Authored by Dr. Mahesh Chikkachannappa, Sr. Consultant – General, Laparoscopic & Bariatric Surgery, Aster CMI Hospital. Piles, which is a serious health problem, and has many causes like pressure around the anus due to constipation, lifting weights, pregnancy and sedentary life, is now becoming common due to an entirely new cause – the lockdown. This may surprise you, but it is true. Lockdown leads to inactivity, personality changes, changes in the mentality of a person leading to boredom as people stay long indoors, anxiety about the pandemic, financial losses, pay cuts, non-availability of regular food products, which in turn leads to dietary changes i.e., either eating more or eating less food etc. All these factors as a result of the lockdown lead to piles. And the problem is common across age groups.
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If not treated appropriately, it’s like a pandemic for an individual and the problem is only going to become big. People are hesitating to visit the emergency department as they are worried about COVID- 19, and the long wait to see the emergency doctor. Piles is a social disease very rampant in society and may be the most common condition a surgeon would see in his clinic, but is less operated upon (not all piles require surgery). And the occurrence increases during a pandemic by at least 20 to 30 percent.
It is considered a stigma to talk about it in society due to which patients try to find solutions stealthily and many a time harm themselves. Lack of adequate medical assistance during the pandemic will lead to hasty and unconventional steps leading to complications like bleeding and rupture of the piles wherein patients have to rush to the emergency. There’s lot of information about COVID 19 and plenty of protocols for many other conditions/surgeries but, everybody has forgotten the common problem of piles, which has been troubling many individuals.
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How do you treat piles? Eating healthy foods like fruits rich in fibers like bananas, mangoes, pulses, raw vegetables, anti-inflammatory foods like almond, salmon fish, vitamins, liquids, physical activity, walking indoors, swimming, yoga and sex, all of this helps burn calories and avoid formation of piles during the lockdown. A tele-consultation with your doctor will also definitely help relieve your agony. There are plenty of ointments and laxative powder and syrups too available to use for patients with piles. Surgery for piles can wait most of the times, but lifestyle changes will definitely help. Beat the lockdown, modify your lifestyle and adapt to the situation – all of this will help.
There are some measures that can be taken people to prevent piles formation during lockdown like – regular warm bath bath, consumption of high fiber foods, oral pain reliever, topical treatments, pure aloe Vera gel, Epsom salt warm bath, cold compresses, comfortable clothing, stool softeners and Increase in water intake and consumption of salads often.
The problem need not always be piles, but it could be fissure, fistula, or tumour. So, as soon as you get an opportunity, it is important to have a physical consultation with your surgeon. There are winter and summer piles in the western world, but the treatment remains the same. Various surgical options like hemorrhoidectomy by laser, staplers or simple removal of the piles by a competent surgeon also help. There is no need to panic as it is a minor surgery and you would be off to home within a day and back to your regular activities in few days. Laser surgery would be the ideal treatment.
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However, a surgeon would avoid doing piles surgery as far as possible during the COVID 19 pandemic, until it is safe for patients and for the surgeons. There is literature that Coronavirus is present in the feces of an individual even if they are asymptomatic carriers. There has to be “safety in safety in safety” during the coronavirus pandemic to protect the healthcare providers as their help and presence is critical.
In conclusion, it can be said that it is important to follow the advise of World Health Organisation Director Tedros Adhanom Ghebreyesus, who said: “This is a time for facts, not fear, this is the time for science, not rumors, this is the time for solidarity not stigma.” This outbreak is a test of solidarity -political, financial and scientific. There is a need to come together to fight a common enemy that does not respect borders, gender or religion. While corona virus has to be fought, it is also important to fight other health problems like piles in the lockdown period. It is important not to ignore the symptoms that may show up during lockdown and consulting a doctor in this regard would be very useful.
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