Hemorrhoids popularly known as piles are enlarged and swollen veins in the anus and lower rectum. Piles tissues are made up of blood vessels, connective tissue and muscle. They do not always grow but with age, this becomes a common problem. Pristyn Care experts will help you know more about the symptoms and treatment of piles.
Piles are caused in a number of ways, often by straining to a bowel movement. Lifting heavy objects along with other activities that cause straining can also lead to piles. During pregnancy, experiencing increased pressure and even being overweight are the other factors. Piles can be painful and can be recurrent if not treated properly.
How common are piles?
Piles are very common in both women and men between the age of 40 to 60. It is also a common problem in pregnant women. Most of the people have experienced piles symptoms such as itching, pain and bleeding. The following conditions can cause piles:
- Chronic constipation or diarrhea
- Straining too hard during bowel movements
- Sitting in the toilet for too long
- Lifting heavy objects
All this affects the blood flow in the area causing blood to pool within the vessels causing piles. There are factors which may further contribute to the risk of developing piles are:
- Lack of a fiber-rich diet
- As you grow older, the tissues connecting rectum and anus weakens, resulting in piles
Symptoms of piles
If you notice blood in the toilet bowl after a bowel movement can be the primary symptom of piles. Some more symptoms are:
- Itching in the anal area
- Bright red blood in the stool after a bowel movement
- Pain in the anal area while sitting
- Painful lumps around the anus
- Pain during bowel movements
If you notice any such symptom, immediately contact the doctor. Also avoid straining, excess rubbing or cleaning around the anus as it may make irritation and itching worse and can even cause bleeding.
What are the types of piles?
Piles are of two types
- Internal piles: They develop inside the rectum and are not usually visible normally. Internal piles often bleed but do not hurt generally. If the internal hemorrhoids protrude through the anus, it is known as prolapsed.
- External piles: This develops under the skin around the anus. If a blood clot develops, they are itchy and can become painful. This is known as a thromboses hemorrhoid.
There occurs a situation where the blood supply to the piles is cut off resulting in a complication called strangulation which can cause severe pain.
Piles is classified into four grades:
- Grade I: There are small inflammations inside the lining of the anus. They are not visible.
- Grade II: This is larger than grade I piles but it remains inside the anus. They may get thrown out during passing the stool but may return.
- Grade III: These are known as prolapsed hemorrhoids and are visible outside the anus. It can be felt hanging from the rectum but can be re-inserted.
- Grade IV: These cannot be pushed back in and need surgery as they cannot be re-inserted and remain outside the rectum
Piles during pregnancy
Piles are very common during pregnancy, especially during the last phase of pregnancy. Piles are not usually harmful to you or the baby. You can reduce the symptoms by certain home remedies. During pregnancy, the enlarged uterus puts pressure on the pelvis and around the anus and rectum. This may be caused due to the increased level of progesterone which results in swelling of the wall.
How do doctors diagnose piles?
The doctors usually diagnose piles after carrying out a physical examination. Give complete information on the symptoms and medical history. Diagnosis of internal hemorrhoids includes the examination of the anal canal and rectum. The doctor checks for the blood in the stool, the muscle tone of the anus and rectal exam to diagnose internal hemorrhoids. The doctor uses anoscope or proctoscope to examine internal hemorrhoids.
The doctor may examine the entire colon if there is any symptom of other digestive diseases or if you have symptoms of colorectal cancer.
Treating piles at home
Piles at early stages may be treated at home or with medication, depending on the severity and type of piles. There are several things that can be done at home:
- Take a sitz bath
- Use ice pack
- Do not strain during bowel movements
- Keep yourself clean, wash after every bowel movement
- Sitting on cushioned surfaces rather than a hard surface
- Over the counter medicines that include painkillers, ointments and creams
- Laxatives if the person suffers from constipation
A doctor recommends lifestyle changes to manage piles such as diet wherein you can involve more fiber content such as fruits and vegetables and increase the water intake. Avoid caffeinated drink such as tea or coffee. Lose weight to reduce the severity of piles. Also, to prevent piles, avoid straining and do exercise.
Surgical treatment for piles
Often a definitive treatment implies surgery. There are various treatment options to treat all grades of piles with and without anesthesia.
This is also known as rubber band ligation and is done without anesthesia. A band is used at the base of the hemorrhoids to cut off the blood supply. It needs two or more sittings and is not painful but you may feel a little discomfort. This isn’t for those who take blood thinners due to bleeding complications.
A medicine is injected to shrink the piles. There is little or no pain and usually done for treating grade II and III piles. This is best for small, internal hemorrhoids.
- Infrared coagulation
A device is used to burn piles tissues and is also known as infrared light coagulation. This is either laser or infrared light or heat. This is also done without anesthesia.
The surgeon opens the anus and gently cut out the hemorrhoids. They can make the cut using a variety of surgical instruments, such as surgical scissors or a laser.
- Hemorrhoid stapling
This procedure treats internal hemorrhoids that have prolapsed or grown. External piles cannot be treated with this procedure. A special device is used to staple the hemorrhoids into a normal position within the canal. This reduces the size slowly.
- Laser surgery
It is a daycare procedure that offers several advantages when compared to the above treatments. It is the most effective and advanced procedure. It is used to safely cut or burn the affected tissue during surgery. The surgery is done under general anesthesia. This laser technique is safer as they are scar-free, bloodless and less painful with fewer complications.
Advantages of laser surgery over other treatments
The advantages of laser surgery are:
- Greater success rate
- Recovery is faster
- Less pain after the surgery
- No scars and less pain
- Less blood loss
- Reduced risk of infection
- Less recurrence rate
- Short hospital stay
Recovery after piles surgery depends on the severity and treatment of piles. But the following tips may help you recover faster:
- eating a fiber-rich diet
- avoiding sitting for long periods
- drinking plenty of water
- taking a Sitz bath
- not straining during a bowel movement
- avoiding regular, heavy lifting
- avoiding long periods of sitting
Book an appointment with Pristyn Care to know more about piles and its treatment.