All You Need To Know About Piles or Hemorhhoids

Piles or hemorrhoids are swollen blood vessels in the anal passage. There are two circular bunches of veins, one inside the anal canal and the second at anal verge. The incidence of hemorrhoids has been found to be equal in men and women. This is most prevalent in age group between 45-65yrs. However, other age groups may also be affected.

Causes

Piles may develop due to chronic constipation which leads to excessive straining resulting in swelling of the veins in the rectal area. Pregnant women may also develop piles due to increased pressure on the veins in the pelvic area.

Symptoms

Painless bleeding is the commonest presentation in all the patients. However, vague associated symptoms could be itching, burning sensation at anus, mucus discharge soiling the undergarments. Piles usually progress in stages with time (graded from Stage I to Stage IV) and can lead to severe bleeding which needs blood transfusions. Sometimes hemorrhoids protrude outside the anal opening associated with extreme pain and causing significant morbidity.

Diagnosis

Physical examination and proctoscopy aid in the diagnosis of piles.

Treatment

In the early of cases, piles resolve on their own without the need for any treatment. Treatments can help significantly reduce the discomfort and itching that many patients experience.

The treatment options available are as follows:

• Depending on the diagnosis, the doctor advises if home treatment is all you need or further intervention is required. Lifestyle and dietary modifications such as regular physical exercise, plenty of fluids and a high fibre diet provide symptomatic relief.
• Surgery: Surgery is used for particularly large piles. Generally, surgery is used when conservative treatment/management is not effective. Sometimes surgery is done on an outpatient basis - the patient goes home after the procedure.

Types of surgery available for piles treatment

1. Minimally Invasive Procedure for Hemorrhoids (MIPH)

This technique uses stapler for performing the surgery. It is relatively painless and be done as a day care surgery.

MIPH procedure involves stapling of vessels at the base of hemorrhoids and dividing high up in the anal canal. The procedure is performed using special circular stapler. There are no external cuts and scars. The advantages of MIPH are reduced postoperative pain, with shorter hospital stay, no cumbersome dressings and early return to normal activity.

2. Haemorrhoidectomy (open surgery of the piles)

The excess tissue that is causing the bleeding is surgically removed. This can be done in various ways. It may involve a combination of a local anesthetic and sedation, a spinal anesthetic, or a general anesthetic. This type of surgery is effective in completely removing piles, but is associated with pain for few days. 

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