Pile (Hemorrhoids) of a problem!

Have you been dreading a visit to the toilet? Has passing stool become particularly painful? What you have been passing off as a bad case of constipation may be something a little more serious – piles of hemorrhoids. Chronic constipation or diarrhea, lifting heavy weights, obesity or pregnancy are some conditions that can cause tissues and veins in the anus area to become inflamed and swollen. These are called piles or hemorrhoids. The size of piles may vary and the related discomfort is often due to how large the inflammations are.

When do I suspect that I have Piles?

If you are finding it uncomfortable to sit or are experiencing an itching sensation in the anus area, it may be a sign of piles, popularly known as hemorrhoids. Other common symptoms include:

  • Painful lump around anus
  • Bleeding while passing stool
  • Feeling of heaviness even after bowel movement
  • Pain while passing stool

Do I need treatment for Piles or Hemorrhoids?

Common Piles symptoms often resolve by themselves over time. Certain dietary corrections and exercise help in rectifying the condition. It, however,needs to be treated if it becomes a severe condition causing:

  • Excessive anal bleeding leading to anaemia
  • Uncontrolled bowel movement
  • Anal Fistula – a channel that gets created from under the surface of the skin to inside the anus
  • Blood supply to the hemorrhoid may get cut off resulting in a strangulated hemorrhoid which can lead to blood clot or infection

Piles or hemorrhoids can be internal or external. The external protrusions are the one that usually cause maximum discomfort and require treatment. Piles are commonly classified into four grades.

Grade I is classified as small swellings inside the anus lining and not visible to the naked eye.

Grade II piles are larger, still inside the lining, may protrude occasionally due to straining but go back inside by themselves.

Grade III piles are known as prolapsed hemorrhoids. These tend to hang out but can usually be pushed back inside.

Grade IV piles are large and remain outside the anus, and need to be treated as early as possible.

How is Piles diagnosed?

Physical examination is the first step in diagnosing piles (hemorrhoids). The doctor would also ask you questions regarding your family history, the discomfort and problems (any recent change in bowel movement) you may be facing, and whether you have recently undergone weight loss.

For internal piles a digital rectal examination (DRE) is required. The doctor may conduct the examination using a protoscope (hollow tune filled with light) and collect some tissue from the affected area for lab testing. The doctor may also need to conduct a colonoscopy or sigmoidoscopy if s/he suspects any other digestive issue.

What is the treatment for piles? What is the treatment for piles?

Treatment of piles would depend on a number of factors and may include its size, location, degree of discomfort and the related complications. For Grade 1 and 2 of the condition, the doctor would usually recommend lifestyle changes. Medications may be prescribed as palliative therapy for the itching and other discomfort.

Dietary changes recommended would include consuming food rich in fibre like fruits, vegetables and cereals. This will help in avoiding constipation, hence straining during bowel movement. Increasing consumption of water and avoiding caffeinated drinks is also recommended.

Exercise is a recommended therapy for managing piles. Regular exercise or as advised by your doctor would help you shed the extra weight and also help with easing constipation.

Medications may include painkillers, ointments and laxatives. These are mostly over the counter medicines that would help in reducing the discomfort related to piles

Surgery is the only treatment when the disease takes on a more severe form causing significant discomfort and other complications. Surgical options include:

  • Banding is an option for piles that are less than Grade IV. The procedure involves placing a band around the base of the swollen tissue, thus cutting of blood supply to it. The hemorrhoid will fall off after a few days
  • Sclerotherapy is an alternative to Banding. Medicine is injected into the hemorrhoid which makes it shrink
  • Coagulation involves using laser or infrared light/heat to burn the hemorrhoid. This method is used for treating smaller hemorrhoids (internal and external). It leaves no scars and chances of complications are negligible.
  • Hemorrhoidectomy is surgical removal of piles. This can be either a minimally invasive procedure or open surgery, depending on the size and related complications. Though most effective in completely removing the piles, like any other surgical procedure, there remains the risk of post-surgery complications.

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