Bawaseer jehnu Haemorrhoide kehnday ah

Bawaseer nu angreezi ch Haemorrhoids, piles, Punjabi urdu/ hindi arabi tay farsi ch vee ehnu bawaseer kehnday ah. Ehday ch bund day bahr tay bund day andhar lining tay tissue tay kuch swelling ho jaandi ah jehnu Bawaseer tay Haemorrhoids kehnday ah.

Ehdiyaan nashaaniyaan mukhtalf ho sakdiyaan. Chotay bawaseer day mohqay aam tor tay dard nehn kerday.. bawaseer dee aam nashani eh ah keh tatti kernay toon  baad khoon aunda yaan khoon wali tatti hundi ah. Waday mohqay naal laisla (mucous) mada discharge kerday ah., kuch dard kharash tay khujli hondi ah..Eh laisla discharge ho sakda bund ch tay bahr irritate skin nu karay.. Tuwanu aidaan lag da tuwadee bund pharee hoi ah.tay eh vee lagay keh tuseen chungi taran full tatti nehn kitti.

grade 3-4  bawaseer ch zara complication hundi ah keh haemorrhoids bund toon bahr thalley nu lamak jaanday ah. Jehra keh Blood clot (thombosis)  hunda a jehra haemorrhoids day wich ban da.. Eh aina common nehn pehr agar huway tay buht dard hundi ah.eh blood clot honay naal

Bahrli bawaseer  jehnu perianal haematoma kehnday ah

Es type dee bawaseer aini aam nehn hundi  jinni internal haemorrhoids. Eh bahrli bawaseer ik lump no kehnday ah jehra bund day mohn tay bun jaanda ah. Kai dafa ehday symptoms day vee pata nehn lagda. Agar haemorrhoids ch blood clot ban jaway (a thrombosed external haemorrhoid) tay ehday naal buht dard ho jaandi ah jehri buht jaldi tuwadi tuwaja chaundi ah. Eh thrombosed haemorrhoids dee pain peak tay hundi ah 48-72 hours. Eh dard phay holi holi 7-10 din ch chally jaandi ah. Eh baaz dafa bleed vee hundi ah tay ehtoon baad lump da size balkol kaht jaanda ah tay nishaan mungu reh jaandi ah.

Andharli Bawaseer  (Internal Haemorrhoids)

Andharli bawaseer   back passage dee opening toon 2-4 cm autay andhar hundi ah. Tay ehday ziyada tay wadah honay dee wajah toon  char grades kittay hoay ahah

Anderli bawaseer  Day darjay (grading)

Grade 1  bund dee andharli lining tay  thori sauj ah. Eh bahron dakhi tay mahsoos nehn kitti ja sak dee. Grade 1 haemorrhoids aam lokaan ch ah tay kai lokaan nu ehton wadh kay grade 2  yaan ziyada ho jaandi ah.

Grade 2 Eh bowaseer day mohqay zara wadhay hunday ah. Ho sakda eh thoray jehay bund toon bahr hoon (prolapse). Jidoon toilet jaanda au tay ohtoon baad eh andher chaley jaanday ah.

Grade 3  ehday ch bawaseer day mohqay bund toon bahr nazar aunday ah

(proplaps).Tuseen ho sakda ik do chotay lumps type  mohqay mahsoos vee karo jehray bund toon  

bahr aunday ah.. Ehna nu tuseen ungli naal  andhar dhak sak day ao.

Grade 4 Bawaseer day es qisam day mohqay buht wadhay hunday ahtay bund toon bahr niklay rehnday ah. Ehna nu tuseen bund ch nehn dhak sakday. Baaz lokaan day eh buht waday ho jaanday ah,

Bawaseer  tay ehnoo kiddaan theek keriyay

Buwaseer (haemorrhoids ) swelling da naa ah jehri bundh dee lining tay tissue tay hundi  ah. Ehday symptoms aarzi darmiyaan tay persistant  tay dard allay. Buht cases ch bawaseer day mohqay chotay hunday ah apai theek ho jaanday ah.. Agar allaj dee zarorat paway tay eh kai taran day ah.

Bundh day andar lining ch small vains (blood vessels) da network ah Eh vains tay ehday tissue ch ziyada blood ah jaanda aam halat naloon. Eh vain stay engorged tissue dee ik swelling ho jaandi ah jehnu haimorrhoids kehnday ah.

Bawaseer honay dee sahi wajah tay hajay tak patta nehn keh eh kiyoun hundi ah. Kiyaan nut ay zahri koi wajah hundi ee nehn bawaseer honay dee. Eh khyal kitta jaanda tatti kernay day doraan bund tay jehra pressure painda ohdi wajah naal hundi ah.

:

Andaza ah Taqreeban Uk dee  adhi abadi ik stage tay ik yaan do tarran dee bawaseer da shaker hundi ah. Kai haltaan ch bawaseer honay day chances wadh jaanday ah.

Bawaseer honay dee wajah

 Qabaz  Bavaseer honay dee ik wajah wadi laindee (Large stool, Faeces) aunay nal jehri straining at the toilet. Ehday naal jehriyaan bund tay vains hundiyaan ohna tay pressure wadh jaanda tay eh aam wajah lag dee ah bawaseer honay dee.

Pregnancy.  Bawaseer pregnancy cha am hundi ah. Eh ho sakda baby day pressure  dee wajah toon howay jehday naal hormones change hunday ah. Eh aam tort ay baby day jamnay toon baad aap ee theek ho jaandi ah.

Ageing. Bund dee lining da tissue jidoon kaht support kerda jawain aseen buday hunday jaandan aan.

Warasat ch  Kuch lokaan nu bawaseer warasat ch mildee ah. Aidaan day lokaan cha am tort ay khandan dar khandan chaldi ah

Bawaseer bund dee ander wali lining tay bund day bahr mohn tay lump ban kay mohqay ban jaanay nu kehnday ah

Buwaseer day honay dee wajah da hajay tak patta nehn pehr aam khial ah keh jidoon aseen tutti kernay wastay zoor launday aan tay ehday naal kadeen  narran phul jaandiyaan. Aam tor tay eh phuliyaan hoyaan naraan apai theek hoo jaandiyan pehr kai wari eh apai theek nehn hundiyaan. Jay tay qabaz rehndi ah tay jidoon tay tutti aam  tutti naloon suki hoi hundi ah. Jes walay tutti kerday aan tay ehdi rugar naal andarli buwaseer day mohqay zakhmi ho jaanday ah jes naal khoon nakal da ah. Es wastay ehno khoni bawaseer kehnday ah.

Aam tor tay ik kissam dee bawaseer hundi ah pehr baaz dafa donu vee ho sak diyaan.

Paranay zamanay ch jidoon aini science nay taraqi nehn kitti see audoon mohqay pahwaan aam hon tay pahwaan bawaseer day ohda ik allaj hunda see. Un (wool ) da dhaga lai kay mohqay dee jerh tay buhn dainday see jehday naal muhqay nu khoon milna band ho jaanda see. Eh khoon dee muhqay nu supply band honay naal muhqa suk kay utar jaanda see. Zamanay ch thori jehi hor taraqi hoi tay dakhia un (wool) da dhaga aam na lubna tay lokaan nay ghoray day baal buhn kay kum chlauna shroh ker ditta.

Saday lokaan ch tay hun her koi apnay aap nu hakeem samaj daa ah. Kissay nu vee apna dukh yaan bamari dussu tay oh tawanu do char nuqsay zaror das dainda ah. Buwaseer saday aba jee nu see ik din meray kol ik sufi baitha hoya. Oh naa da sufi see aseen jehra thori jehi dari wadah luway ohnu sufi kehn lug painday aan. Aina pehrya likhya neh see tay namaz tay namaz pehri rakh da see. Kum tay hauna tay ohnay wajbi namaz ve pehrni hundi see. Jidoon ohnay bowaseer da naa sunyaa tay kehn lugga. Buwaseer day mohqiyaan da kih ah ehna nu phur kay khich kay bahr kadh dau. Odoon tay main ohdi gal sun lai kiyoun keh anparh lokaan naal jay tuseen gal nu wadauna shroh kar dawo tay gal kitay dee kitay upper jaandi ah.

Eh sufi nay tay keh ditta eh mohqiyaan nu phur kay khich dio pehr ohnu eh nehn pata see keh mohqay kidaan ban day ah. Mohqay khoon diyaan antaan kai jagah toon phulan naal ban day ah. Tay ais taraan day khich khchaunay toon bachu.

Main tuwanu eh ee kahwaan gha keh agar tuwanu andarli bawaseer ah tay tuseen apnay doctor koloon ehdnu check kerwao. Eh vee ho sak da keh tuwanu khoon aunay dee hor koi wajah howay. Eh doctor da kum ah keh tuwanu mashwara daway keh tawanu kih kerna chai da ah.

Her koi allaj vee neh kerwa sak da. Kai lokaan wastay allaj tay kih roti khany nu nehn labh dee. Agar aidaan howay tay tuseen apni zindgi nu kuch chunga ker sakday au khanay peenay  ch khiyaal kernay naal

1  Tuseen buhta paani peewo (din ch 2litr tak). Paani toon murad eh nehn keh paani ee         peena ah. Tuseen Jo vee peena paani chaa, lassi, dudh, yaan koi fluid peenay wala.

2  Apnay khanay ch agar tuseen fruit yaan vegetables jehriyaan kachiyaan kha sakday ao tay khawo. Moliyaan gongloo, gajraan, taraan , kheeray kharbozay, phutaan hadwanaa Agar ainay paisay nehn tay mausam da koi vee phul tay vegetables jehriyaan sab toon sastiyaan aan ohna nu khawo. Aseen pattay sit  dainday aan yaad rakhu eh pattay vee ainay ee chungay ah jinay keh savziyaan tay phul. Moliyaan day patyaan da suad moliyaan warga hunda  tay ehna nu sit kay zayaa nah karo. Pakistan tay punjaab ch tay ainay keh tariqay warat sakday ao keh tuwanu paisay kharach kernay dee lore ee nehn. Pakistan ch namauliyaan hundiyaan see jehriyaan aam luggian hundiyaan see. Eh jinyaan kay khaa sakday ao khawo. Palak day pattay saday aam tor tay paka kay khaday janday ah pehr Europe ch palak day patay jehray chutay hunday ah oh salad ch khanday ah

3  Tutti nu her rose liyaunay wastay tuseen apnay khanay ch fibre wadah dawo. Eh fibre kih ah.? Ehdi sab toon sidhi masal attay da bura ah. Saday aam kahraan ch hunda see keh atta chaan kay bura pasoaan nu paa daina yaan sukiyaan ruttiyaan naal baich daina. Ik wari main Pakistan ghia tay bibi jee rutiyaan pkaun luggay tay main kehya eh atta chunghi tarran chaan liyaa see? Kehn luggay hun tay  jidoon diyaan Chinese chukiyaan aiyaan audoon toon atta chanan da chukker eh nehn rehya. Hun tay aina kay mulk ch kum bigar ghia bura vee peeh dainday ah. Buray ch thora atta paa kay roti bana kay khawo.

Ispaghol da chilka vee ik buht chungi masal ah fibre dee. Ehnu Ispagola angreezi ch kehnday ah. Ehday khanay naal tuwadi tutti malaim ho jaandi ah tay kerday hoay bawaseer day mohqiyaan nu zakhmi nehn kerdi. Kissay zamanay ch rupiyay day sikkay hunday see jehna da wazan ik tola hunda see tay ehday naal tool kay isapghol da chilka khanday see. Eh isapghol da chilka jay tuttiyan yaan dast lug day see tay log khanday see.

Hun tay kai angreezi companiyaan nay ik tolay diyaan puriyaan bana dittiyaan tay ohna ch phulan da essence tay mitha paa ditta. Ehday ch paani paa kay tuseen ik glass sharbat bana kay pee sakday au. Ik company nay ehda naa “Fybogel” rakhya ah. Agar tuwanu qabaz rehndi ah tay ehnu hataunay wastay Ispaghol da chilka buht chunga ah. Ik tolay diyaan puryaan bana lawo tay din ch do dafa ehnu glass ch paani ch paa kay mix ker kay pee lawo. Tin char haftay wartnay naal tuwad maida tay bowl normal ho jawo gha.

4 Jidoon ve tuwanu tatti kernay deen lore paway tay ehnu jaldi ker daiwo tay dair naa karo. Eh tuwaday dair kernay naal vee kum kharab hunda ah. Baazlok nu zarorat hundi ah tay toilet nehn jaanday.  Ehday naal laindi day size chaura tay ehday ch kuch kushki ho jaandi ah.Eh ik natural cheez ah tay ehnu natrual time tay karo.

5  Toilet jawo tay jaldi tuseen ehtoon farag ho jao eh nehn keh tuseen apnay naal katab yaan digest lai jawo tay tuseen perh day rehwo. Tuwada damaag tuwaday natural system nu signal dainda ah ah keh tatti bahr auni chai dee ah. Jes waqat tuseen toilet ch jaa kay pehrna shroh ker dainday ao tay tuwada damaag eh automatic signal toon hut kay jo tuseen perh day au ohnu store kern lug painda. Eh toilet ch perhna vee tuwanu qabaz honay dee ik wajah ah

6 Tuseen shower  kerday ao tay apni adapt bana lawo agar tuwanu bawaseer nehn vee tay apni bund tay tuhni nu chungi taran saban laa kay dohwo. Eh kernay naal tuseen tuhni tay bund diyaan kai bamariyaan toon bach sakday ao.

7 Apna underwear her rose badlo tay agar ho sakay tay istri ker kay pawo kiyoun keh istri kernay naal koi germs underwear ch hon tay oh mar jaanday ah.

8  Dard waliyaan oh goliyaan yaan syrup jehday ch codeine hundi ah such as co-codamol, as they are a common cause of  qabaz or constipation.

Agar tuseen eh autlay aath mashwariyaan nu warto tay  ehday naal tawanu jehra khoon aunda tay tatti kerday hoay takleef hundi ah oh kath jaiay ghi. Eh vee ho sak da keh tuwanu eh kernay naal kuch arsay baad bawaseer toon aram ah jaway tay towayday grade 1 day mohqay khatam ho jaan. Small grade 1 mohqay aam tor tay apai theek ho jaanday ah.

Waqti Allaj

Eh waqti allaj dan naa es wastay wartiyaa keh jiniyaan creams yaan mulmaan aan oh bawaseer nu theek tay nehn ker diyaan pehr khaj tay discomfort nu kaht ker diyaan jehday naal kuch rehn sehn chunga ho jaanda.

1 A bland soothing cream , ointment , or suppository may ease discomfort. Kai kisam diyaan mil diyaan baghair dotor day likhay toon. Apnay pharmacist de salah lawoo tay ehday naal wartnay da trikay naal warto.

2  oh cream  jehday ch anaesthetic hundi ah oh dard kathaun dee ah pehr tuseen eh lambay time wastay nehn wart sakday. Eh sirf tuseen thuray din wart sak day ao 5-7 din. Agar eh toon ziyad warto gay tay ho sakda ehday naal tuwadi bund tay kharash honi shroh ho jaway. Chungi gal ah jidoon eh khareed tay pharmacist koloon chungi taran puch lavo.

3  Agar tay mohqiyaan day dawalay sauj pai hoi ah tay tuwada doctor ho sakda tuwano cream jehday ch steroid likh  kay davay. Ehday naal sauj tay kharash kath jaandi ah. Aam tort ay tuwanu aidaan dee cream tuwanu ik haftay toon ziyadah nehn wartni chai dee. Ehday baray ch apnay doctor koloon pucho.

4  buht dard walay prolapsed  haemorrhoids aam neh pehr agar hon tay tuseen 15-30 min ice pack press ker kay  vee dard nu katha sakday au. Strong painkillers may bee needed.

5  Agar tay tuwan bahrli bowaseer ah tay kai lokaan nu cloitrimazol 1% cream 3 haftay wartnay naal araam aah ghia. Tuseen vee wart kay daikh lowo pehr eh sirf bahr wali bawaseer wastay ah.

6  Agar bowaseer pregnancy ch howay tay aam tor tay theek ho jaanday birth toon baad.

 ehda vee allaj autay wang ah.

Bawaseer daa Allaj

Doctors dee surgeries ch basic allaj kitta jaand jehra kay aam tor tay theek ah pehr buht kaht cases ch ho sak da perianal sepsis ho jaway

1 Rubber band ligation tajweez kitta jaanda grade 1-3 type haemorrhoids wastay. Ehday chi k plastic band mohqyaan  tay chrahya jaanda atleast 1cm above dentate line day blood supply nu cut kernay wastay. Kuch dinaan baad eh mohqay suk kay chahr jaanday ah. Agar  rubber band dentate line day buht close laa ditta jaway tay buht ziyada dard hundi ah. Ehday ch taqreeban 70% cure rate ah. Jehday ch 3% complication rate.

2  Sclerotherapy  ch sclerosing agent such as phenol da injection haemorrhoid ch laiya janda ah. Ehday naal vain walls collaps ho jaaniyaan tay haemorrhoid suckker jaanda.

Success rate four years after treatmen is more than 70% jehra keh rubber band ligatin naloon ziyada ah.

3  Kai hor taran day allaj vee dasay jaanday ah jehna nu Cauterization methods kehnday ah . Eh audoon wartay jaanday ah jidoon autlay allaj naa kitay jaa sakan. Ehna methods ch Electrocautery ,  InfraRed Radiation,  Laser surgery, or  Cryosurgery .  Infrared cauterization grade 1-2 ch kitti jaandi ah tay grade 3-4 ch dubara honay da rate buht high ah.

Surgery

Surgery day kai taraqay wartay jaanda ah tay her taraqay naal koi risk zaroor ah I .e bleeding , infection,  Anal strictures and urinary retention, kiyoun keh bladder diyaan nerves ehday buht lagay . Ho sak da small risk of fecal incotinence  khas tor tay liquid  rates reported 0-28% Mucosal ectropion ik hor condition ah jehri ho jaway after hemorrhoidectomy (often with stenosis). Eh oh ah jethay Mucosa becomes averyed from anus jehri keh very mild kisam dee rectal prolapse ah

Excisional hemorrhoidectomy eh buh ziyada serious cases ch kitti jaandi ah. Ehday operation too baad buht dard hundi ah tay 2-4 weeks recovery wastay chai day ah.. Long term ehday buhtay faiday ah grade 3 ch rubber band ligation day. Eh treatment nu thrombosedexternal haemorroids wastay recomenfd kitta jaanda.. Agar tay 24-72  ch kitta jaway tay Glyceryl trinitrate ointment kaffi madad kerdi ah dard tay theek honay ch.

Doppler-guided , transanal hemorrhoidal dearterialization is an invasive treatment jehday ch ultra sound doppler use ker kay arterrial blood inflow locate  kita jaanda. Ehtoon baad arteries nu bhun ditta jaanda. Tay prolapsed tissue nu saturate back ker ditta jaanda ehdi normal position tay.. Ehda success rate zitada ah tay kaht complications hundiyaan aan hemorrhoidectomy nallon.

Stapled hemorrhoidectomy  no stapled hemoorrhoidopexy  ik surgery da tariqa  jehday ch “Abnormaly enlarged  hemorrhoida tissue nu remove ker ditta jaanda.. baqi tissue nu normal  anatomic position tay ker dainday ah. Eh kath dard alla ah tay jaldi theek ho jaanda ah compared to complete removal of haemorrhoids.  Pehr ehday ch duparay honay day chances ziyda ah.  Es wastay es wastay ehnu grade 2-3 bawaseer wastay tajweez kitta jaanda ah.

 References and further readings

Rivadeneira, DE; Steele, SR; Ternent, C; Chalasani, S; Buie, WD; Rafferty, JL; Standards Practice Task Force of The American Society of Colon and Rectal, Surgeons (September 2011). "Practice parameters for the management of hemorrhoids (revised 2010)". Diseases of the colon and rectum   1059–64.

 Lorenzo-Rivero, S (August 2009). "Hemorrhoids: diagnosis and current management". Am Surg   635–42

Pescatori, M; Gagliardi, G (March 2008). "Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures". Techniques in coloproctology   7–19

Ommer, A; Wenger, FA; Rolfs, T; Walz, MK (November 2008). "Continence disorders after anal surgery--a relevant problem?". International journal of colorectal disease  1023–31

Lagares-Garcia, JA; Nogueras, JJ (December 2002). "Anal stenosis and mucosal ectropion.". The Surgical clinics of North America : 1225–31

Lorenzo-Rivero, S (August 2009). "Hemorrhoids: diagnosis and current management". Am Surg : 635–42

Ratnasingham, K; Uzzaman, M; Andreani, SM; Light, D; Patel, B (2010). "Meta-analysis of the use of glyceryl trinitrate ointment after haemorrhoidectomy as an analgesic and in promoting wound healing". International journal of surgery (London, England)  606–11

Jayaraman, S; Colquhoun, PH; Malthaner, RA (Oct 18, 2006). "Stapled versus conventional surgery for hemorrhoids". Cochrane database of systematic reviews