21/01/2017
MANAGEMENT OF PILES(KOOKO)
BACKGROUND
Piles know in medical circles as Haemorrhoids is very common affecting people
of all categories and race, poor and rich, rural and urban, male or female adults
from about (20) twenty years to old age.
It affects only human being due to the upright stature. The condition is so widespread in Ghana
That almost all the herbal medicines are said to treat piles (kooko). This has led to proliferation of
Herbal drugs peddlers who are a community to lure people to try the herbal preparation.
The health hazard that these so-called piles medicines causes are so devastating that it needs the
concerted effort of all sundry to tackle this problem of drug abuse and misdiagnosis of health conditions as piles
People resort these herbs because they are afraid of the (surgical operation that forms part of the treatment of certain stages of Haemmorhoids and its complications. The palliative treatment in, the form of suppositories does not also help much since these patients have recurrences.
WHAT ARE HAEMORRHOIDS (PILES / KOOKO)
Haemorrhoids are caused by redundancy of part or all of the tissues lining the muscular tube which is the a**l ca**l.
Prolonged constipation results in hard faecal masses rubbing against at the mucous membrane as the bolus makes its way out of the a**l ca**l. Other causes such as straining or increased intra-abdominal pressure in cough, sneezing, lifting heavy objects, cyesis and child birth, obesity contribute to produce haemorrhoids. Many women date onset of piles from pregnancy. There is no doubt that the general softening of collagen which occurs during pregnancy. There is no doubt that the general softening of collagen which occurs during pregnancy and the severe stretching to which all the perinea tissues are subjected during parturition frequently combine to start the process.
STAGES IN PILES
1st Degree: there is slight protrusion of mucosa and bleeding while the affected person is passing stool.
2nd Degree: the piles mass protrudes from the a**s while passing stool and it returns when pushed inside
3rd Degree: the mass remains outside the a**l opening all the time causing great discomfort in addition to bleeding, constipation and resultant anemia and flatulence.
MANAGEMENT
The main aim of management of Haemorrhoids is the preventive measures which educate the patient on the causes and avoidance of recurrences when it is treated by modern methods. There are certain foods and drinks which causes bleeding in patients with piles, these include alcoholic beverages of any kind, too much sweet and bitters, okro, groundnuts, cola, coffee, hot pepper, pineapple, coconut, sugar cane, honey and mango. Patients are advised on having a regular passing of good-sized soft and include a regular diet of fruits and vegetables that allow free motion of the bowels.
NEW MODE OF TREATMENT
The patient is helped by the use of a new system of piles treatment recently introduced into the country by this hospital called the RING HAEMORRHOIDECTOMY. In this procedure, which is an outpatient treatment only there is no operative cutting or need for anesthesia. The procedure is painless and so is not and operation in its real sense.
A special rubber ring is applied over the base of the piles by use of directive vision through a protoscope an a piles gun. The procedure takes only three (3) to (5) five minutes and the patient can go home and do his or her normal work. It can also be done outside the hospital where special camps are set to treat large number of patients.
The rings do their job of thrombosis (clotting of the piles mass which gets fibrosed gradually and in three (3) to seven (7) days, are passed out together with the rings in the stool. The piles disappear thus affecting a total cure. The third stage of piles often is referred to as pr*****ed piles can only be cured by operative procedure in an institution as an indoor patient.
The Ring Haemorrhoidectomy is well established at Asafo Agyei Hospital, Kumasi. Many of its advantages include its non traumatic nature, no need of anesthetic, an outpatient one and quick and well suited to the poor and rural population of our country where the people cannot have modern medical facilities due to ignorance and poverty. The procedure has proved to a blessing to our poor and rural population aiming at this very common and debilitating ailment. As at now thousands of cases have been treated successfully at Asafo Agyei Hospital.
The procedure is cost effective and quite convenient when compared with other method such as cryosurgery, laser diathermy and injection. If patients are screened early and treated then the requirement for surgical operation will be limited. The patient needs not stay away from work after treatment.rning
