Painful Piles

The constant straining caused by constipation causes the apana to pull the physical structure out of alignment.

Haemorrhoids or piles commonly occur with constipation, being caused by the straining associated with the difficult passage of faeces. Despite popular opinion, they don't necessarily require surgical treatment and are potentially curable by simple yogic exercises. The same yogic techniques that remedy constipation can be used with amazing efficacy in haemorrhoids. If you treat one condition, you also treat the other. Haemorrhoids are swellings of the veins around the outlet of the rectum. They appear as distended purple sacs, like varicose veins on the legs. Haemorrhoids are a common problem with all age groups and it is estimated that in the western hemisphere more than 50% of the population over 5o years of age have at least some haemorrhoidal formation, with or without any symptoms. Haemorrhoid symptoms include: bright red blood, prolapse of the haemorrhoid mucus discharge, anal irritation, itching, and anaemia (caused by blood loss). They are classified from mild to severe, depending on the degree of prolapse, that is, how much they protrude from the anus:

  1. First degree haemorrhoids project into the anus.
  2. Second degree are larger and prolapse on defecation, but come back into place spontaneously.
  3. Third degree prolapse at any time and must be pushed back manually.

Cause of haemorrhoids

Though haemorrhoids are associated with constipation and straining, they also occur in pregnancy, cirrhosis of the liver, and as an inherited condition. As they may be found with cancer of the large bowel, a thorough medical check up is recommended. This will free the mind from worry and enable the therapist to institute the correct treatment.

Mental tension is the primary cause of haemorrhoids. People who are always in a hurry often strain on the toilet because they want to finish quickly in order to do something else. These people live in the future and cannot enjoy the present. Instead of allowing defecation to be a relaxed and pleasurable experience, they rush through it and in the uncontrolled actions that follow, the tissues deform under the pressure of excessive tension and strain. Stress causes spasm of the anal muscle, although we may not be aware of it, and defecation is disturbed. The spasm increases the intrarectal pressure leading to congestion of veins and straining. Eventually haemorrhoids form.

When we are always straining downwards, the body's energies adapt and form new patterns. The downward energies in yogic literature called apana (those involved in defecation, urination, the passing of flatus and the birth process) become predominant over the upward energies called prana (those involved in the breathing cycle), causing imbalance in the body. Unless we rectify this problem through yogic means, no cure can be permanent. This is why haemorrhoids reappear even after surgery, which is a painful and distressing procedure.

Diet is another factor implicated in the cause of haemorrhoids. Constipating, low fibre, high protein, high fat foods are hard to digest and transport through the intestines. Much energy is depleted in the effort to metabolise this diet. A sedentary lifestyle with little physical exercise further weakens the body and lowers the energies within. As a result, peristalsis, which requires an abundance of energy to work efficiently, is slowed down and there is not enough power left to make the expulsion enjoyable.

Reversing the condition

At the physical level we have to break down the tension that is causing the haemorrhoids to form. The first area to treat is tension in the haemorrhoidal area itself, and the second is tension within the personality. Yoga offers the techniques to directly approach both these problems and to eliminate them.

Many doctors believe that haemorrhoids are a reversible condition and have based their cures on this fact. Lord, who devised a relatively successful and widely used method, has based his procedure "on the belief that haemorrhoids constitute a reversible condition and that they are caused by a narrowing of the lower rectum and/or anal canal. The narrowing interferes with the normal processes of defecation and leads to an abnormal raising of the intrarectal pressure during the act, causing congestion and hence haemorrhoids."*1

This raised pressure is the increased energy in the lower abdomen (apana). Lord tried to disperse this tension causing energy by forcibly dilating the anus and thereby breaking the muscle spasm. Yoga uses a much more gentle approach, but with the same objective in mind. Moola shodhana massages and soothes swollen, inflamed haemorrhoidal tissue, and breaks up spasm. It also sends the stagnant, pooled energy and blood upward by stimulating the mooladhara chakra area.

Modern medical therapy, on the other hand, offers the following treatment when piles are causing symptoms such as pain, itching, bleeding or discomfort:

  1. General measures start with keeping the anal area clean and dry. This means that after every motion, the area should be washed with cold water and dried; toilet paper should be avoided. This is the traditional Indian method of hygiene and proves to be more soothing and sanitary, (provided soap is used to wash the hands afterwards), because the cold water constricts the vascular tissue. Regulation of bowel habit is another important item. For this a high fibre diet is recommended using bran, wholemeal bread or chapattis, fruits and vegetables as well as plenty of fluids. This eliminates constipation and may be all that is required for cure.
  2. Injection therapy uses a corrosive substance which is injected into the haemorrhoid to create scar tissue. It is hoped that this will stop first degree haemorrhoids from developing into second and third degree.

Rubber band ligation is the tying of second and third degree internal haemorrhoids with an elastic band to strangle it and cause it to slough off. It has been quite successful and it is painless. It does not require hospitalisation whereas operation does.

Operations are of two types:

  1. anal dilation such as Lord's procedure where 8 fingers are inserted into the anus which is subsequently stretched.
  2. excision of the haemorrhoid, an old, painful and time consuming procedure which is losing favour with many doctors. It should only be used when absolutely necessary and other modes of treatment have failed. It is unnecessary when one uses yogic techniques which remove the haemorrhoids, and the root cause.

Haemorrhoid sadhana

Haemorrhoids very rarely require urgent medical treatment, and therefore it is worth your while to give some time to the following yogic techniques Which have been time tested and shown to remove the bodily and mental tension which causes spasm and constriction of the rectum muscles.

Haemorrhoid sadhana is divided into two main parts:

  1. The alleviation of constipation - see the section on constipation.
  2. Specific practices for piles:
    • Hatha yoga: Moola shodhana, nauli.
    • Asanas: Sarvangasana or vipareeta karani mudra (which drains stagnant blood from the anus).
    • Mudras and bandhas: Ashwini mudra (can be practiced on its own at any time of the day or with the inverted asana), moola bandha.

References

*1. P.H. Lord, Proc. Roy. Soc. Med., 61: 935, 1968.