Piles(also known as Haemorrhoids ) are swollen and inflamed veins in the rectum or anus. Typical symptoms are pain, itching and bleeding around the anal area. Treatment usually non surgical measures like stool softner, ointment application , sitting in warm water . Sometimes they require some minor OPD procedures like injection sclerotherapy or banding . Haemorrhoids that don’t clear up with these measures may require surgery.
The exact cause is unknown. Any increase in pressure in the lower rectum which can cause the blood vessels in the lower rectum to become swollen and inflamed. They tend to occur more frequently later in life due to age-related weakening and stretching of the tissues supporting the veins in the rectum and anus.
The following factors can increase pressure within the lower rectum and hence may increase the risk of developing piles:
- Straining to have a bowel movement
- Sitting for long periods of time, especially on the toilet
- Chronic (long lasting) constipation or diarrhoea
- Being overweight or obese
- Anal intercourse
- Low-fibre diet
- Spinal cord injury
- Poor posture
- Family history of haemorrhoids.
Signs and symptoms:
Internal haemorrhoids lie inside the rectum and usually do not cause discomfort. However, straining or irritation when passing a stool can damage the surface of a haemorrhoid causing it to bleed.
External haemorrhoids lie under the skin around the anus. When irritated they can itch or bleed. Blood can pool inside an external haemorrhoid and form a clot, which causes severe pain, swelling, and inflammation.
Signs and symptoms may include:
- Pain or discomfort, especially when sitting
- Pain during bowel movements
- Itching or irritation around the anal region
- Bright red blood on your stools, toilet paper or in the toilet bowl
- Swelling around the anus
- One or more lumps near the anus, which might be tender or painful.
Home treatment is often sufficient to relieve mild pain, swelling, and inflammation associated with piles . It includes :
- Use of ointment
- Stool softener
- Sitting in warm water ( Hot Seitz bath)
For an external haemorrhoid in which a clot (thrombosis) has formed, prompt relief can be obtained from your doctor performing a haemorrhoid thrombectocmy, which is a simple ‘incision and drainage’ OPD procedure to remove the clot.
For persistent bleeding or painful haemorrhoids, the following non-surgical procedures to destroy the haemorrhoid can be performed in a doctor’s office:
- Rubber band ligation(Barron Banding), which involves using a rubber band to cut off the blood supply to the haemorrhoid causing it to shrivel and die.
- Injection (sclerotherapy), which involves injecting a substance into the haemorrhoid to make it shrink and die .
- Electrotherapy (electrocoagulation), which is a type of heat treatment that causes the haemorrhoid to harden and shrivel.
If non-surgical procedures are not successful or if the haemorrhoids are particularly large, one of the following surgical procedures may be necessary:
- Haemorrhoidectomy – removal of a haemorrhoid with a scalpel or laser, usually under general anaesthesia.
- Haemorrhoid stapling – removal of an internal haemorrhoid with a special staple gun that also inserts a ring of staples to close the wound .
Keeping your stools soft is the best way to prevent haemorrhoids from occurring.
- Eat high-fiber foods
- Drink plenty of fluids
- Avoid straining when on the toilet
- Go to the toilet as soon as you feel the urge
- Get plenty of exercise
- Lose weight if you are overweight
- Avoid sitting for long periods.