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  • What is Piles?
    Piles Disease Form
    Causes and Symptoms
    Diagnosis
    Grades of Piles
    Risks & Complications
    Prevention
    Myths and Facts
    Consult With Doctor
    Treatment Options, Cost and Insurance

    What is Piles (Hemorrhoids)?

    Piles or hemorrhoids, commonly known as Bawaseer (बवासीर) in Hindi is a very common anorectal condition. Piles are collections of veins and tissues located at the anal area that becomes swollen and inflamed. Piles may develop around the anal skin or inside the rectum.

    Piles is common in the case of both men and women. If global medical reports are to be believed, one out of every four adults suffers from piles or hemorrhoids at some or other point in their life. Piles is most common in people within the age group of 50-60 years but can affect people of other age groups too. No medical expert to date could ascertain the exact cause of hemorrhoids.

    However, several risk factors have been identified which can significantly increase an individual’s chances of developing piles. Piles can be managed with home remedies to a certain extent at an initial stage, but when piles grow severe or become advanced, medical intervention is extremely important.

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    How Do Piles Disease Form?

    The condition of piles is formed by constant pressure in the lower rectum. When a person constantly exerts pressure in areas around his rectum and the anus, due to reasons like constipation or lifting heavy weights, the blood vessels around those parts bulge and become swollen, forming piles. Due to constant straining, sometimes the veins might get wider and engorged with more blood than usual. These veins might form into one or more piles.

    Piles Causes and Symptoms

    Piles Causes

    • Constipation
    • Chronic diarrhea
    • Lifting heavyweights
    • Obesity
    • Pregnancy

    Piles Symptoms

    • Pain and discomfort in the anal area while sitting
    • Pain while passing a stool
    • Blood with stool
    • Itchiness, redness, and swelling near the anus
    • Painful lump around the anus
    • The feeling of unclear bowel even after passing stool

    Piles (Hemorrhoids) Diagnosis - Tests, Self-Diagnosis and Diagnosis by Doctor

    Tests to Diagnose Piles

    If it is a case of external piles, the anorectal specialist will be able to diagnose it just through physical examination. In case the hemorrhoids are internal, the doctor might do an examination of your rectum and anal canal. Two common tests which are done to diagnose piles are:

    • Digital examination – In this test, the piles specialist inserts a gloved, lubricated finger into the rectum to check if there are any kind of abnormal growths.
    • Visual inspection – Since internal hemorrhoids are too soft to be felt, the piles doctor might examine the lower rectum using a proctoscopy, an anoscope, or a sigmoidoscopy. Using any of these devices, the doctor will carefully examine the lining of your anal tissues to check the severity and growth of your piles.

    Self-Diagnosis

    Self-diagnosis of piles is not very difficult if you are well aware of the symptoms. If you think you have hemorrhoids, you can be pretty sure about it by checking your rectal motions. If you have piles, you will feel a hard and painful lump around your anus and that is the first and foremost sign of piles. When a person develops piles, he or she may experience the feeling of incomplete bowel even after passing a stool. The color of the stool may visibly change in case of piles, which is yet another way to self-diagnose piles. If you develop the problem, the color of the stool may be bright red or visibly change into red. You may experience itchiness, soreness, and redness around the anal area. Additionally, you may also see blood in your stool or feel excruciating pain while passing a bowel movement.

    Piles Diagnosis by Doctor

    Most proctologists or anorectal surgeons diagnose piles through physical examination alone. Once you visit the doctor’s clinic, you are likely to be asked a few questions, including:

    • Do you have a family history of piles?
    • When did you start having the symptoms?
    • Do you pass blood with your stool?
    • What are your dietary and lifestyle habits?
    • What is your fitness regime like?

    The doctor may also do a digital rectal examination to diagnose your piles. The piles specialist may also suggest tests like colonoscopy, sigmoidoscopy, and anoscopy to check for the presence of any gastrointestinal disease. In all these tests, the doctor inserts a small camera to check for any abnormalities in the anus, rectum, and colon. If the doctor sees that your piles are in an initial stage, the doctor might recommend lifestyle changes and some changes in your food habits. But if your diagnosis shows severity in your condition, you might be recommended to undergo surgery for piles.

    Different Grades of Piles (Hemorrhoids)

    • Grade 1 Piles: This is the initial stage (Grade 1) of the piles categorized by minor pain and inflammation.
    • Grade 2 Piles: At this stage (Grade 2), piles may protrude outside the rectum during bowel movements, but spontaneously reduce on its own.
    • Grade 3 Piles: may protrude outside the anus but can be manually pushed back in.
    • Grade 4 Piles: This is the most advanced stage of piles. At this stage, the piles may permanently protrude out of the anus and can’t be pushed back manually. It requires immediate surgical intervention to avoid further complications.

    Piles (Hemorrhoids) - Risks & Complications

    During the Surgery

    Piles surgical treatment is not a complex one. Hence, the chances of any risks are very rare. But, like any other surgical option, the success or risks associated with piles treatment are also highly dependent upon the severity of the condition and the surgeon’s experience. In rare conditions, a patient may suffer any of the following conditions after a piles surgery:

    • Bleeding – The chances of bleeding during piles surgery is higher in the case of open surgery. In case the surgeon is not experienced enough to precisely remove the inflamed tissues, there are chances that the patient may suffer from bleeding
    • Infection – Infections can develop at any point during piles surgery. The chances are higher in rubber band ligation treatment for piles.
    • Reaction to anesthesia – Many patients report experiencing side effects of anesthesia. Due to the reaction, the patient might feel drowsy and nauseated for a longer time than usual.
    • Rectal prolapse – According to a report published on ScienceDirect, 12 random clinical trials have indicated that hemorrhoidectomy (hemorrhoid surgery) has an association with long-term risks of rectal prolapse.

    If Left Untreated

    The most common possible complication of piles is that they can get strangulated if left untreated for a long time. When piles become strangulated, the blood supply to those tissues is cut off. Due to this, the person might experience venous thrombosis within the piles. This may cause severe pain and even make the treatment complex. In case of piles get strangulated, the person may experience excruciating pain within 48-72 hours which may gradually disappear after a week or so.

    Another significant risk that a person may suffer if he or she leaves hemorrhoids untreated is anemia. Piles, when grows, may cause blood loss along with stool. If the problem is not treated in time, the constant blood loss may make the person anemic and that may further give rise to several other health complications.

    How to Prevent Piles?

    In the words of Steven Kussin, a gastroenterologist based in New York, “Hemorrhoids are normal features of anatomy. We all have them.” Though people find it extremely discomforting to talk about piles or hemorrhoids, they are actually very common and can happen to anyone. There are no definite ways that can help prevent piles, but the condition can definitely be managed. Adopting the following can surely go a long way in helping you keep the painful anal disorder at bay.

    1. Swear by fiber in your diet

    Piles is most common in people who do not consume enough fiber in their regular diet. To prevent piles, one of the easiest and most natural ways is to stock up your diet with fiber-rich food. If you want to keep piles at bay, it is crucial to eat at least 25-30 grams of fiber per day. Some foods rich in fiber are:

    – Whole grains, oatmeal, and brown rice

    – Beans and lentils

    – Vegetable and Brussels sprouts

    – Fruits such as bananas, apples, pears, and berries

    2. Drink sufficient water

    Water along with a fiber-rich diet is very important for the prevention of piles. Drinking enough water prevents constipation which in turn decreases the need to strain while passing a bowel movement. If you want to prevent piles or manage your current condition of piles from becoming worse, add 6-8 glasses of water to your system. It will help your digestive system function properly.

    3. Don’t hold the urge to pass stool

    If you feel you need to go to the toilet, go, don’t wait. Going to the toilet when the system calls is actually a very simple way to prevent piles. Ignoring nature’s call can have its own complications and repercussions. When your body says you need to go and sit on the toilet seat, go, don’t hold. When you listen to your body calls, preventing piles from becoming worse is much easier and simpler.

    4. Stop sitting on the toilet seat for too long

    Don’t spend long hours reading a book or scrolling through the mobile sitting on the toilet seat. The more time you spend sitting on the toilet seat, the more likely you are to strain and make your bowel movements worse. The position of sitting on the toilet seat directly exerts pressure and stress on the blood vessels of the anus causing them to protrude.

    5. Stay physically active

    Hemorrhoids have a direct relation to physical activities and how you keep your body active. Staying physically active keeps the colon active and functions in a regular manner. But that being said, you should know which physical activity is good for you and which is not. Avoid any activity that puts strain and pressure on your abdominal region. Do not lift weights. Do not sit in one place for long hours. Moderate exercises like walking, jogging, yoga, and swimming can help the piles of tissues from flaring.

    Myths and Facts About Piles

    Myth 1: Spicy foods cause hemorrhoids.

    Fact: Hemorrhoids are caused by strain on the veins near the anus. The straining might be caused due to constipation or hard stool or by spending more time on the toilet seat. Spicy foods have no direct correlation with hemorrhoids. But since spicy foods might be hard on the digestive system, people might need to exert more pressure while passing the bowel after having any spicy food.

    Myth 2: Hemorrhoids generally happen to old people.

    Fact: Age is not a factor for this disease. Yes, it is common in older people as the tissues get weaker but it can happen to anyone who has chronic constipation or strains during a bowel movement.

    Myth 3: Hemorrhoids can cause cancer.

    Fact: There is no such study or evidence that says hemorrhoids cause cancer. But you must visit a doctor if there is rectal bleeding as both colon cancer and piles have the same symptoms.

    Myth 4: All kinds and sizes of hemorrhoids need surgical intervention.

    Fact: No, not all hemorrhoids need surgery as treatment. Hemorrhoids which are at an early stage, i.e. Grade 1 and Grade 2 piles can be easily managed with medication and regular home remedies. Hemorrhoids that get bigger in size, protrude out of the anal opening, and cannot be pushed back even after trying hard may need to be surgically removed since medicine and home remedies won’t be effective in such cases.

    Myth 5: Hemorrhoids is recurrent

    Fact: Hemorrhoids is not recurrent if you undergo the best treatment. With a success rate as high as 98%, laser surgery is considered to be the most effective treatment for hemorrhoids. If you undergo laser piles removal, there are almost nil chances that your piles will appear again. It is the best, most effective, and considered to be the only permanent cure for hemorrhoids.

    When to Consult a Doctor for Plies?

    Knowing when to seek professional help for any health condition is extremely important and hemorrhoids are no exception. Getting medical help at the right time can help you avoid unnecessary complications. If you experience any of the following complications or conditions, it is time you check with an anorectal surgeon.

    • You have excruciating pain and discomfort in your anal and rectum area.
    • The stool that you pass is dark red, maroon, or tar-like in color. This can be a sign of internal bleeding.
    • You experience blood in the toilet paper every time you pass bowel movements.
    • No amount of medications and home remedies are able to provide you relief from your symptoms.
    • If you feel dizzy and weak due to continuous blood loss along with your stool.

    Treatment Options, Cost and Insurance of Piles (Hemorrhoids) Surgery

    Non-surgical Options:

    Rubber Band Ligation: Rubber band ligation is a non-surgical approach commonly performed to treat piles. This is a non-invasive procedure and is performed on an outpatient basis, allowing you to return home on the same day of the procedure. In this procedure, the doctor will use a small tool to tie rubber bands around the piles lumps.

    Within a few weeks after the procedure, the piles lumps will shrink and fall off naturally. While this method is quite effective, if dietary or lifestyle changes aren’t adopted to prevent piles, they may recur even after the procedure. This procedure is swift and ensures a quicker recovery compared to surgical methods.

    Sclerotherapy: Sclerotherapy is another non-surgical procedure to treat piles. It is performed under topical anesthesia on an outpatient basis.

    In this procedure, the doctor injects a special chemical into the piles to hinder the blood supply into the lumps. It will shrink piles over time and they fall naturally.

    Home Remedies to Cure Piles

    • Lemon juice: Lemons are considered as one of the best home remedies for piles. Being the best source of vitamin C and antioxidants, it can help flush toxins and prevent itching or burning sensation. It ensures healthy bowel movements and helps in reducing piles size.
      How to use: Slice a lemon into two halves. Powder a pinch of salt and swallow the juice. You can also drizzle lemon juice over fruits or vegetable salads.
    • Aloe Vera: Aloe vera is renowned as one of the best home remedies to cure various conditions, including piles. It has anti-inflammation properties, which help with inflammation and swelling.
      How to use: Extract the aloe vera gel and apply it directly to the affected area. You can also add a pinch of turmeric powder.
    • Coconut oil: Coconut oil stands out as an excellent natural remedy for external hemorrhoids. Its properties help alleviate inflammation, itching, and the burning sensations often associated with piles. Additionally, its rich antioxidant content promotes overall well-being and eases discomfort.
      How to use: You can directly apply coconut oil to the affected areas multiple times daily to the affected area.
    • Garlic: Garlic is popular in home remedies to treat piles due to its antibacterial and anti-inflammatory properties. It helps reduce pain, itching, inflammation, and swelling. Additionally, it also ensures a healthy digestive system essential in managing piles.
      How to use: You can consume it directly or make a paste and apply it to the affected area.
    • Olive oil: Olive oil is an effective home treatment for piles. It helps lessen swelling and makes the area smooth to reduce pain. It’s best to use extra virgin olive oil to reduce inflammation, swelling, and itching of the piles.
      How to use: You can apply it on the piles directly or even use it in your food. Using it often can help with piles of pain and discomfort.

    Medicines

    There are several medications available that can be used to manage the symptoms of piles.

    • Over-the-counter (OTC) medicines – OTC medicines such as painkillers, ointments, and creams can provide relief to the swelling and redness around the anal area.
    • Corticosteroids – These medications help in reducing pain and swelling in the anal area.
    • Laxatives – If haemorrhoids are caused due to constipation, you can take laxatives to find relief. Laxatives can aid a person in having an easier bowel movement and reduce pain in the anal area.

    Surgical Treatment for Piles

    1. Hemorrhoidectomy – Hemorrhoidectomy is done to remove the protruded anal tissues that cause bleeding. This procedure is mostly used to treat piles of severe grades. The surgery can be performed under general or local anaesthesia. In this procedure, the surgeon makes a few incisions around the hemorrhoidal tissue. The swollen veins inside the haemorrhoids are tied off to prevent bleeding and then the haemorrhoid is removed.
    2. Hemorrhoid stapling – Hemorrhoid stapling procedure disrupts the blood flow to the inflamed tissues. This procedure is mostly used for internal piles. During the procedure,  the arterial blood vessels within the piles are cut off which does not allow any further blood flow to the piles vessels. Due to this, with time, the size of the piles reduces and finally shrinks off. The surgery does not inflict much pain and ensures quick recovery of the patient. Complications include chances of recurrence, rectal prolapse.
    3. Laser Treatment – Laser surgery is considered to be the most advanced and effective treatment for piles. During this procedure, a laser beam is used to burn and shrink the haemorrhoids. The surgeon focuses a narrow beam of light on the anal tissues. The procedure is less invasive, causes no bleeding, and very minimal pain.

    How to Prepare for Piles Surgery?

    Piles surgery is not a very complicated treatment and as such requires no thorough preparation. But like any other surgery, you need to follow the doctor’s instructions to ensure that your surgery goes well and you recover with no complications. Before your surgery for piles:

    • Do not eat or drink anything heavy. Take a very light meal, preferably only breakfast.
    • Do not drink any form of carbonated or caffeinated drinks, just consume clear liquids at least for 5 hours before the surgery.
    • If you are on any anti-inflammatory, allergy medicines or any blood thinners, the doctor will recommend you to stop it as soon as possible before the treatment.
    • Stop smoking and drinking alcohol. It will help you heal faster after the surgery.

    How to Recover After Piles Surgery?

    The recovery route after piles surgery is usually simple with no major complications. If you diligently follow the doctor’s recommendations and tips, you will not experience any complications.

    • Eat a high-fiber diet.
    • Avoid lifting heavy weights.
    • Use a stool softener that can aid you in having smooth bowel movements.
    • Stay hydrated. Drink at least 8-10 glasses of water every day.
    • Do not strain while passing a stool.

    Insurance Coverage

    Piles surgery is generally covered under health insurance. Most insurance companies offer a specific amount of coverage for piles and other anorectal diseases. The amount of coverage you have will depend on the policy you buy.

    One thing you should know is that medical treatment for piles won’t be covered in the insurance policy. Only the expenses of surgical treatment are covered and you also need to be hospitalized for at least 24 hours to file for a claim. You can opt for cashless payment or get reimbursement claims from your insurance providers as well.

    If your claim is approved, you will be able to cover the entire cost of treatment, including diagnostic tests, medications, hospital stay, bed charges, and other consumables. Some of the best and most popular healthcare insurance providers are Oriental, Religare Health, Manipal Cigna, United India Insurance, Care Health, New India Insurance, Star Health & Allied, Bajaj Allianz General Insurance, ICICIA Lombard, Max Bupa Health Insurance.

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    FAQs Around Piles

    Who is at risk of getting hemorrhoids?

    Irrespective of age and gender, any individual can suffer from hemorrhoids. Globally, over half the population suffers from piles by the time they turn 50. Hemorhhoids can equally affect both men and women. But the risk is a bit greater in the case of pregnant women and people over 3 years who do not follow healthy dietary and lifestyle habits.

    How to know if it is piles or anal fissures?

    Piles is a condition in which the anal tissues get swollen and inflamed and often protrudes out of the anal opening. An anal fissure is a tear that is caused by long periods of hard stool or diarrhea. Both the conditions are associated with common symptoms such as rectal bleeding, anal itching, and painful bowel movements. It can often be confusing to distinguish between the two. The best way to understand whether the condition is piles or fissures, the best way is to consult with an anorectal expert and get a detailed consultation to rule out potential complications.

    What factors increase the risk of piles?

    The following factors may put you at an increased risk of getting piles:

    • Constipation
    • High BMI
    • Less intake of fibrous foods
    • Sedentary lifestyle
    • Pregnancy

    Which Doctor Should I Consult for Piles Cure?

    If you are suffering from piles or any anorectal disease, you can first consult with a general physician. If the general physician finds any major problem in your health condition, the doctor is likely to refer you to an anorectal expert. In that case, you can consult with an experienced and trained colorectal surgeon, proctologist, and anorectal surgeon.

    Can home remedies provide long-term relief from piles?

    Home remedies can only manage the symptoms of piles from getting worse but not provide permanent relief to the condition. At-home remedies like topical ointments, sitz baths provide temporary relief from painful piles symptoms rather than fixing the cause of the disease. The only effective permanent treatment for piles is the surgical removal of the hemorrhoid itself.

    What are the Causes of Hemorrhoids?

    • Constipation: Constipation is considered as the primary cause of hemorrhoids. Regularly passing hard stools can strain anorectal veins which can lead to the development of piles.
    • Less Fiber in Diet: Consuming a less fiber rich diet can cause constipation, which might lead to developing piles or exacerbate existing ones.
    • Family history of piles: If you have a family history of piles then you are at an increased risk of developing piles.
    • Prolonged sitting: If your job involves prolonged sitting and you are not taking ample breaks, it can strain the anorectal area and increase the chances of developing piles.
    • Being overweight: If you are overweight or obese, then you are at an increased risk of developing piles.
    • Pregnancy: During pregnancy, anorectal veins can weaken and swell, leading to the development of piles in approximately 35% of pregnant women.
    • Aging: Piles is common in adults aged over 50. As we age, tissues become weaker and elevate the chances of developing piles.
    • Anal intercourse: Anal intercourse can also contribute to the development of piles due to straining and friction.