HEMORRHOIDS

What are piles (hemorrhoids) ?
Piles(hemorrhoids) are enlarged, bulging blood vessels around the anal canal and lower rectum. There are two types of piles;
external and internal, which refer to their location.

External (outside) piles develop near the anus and are covered by very sensitive skin. If a blood clot develops in one of them, a painful swelling may occur. Generally they do not produce any symptoms other than a clot in them. Very rarely an external pile may rupture and bleed profusely. Some times a fissure sitting over an external pile can also bleed profusely.

External and internal piles
Internal (inside) piles develop within the anus beneath the lining. Painless bleeding while passing stools and protrusion are the most common symptoms. However, an internal pile can cause severe pain if it - protrudes from the anal opening and cannot be pushed back inside.
Internal piles are graded according to their severity into four grades.

What causes piles( hemorrhoids)?
The upright posture of humans alone forces a great deal of pressure on the rectal blood vessels, which sometimes causes them to bulge. Other contributing factors include:

Do piles leads to cancer ?
No. There is no relationship between piles and cancer. However, the symptoms of piles, particularly bleeding, are similar to those of colorectal cancer and other diseases of the digestive system. Therefore, it is important that all symptom are investigated by a specialist doctor trained in treating diseases of the colon and rectum. Do not rely on quacks(unauthorized and unqualified practitioners) or other self-treatments.

How are piles(hemorrhoids) treated?
Early grades of piles - do well if Straing at stools and constipation are relieved. Sitting in hot water bath or applying cold packs helps in reducing congestion .

In cases of severe, persistent pain, due to a clot in the pile, your doctor may suggest to remove the clot with a small procedure. Performed under local anesthesia as an outpatient, this procedure provide immediate relief.

Severe hemorrhoids may require special treatment, much of which can be performed on an outpatient basis.

Ligation - the rubber band treatment - works effectively on internal piles that protrude while passing stools. A small rubber band is placed over the piles, cutting off its blood supply. The piles and the band fall off in a few days and the wound usually heals in a week or two. This procedure sometimes produces mild discomfort and bleeding.

Injection and Coagulation can also be used on bleeding piles that do not protrude. Both methods are relatively painless .

Surgery for piles (Hemorrhoidectomy);
>> Stapled
>> Classical

Stapled hemorrhoidectomy: A disposable instrument is used to surgically remove internal hemorrhoids. Relatively painless after the surgery. Expensive because the instrument is disposable.

Classical - surgery to remove the piles - is the best method for the permanent removal of piles. It is necessary when (1) clots repeatedly form in external hemorrhoids; (2) non operative methods fails to treat internal piles; (3) the protruding piles cannot be reduced; or (4) there is persistent bleeding. A hemorrhoidectomy removes both external and internal piles causing bleeding and protrusion. It is done under anesthesia , require hospitalization and a period of inactivity due to pain. Laser hemorrhoidectomies do not offer any advantage over standard operative techniques. They are also quite expensive, and contrary to popular belief, are no less painful.

Other treatments include cryosurgery, BICAP coagulation and direct current. Cryosurgery, popular 20 years ago, consists of freezing hemorrhoidal tissue. It is not recommended for hemorrhoids because it is very painful. BICAP and direct current are methods that shrink the hemorrhoid. None of these treatments have gained widespread acceptance.

© 2011 Piles Doctor

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