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Piles / Hemorrhoids--causes, symptoms and treatment.

Information About Hemorrhoids / Piles

Hemorrhoids or piles are abnormally enlarged and dilated blood vessels (mainly veins) near the anus.

They occur in both men and women, most often between the ages of 20 and 50 years. Several factors like Age, Heredity factors, Diet and fluid intake are responsible for the development of piles.
In many cases, hemorrhoids are very small and the symptoms usually settle down without treatment.

Hemorrhoids are effectively treated with over-the-counter medications, good fluid intake, and by following a diet rich in fiber to avoid constipation. In severe cases, the piles may require surgical intervention.

Symptoms of Piles.

Signs and symptoms of hemorrhoids can include:

>Irritation and itching in your anal region
>Bleeding during bowel movements – you may notice small amounts of bright, red blood in the toilet or when wiping on your toilet roll tissue
>Discomfort, pain and swelling around your anus
>A lump near your anus that may be sensitive or painful
>When piles occur, they can also vary depending on the location.

>External Hemorrhoids: They form under the skin external haemorrhoids be itchy or bleed.

>Internal hemorrhoids: They develop and are located inside the rectum, where you usually can’t feel or see these hemorrhoids. Though they rarely cause discomfort, straining during passing stool can damage the hemorrhoid’s surface and cause it to bleed. Occasionally, an internal haemorrhoid can also be pushed through the anal opening through straining, also known as protruding or prolapsed haemorrhoid.

>Thrombosed hemorrhoids: At times, a clot may be formed in an external haemorrhoid and can be extremely painful with swelling and inflammation. It can cause a hard lump near the anus which sometimes needs to be drained.

Treatment for hemorrhoids/piles.


#Local applications of creams, ointments or suppositories to reduce pain and swelling. Corticosteroids cream is used for severe swelling and inflammation.

#Warm (but not hot) sitz bath –sit in 8 cm warm water for 15 minutes, 2-3 times per day.


#Analgesics to reduce the pain
#Laxative to relive constipation

#Anal dilatation- Manual stretching of the anal canal sphincter for inflamed, permanently prolapsed and oedematous piles.

#Injectable sclerotherapy- Injection sclerocent (3-5 ml of 5% phenol in almond oil) is used for 1st degree and early 2nd degree internal hemorrhoid that creates a scar and closes of hemorrhoids.

#Banding –Usually it is used in 2nd degree hemorrhoids

#Coagulation- It is done by using either electric probe, a laser beam or infrared lights which seal the end of the haemorrhoid causing it to close off and shrink.

#Surgery- Success rate approaches 95% but without dietary and life style changes haemorrhoids may recur. There are many different surgical procedures. The main types of operation are followings:-

#Haemorrhoidectomy- It is indicated for following cases- – Large internal haemorrhoids (3rd degree or 4th degree ) – Faliur of nonoperative method – Fibrosed piles – Extremely uncomfortable haemorrhoids (thrombosed)

#Transanal haemorrhoidal deartelialisation (THD) or Haemorrhoidal artery ligation (HA20).

#Stapled haemorrhoidopexy- It is done only for plolapsed piles. In this technique circumferential excision of mucosa and submucosa 4 cm above dentate line is done by using circular haemorrhoidal stapler passed per anally (MIPH) Advantages of this technique are less painful procedure, less blood loos, shorter recovery time (1 week), short hospital stay and equally efficacious as compare to conventional haemorrhoidectomy.



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