
to the inherent social stigma attached to the disease,
does not usually divulge the true nature of his condi­
tion. Hither-to Piles was considered to be a problem
for the affected individual and the Piles patient, due to
his proverbial irritability and idiosyncracy was at best
a source of nuisance to his familv members and imme­
diate neighbours also. It is with the intention of attra­
cting the attention of national leaders to the magnitude
or this grave national problem, we had undertaken
the conduct of free Piles Camps. The K. G. F. Camp
conducted in December 1985 at Kolar Gold Fields,
Karnataka, was unique in the history of medicine as
nobody had ever conducted a camp for Piles on such
a vast scale any where in the world. In two days time
more than five hundred Piles patients were examined
and treated free. Moreover, in December 1986 we
conducted a second follow-up camp to see that every­
body treated at the first camp was cured of the disease
and happy. The Ministers, M. Ps, M. L. As and other
leaders who participated in the camp were very much
impressed and they had assured me that they will take
up the problem at the national level and convey it to
the national leaders so that Piles can be taken up for
national eradication like Malaria, Tuberculosis etc.

Piles-signs & Symptoms,
One of the earliest symptoms of Piles is an awa­

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reness about the disease itself. A normal person has
no business to think about his anal canal, unless there
is some problem there. Once he starts unduly worrying
about the lower passages, it is usually the beginning
of the mischief. Bleeding during the time of stools is
a very important visible manifestation of Piles. Piles
is other wise known as Haemorrhoids due to this pre­
dominant symptom.
As the blood loss, increases,
the patient become anaemic and lethargic and the phy­
sical energy and mental efficiency deteriorate. In the
early stages the Pile masses are inside the anal canal
and the disease manifests by the presentation of sym­
ptoms like bleeding, irritation, itching, discomfort,
difficulty in passing motion and various other vague
symptoms. During the second stage. Pile masses come
out during motion but go in automatically after the
motion. During the third stage Pile masses come out
but they will not go inside, and has to be helped in with
the help of fingers. And when the disease progresses,
the Pile masses will come out during coughing, sneesing and weight-bearing etc. causing great inconveni­
ence in delicate situations. During the fourth stage
Pile masses come out and will not go inside and due to
thrombosis and swelling, it will cause unbearable pain
and suffering. I remember the story of an Honourable
Minister who had to excuse himself from Cabinet sess­
ions under the pretext of meeting some party bosses
because of this inconvenient symptom. The mucoid
discharge coming from the Piles produces intractable
itching and irritation, and becomes a social inconveni­
ence for the unfortunate victim. Due to the disturba-

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nee and loss of sleep for several nights, the mental
equilibrium is also upset and he becomes a candidate
for the psychiatrist also. Due to the constant wetting
and soiling of the under clothes, the patient may have
to avoid long journeys and social contacts. So ultima­
tely the Piles patient is going for a lonely and depress­
ive phase of life, avoiding public contacts and thinking
only about the gloomy picture of his own disease.
Eventually the Piles patient becomes so morbidly con­
cerned about his bottom, so that whatever topic, poli­
tical or social, you try to engage him, he always reverts
back to his bottom. This is known as the Piles person­
ality.

Another important symptom of Piles is constipa­
tion-difficulty in passing motion-and a sense of incom­
plete evacuation.
"A good morning begins with a
good motion". If you don't get a good motion, the
sense of dissatisfaction and irritability will persit throu­
ghout the day. Some people go to the toilet with a pack
of cigarette and come out satisfied after finishing the
whole as smoke. There are some others who go for
the morning routine with the newspaper and go throu­
gh it from top to bottom before attaining their motive.
Constipation can not only cause Piles, but aggravates
it also. Moreover, constipation can be caused by Piles.
Anybody who goes to the toilet and engages in protra­
cted orgy of straining for half an hour or frequently
visits the same and spends a few minutes will ultimat­
ely develop Piles. There are people who take their
regular daily dose of purgatives and some people go in
for daily enemas and there are some others who resort
to the help of their fingers for achieving the some goal.

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"Gas Trouble" is a common complaint of the Piles
patient, even though the modern medical man does not
give much importance to "Gas", it is a real problem for
the patient. Due to the "Gas", patients can have a lot
of vague and ill-defined symptoms in the Abdomen.
Chest and head, simulating Peptic Ulcer, heart disease
and neurotic problems also.
I know a Piles patient
working in the Gulf who was treated by the GastroEnterologist and Cardiologist for his symptoms pertain­
ing to the respective organs. Ultimately he landed in
the hands of the Psychiatrist and was admitted in the
Mental Hospital. After undergoing treatment for Piles
he was pleasantly surprised to see all his symptoms
disappear and that was conveyed to me in his letter.
They are subject to vague rheumatice type of pains in
the joints, back and legs etc. There may be discomfort
and difficulty in passing urine also and some people
complain about sexual neurasthenia also. In elderly
male patients, It can produce symptoms suggestive of
Prostatic enlargement. I have seen so many patients
posted for operation for Prostate getting relieved of
their trouble in passing urine after treatment for Piles.

Piles patients are traditionally afraid of chicken,
eggs, meat and other rich foods. Just like Diabetic
patient is detected when he says "without sugar” in
coffee, the Piles patient can be easily found out when
he cleverly avoids chicken when others are relishing it.
Even if you are endowed with all good things in life.
Piles is a nasty condition which will not allow you to
enjoy it. So ultimately the Piles patient becomes the
laughing stock in any company. When patients with
Diabetis, Hypertension and Heart Disease proudly

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present their symptoms in front of the audience, the
Piles patient usually avoids mentioning about his
condition for fear of losing face in public.

A description of the symptomotology of Piles will
not be complete without going through other associate
conditions [ike Fissure-in-Ano, Fistula, Prolapse Rect­
um, Polyp, Peri Anal Infection and Abscess. Most of
these conditions are seen along with Piles. Whatever
happens around the Anal Canal, the patient always thi­
nks it is Piles.
Fissure-in-Ano is one of the most painful Anai
disorders. It is a small crack on the Anal margin and
everytime when the Anal Canal dilates during the pass­
age of-motion it causes excruciating pain, radiating to
surrounding areas lasting for a few hours forcing the
tired patient to the bed. Ultimately the patient is afraid
of passing motion and takes to strong purgatives and
local applications without much benefit.

Fistula-in-Ano is actually a communication bet­
ween the inside and outside of the Anal Canal. It is a
distressing and troublesome condition producing recu­
rrent infection and discharge of pus and escape of
flatus and fecal material also.
Peri Anal Abscess is an acutely painful condition
caused by local infection. Unless it is properly treated
by suitable early surgical measures, it can give rise to
complications like Fistula-in-Ano.
Prolapse Rectum is a distressing condition where
the rectum protrudes outside duting motion. Whereas

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Piles appear as discreet masses at 3, 7 & T1 O' Clock
positions. Prolapse appears almost like a balloon
coming out of the Anal opening,
Polyp usually occurs in children appearing as
cherry-red bleeding nodule coming out of the Anal
Canal during motion.

Causes of Piles
As I had mentioned earlier Piles is caused by the
unavoidable downward pulling action of gravitational
force and the intermittend pushing during daily motion.
Heredity is an important factor. I have got so many
Piles patients in my list presenting as father and chil­
dren, mother and children and other blood relations.
Just like Diabetis, Hypertension and Heart Disease, the
root cause of Piles is due to irregularities in exercise
and sofisticasion in food habits associated with adva­
nce of civilization. The anal canal is so designed that
it should be dilated by the passage of a proper sized
motion. For that you should take plenty of fiber-con­
taining food along with the usual food. Instead of
correcting their faulty habits of food and exercise, peo­
ple try to purchase health by paying money going to the
Doctors and medical shops.

In females. Piles is associated with pregnancy
and delivery. The increase in intra abdominal pressure
and the associated constipation is the casuative factor.
Most of the cases recover after the delivery only to
recur with renewed vigour in the next delivery. So by
making use of the family planning methods you are
helping your cause in both ways-by preventing unwan­
ted additions to your family as well as by avoiding the

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onset of adire disease like Piles. So the family planning
workers can take up this new slogan "for prevention of
Piles adopt family planning methods".
But ofcours
this is not applicable to males.
One interesting observation is that Piles is very
common in people going to the Gulf countries. This is
not mentioned in medical literature. Those who don't
have Piles develop afresh and those having minimal
symptoms get aggravated after going to the Gulf. This
may be due to changes in climatic conditions and food
habits.

Piles-Treatment
It is with the intention of clearing certain misun­
derstandings and misconceptions about the treatment
of Piles that this article is presented.
Nobody has
ever discovered any medicine for the cure of Piles in anv
system of medicine. Just like treating other diseases
like Typhoid and Tuberculosis, you cannot get Piles
cured by taking medicines internally or by taking a few
injections. Don't waste your valuable time and money
by prolonged medical treatment. Medicines can at best
produce only temporary palliation of symptoms along
with the natural ups and downs of the disease with the
everpresent danger of complications and progression of
the disease from first to fourth degrees Don't delay the
treatment of Piles. That will lead to avoidable compli­
cations and unnecessary sufferings due to complica­
tions like Infection, Abscess, Fistula and Fissure-inAno, Thrombosis and prolapse severe bleeding and
Anaemia and loss of mental peace also.

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The Piles patient is actually facing a dialemma.
If he goes to the ordinary Doctor he will be prescribed
with the universal ointment and Piles tablets which are
uniformally ineffective. And once he goes to the surg­
eon he is prescribed with the dreaded operation for
Piles and the operation is considered to be more pain­
ful than a heart operation. So the patient unwillingly
goes on prolonging the treatment until he lands up with
some complications.
Now there are easy and effective methods for
the treatment of Piles without much discomfort, prolon­
ged hospitalisation and Anasesthesia. Early treatment
of Piles is easy both for the patient and Doctor.

A message for Piles Patients
Piles patients need not be disheartened or disapp­
ointed Just like Diabetis Association, Heart Founda­
tion and Cancer Society, there is an association for the
Piles patient based in Kolar Gold Fields, Karnataka
known as Piles Treatment Promotion Council.
For the prevention of Piles and other diseases
you have to cultivate regular habits in food and exercise.
Suppose you take mainly meat, fish, chicken, eggs,
milk, butter etc. after digestion and absorption there is
very little residue is left behind. So it is essential that
fibre-containing foods like fruits, and vegetables also
should be included in sufficient quantities. As far as
possible, fruits should be taken with the outer convering and the habit of preparing fruit juice in modern
Mixies discarding the fibre-containing residue should
be discouraged. Taking lot of water is good for the
prevention of Piles as well as stones in the urinary
passages. It is not advisable to sit for a long time at
one stretch. Straining too much in the toilet nor going
to the toilet at frequent intervals is advisable. And the
system of taking laxatives and purgatives is also a bad
habit.
But fibre-containing bulk producing laxatives

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like Isabgol Husks can be taken in sufficient quantities
for re-educating the bowel habits. By adopting suitab­
le family planning methods, number of deliveries should
be brought down so that incidence of Piles also will be
reduced. Even if you are ill or well it is advisable to go
to your Doctor or hospital for a complete medical
check-up periodically for the prevention of disease as
well as for the detection of early warning signs. During
my medical career I have seen so many patients but no
normal person has ever come to me and told me
"Doctor, I don't have any particular disease, but I feel
1 should have a medical check-up". All that glitters is
not gold and all that bleeds from the bottom is not
Piles. So many patients who have come to me with the
firm self-made diagnosis of Piles have even turned out
be Carcinoma of the Rectum. Almost all the diseases
of the lower passages including Carcinoma and Piles
etc. have common manifestations. So if there is a
minor symptom, do not neglect. Now we have got eff­
ective diagnostic and preventive methods for Diabetis,
Hypertension and Heart Disease even before the patient
is aware of it. So by taking the necessary corrective
measures by changing food, habits, physical exercise
and also by avoiding smoking and excessive drinking of
Alcohol, you can be a useful member of the society.
Once you become ill, it affects not only your health but
it affects the health of the family, society and the
nation at large.
Courtesy
Piles Treatment Promotion
A. I. R.
Council, Robertsonpet,
Calicut.
Kolar Gold Fields, Karnataka.

Dr. V. BHAftATHAN
Santhosh Hospital for Piles & Proctology
TELLICHERRY-1.
Kerala, South India.
Phone: 702

C"LL

;
47/!.

Flee . St.
'■ ro C01.

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SANTHOSH HOSPITAL

Where the doors are open for all
irrespective of caste, creed or poverty.
Neither Kingdom nor Heaven do
I desire but only the selfless service of the
suffering Humanity.

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