Piles

Piles or Haemorrhoids is a very common disease and affect both men and women, are swollen or inflamed tissue which contains enlarged blood vessel found around the anus or inside the rectum.

Usually, piles do not cause any problem, until their blood supply slows down or interrupted. Piles occur when anal passage get inflamed and vein wall becomes thin and irritated by passing the bowel movements.

Around 50% of people get affected by Piles at any age in their life. Pregnant women also get experience with this condition. There is not any clear reason for what causes piles although researchers say that it might be due to weak veins

What are the Causes of Piles?

There is not an exact reason what causes piles. Some may appear with no reason while some may develop just because of the increased pressure in the lining of the anal canal which contains many blood veins. Due to this pressure, these veins got swelling and inflamed then develop piles.

Other factors which might increase the risk of developing piles:

Genetic History: If there is a family history of piles then there is an increased risk of developing piles.

Diet: Taking less fluid and fiber in the diet is a risk of developing piles.

Obesity: Being overweight is one of the causes of a pile.

Pregnancy: Pregnancy gives you increased pressure on your pelvic blood vessels and causes piles.

Sitting position: Sitting for a long time in the same position and also for the toilet.

Age factor: Getting older will get your supporting tissue weaker which increases the risk of piles.

Heavy Weight: lifting the heavyweight on a regular basis will also increase the risk of piles.

Diarrhea: Constipation and cough with vomiting is a reason of pile.

What are the Symptoms of Piles?

In many cases, haemorrhoids are not serious and resolve after a few days on their own. A person may have the following symptoms:

• The painful lump may be found around the anus.
• Bleeding after and during passing a stool – the blood is usually bright red.
• Pain during passing stool.
• Bowel feeling even after passing stool.
• Itching at the bottom.
• A mucus discharge after passing a stool.
• Anus area is sore, red and swollen.

What are the Types & Grades of piles?

Piles can be divided into two categories:

Internal Piles – Which cannot be seen or felt from the outside and which lies only inside the rectum. Bleeding is the only symptom of this type of piles.

Internal piles can be classified into 4 grades:

Grade 1: This lies within the lining of the anus.

Grade 2: which also lie within the anus but larger than type 1. It might be pushed out during passing stool and get back to its position on its own.

Grade 3: This is known as ‘prolapsed haemorrhoids’. It appears outside the anus and it can be pushed back by pressing against them.

Grade 4: This permanently hangs outside the anus and remains outside. These cannot be pushed back. Sometimes it becomes larger and needs to be operated by doctors.

External Piles – Which are formed in small lumps and located around the anus, beside the pain-sensing veins. It will get worse when the blood clot blocks the flow of the blood and start bleeding. It may require immediate medical attention.

How to Diagnose the Piles or Haemorrhoids?

If you have piles, a doctor can usually perform a visual examination of the anus to diagnose piles.

You may also be asked some questions to be a doctor like:

• If you have a family history of piles?
• If you have seen any blood while passing stool and also the stool color?
• If you have been obesity or any weight loss in recent time?
• If you notice changes in the bowel movements?

A Doctor may also Lab examination:

Proctoscope: Doctor may also perform a digital rectal exam to check signs of piles inside the anus with the help of Proctoscope. A proctoscope is a hollow tube fitted with light to see the anal canal closely. It also can take small tissues from inside for lab analysis for pile or any other digestive system diseases.

Colonoscopy: If a person has symptoms of piles, The doctor may recommend a colonoscopy, for the analysis of any other digestive system disease or if there is any risk of colorectal cancer.

Sigmoidoscopy: It is a small fiber-optic camera that is used to diagnose internal hemorrhoid or piles. The sigmoidoscope is fitted into a small tube and is inserted into the rectum to examine. It provides a clear view of the rectum and displays abnormalities inside the rectum.

The doctor may also suggest anoscopy which can clearly show the internal piles.

If you are facing the symptoms mentioned above, then you are required to go through the surgical treatment. Although non-surgical and Ayurvedic treatments are also available, these techniques will bring temporary effects on the disease and may recur later. Surgical Treatments cut the piles from the root so they there is no or fewer chances of recurrence.

To get rid of Painful Piles and to reduce the blood supply to Haemorrhoids, Surgery is the best option. One of the major advantages of Surgical Treatment is that it might help to cut multiple haemorrhoids in one go.

To cure the Piles effectively, the surgeon must be aware of the grade of Piles, the patient is suffering from. To treat the grade -1 to grade 3 piles, a single treatment is enough, but to treat grade 4 piles, 2 or more treatments are required simultaneously. Given below are the various surgical procedures to treat the piles:

Haemorrhoidectomy: It can be a painful process, although it is performed using local anaesthesia. Anus area is opened to cut out hemorrhoid by using surgical tools like scissors or laser. After this, the surgeon may leave the wound open to let it heal by own or may seal the wounds. Sealing the wounds may be difficult due to a sensitive location.

Stapler haemorrhoidectomy: This is done to treat the internal haemorrhoids which have grown too large. This is performed under local anaesthesia. A special device is used to staple the piles. Again it restricts the Blood supply to haemorrhoids reducing the size of the same. In comparison to traditional methods, Stapler methods are less painful and recovery is faster

Laser Treatments: This treatment is taken as the miracle due to its extraordinary features. Laser treatment is one of the less invasive, less painful, and quick processes which can be performed on all age groups with no diet restrictions. It is effective to cure the Grade 1,2, 3 piles safely, for Grade 4, more than 2 procedure can be used.

At QMCH, Laser Treatment is used which has the following benefits:-

• There is no better option than this in the world currently.
• Very minimum Pain; as good as none.
• Instant relief from existing pain and symptoms.
• It’s only a 20 mins procedure.
• Resume work the same day after the Laser Surgery.
• No Scar post the Laser Piles Operation.
• Minimal bleeding so low risk & faster recovery.
• Greater precision during surgery.
• No more Piles Pain for your posts the Surgery.
• Managed zero recurrences till date.

Apart from these techniques, Home remedies can be applied such as eating high fiber diets, using topical treatments, taking a sitz bath, applying ice packs, intaking oral pain relievers, and using medications prescribed by the doctors. Some Ayurvedic medicines are available which helps to cure the Initial grade of Piles only.

What is the Preparation before the Surgical Treatment for Piles?

Going through the surgical process, a patient will be asked to:

Various diagnostic measurements just to ensure the grade of piles, & medical history.

Follow some Diet Rules

Use some ointments to apply on the affected area

Quit smoking and alcohol

What are the risks attached to Piles Treatment?

Usually, risks are associated with the severity of piles and types of treatment offered to the patients. Although Doctor will always make an analysis and will examine the problem before rendering the treatments, still some of the risks are mentioned which are rare in nature:-

• Bleeding from the anal area
• Hematoma or collection of blood in the surgical area
• Fecal Incontinence
• Infected Surgical area
• Fecal Impactions
• Recurrence of hemorrhoids
• Formation of fistula at a later stage
• Rectal prolapse

What is the Post Operating care for Piles Surgical Treatment?

Piles can be cured after surgical treatments but to stop the chances of recurrence, one is advisable to follow some preventive care tips such as:-

• Intaking finer rich diets
• Avoid sitting for long periods
• Drinking Plenty of Water
• Not straining too much during a bowel movement
• Avoid heavy exercising
• Avoid lifting heavy stuff