What are Piles or Hemorrhoids?

Piles are hemorrhoids that become inflamed.The size of piles can vary and are found inside or outside the anus.Half the world population are affected by piles, usually before the age of 50. Around 10% of patients who go and see their doctor about piles, require surgical treatment.Piles are often not serious and go away on their own.Internal hemorrhoids are into four grades. External hemorrhoids are called perianal hematoma but can be extensions of internal piles. Piles occur due to chronic constipation, chronic diarrhea, lifting heavy weights, pregnancy or straining when passing a stool. A doctor can usually diagnose piles rapidly on examination.Early grade pies may be treated with medicine for piles but grades 3 or 4 hemorrhoids, surgery may be necessary. In the majority of cases, piles are effectively treated with over-the-counter medications, a good fluid intake, and by following a diet high in fiber. In severe cases, the piles may have to be surgically removed. About 10% of patients who go and see their doctor about piles eventually require surgical intervention.

What causes hemorrhoids/piles?

Piles  swelling occurs when there is an increase in the pressure in the small vessels that make up the hemorrhoid causing them to swell and engorge with blood. This causes them to increase in size leading to symptoms. Increased pressure may be caused by a variety of factors:

Low fiber diet and smaller caliber stool causes a person to strain when having a bowel movement, increasing the pressure within the blood vessels.

Pregnancy is associated with hemorrhoid swelling and is likely due to increased pressure of the enlarged uterus on the rectum and anus. In addition, hormonal changes with pregnancy may weaken the muscles that support the rectum and anus.Prolonged sitting on the toilet may increase pressure within the hemorrhoid blood vessels

Symptoms

Bleeding when you have a bowel movement

A lump in or around your anus

Itchy or sore skin around your anus

A slimy discharge of mucus from your anus

A feeling that your bowels haven’t emptied completely

Frequently asked questions (FAQ)

Non-surgical approaches

Early grade Piles are initially treated the same way, using techniques to destroy the hemorrhoid. These include Cryotherapy , Infrared coagulation,injecting the hemorrhoid vein to make it sclerose or harden, using rubber bands to choke off the blood supply and make the hemorrhoidal tissue shrivel, or other procedures that cause the mucosa to shrivel and die.

Surgery For Piles
Patients who have failed conservative therapy and  non surgical treatment or who have grade 4 hemorrhoids are candidates for surgery to remove the swollen hemorrhoids and the larger external hemorrhoid skin tags. Options include hemorrhoid removal with laser surgery or hemorrhoidectomy using a scalpel or laser. Another latest surgical treatment  is stapled hemorrhoidectomy, where a special staple gun is positioned to remove the hemorrhoid and surround the tissue with a ring of staples to close the area as well as controlling the bleeding.In this technique there are no open wounds or dressings and tissue of haemorroids can be removed from its base.
A thrombosed external hemorrhoid indicates that a clot has formed in the hemorrhoid causing significant pain. Treatment is to  remove the clot and reduce the swelling.
What does a hemorrhoid look like?
  • Normal hemorrhoidal tissue cannot be seen since they must first swell and become inflamed or develop a clot to cause problem.We can see swollen external hemorrhoids or prolapsed internal hemorrhoids exposed outside the anus but internal hemorrhoids cannot be seen because they remain inside the anus. A thrombosed hemorrhoid will appear as a lump at the anal opening, protruding from the anus and will be dark bluish in color because of the blood clot contained inside the swollen blood vessel. A non-thrombosed hemorrhoid will appear as a soft rubbery lump.Internal hemorrhoids are classified into four grades.
What are Grade 1 piles?

there are small inflammations, usually inside the lining of the anus. They are not visible

What are Grade 2 piles?

Larger than grade hemorrhoids, but also inside the anus. When passing a stool, they may get pushed out, but return unaided

What are Grade 3 piles ?

often called ‘prolapsed hemorrhoids’ these appear outside the anus. The patient may feel them hanging out. They can be pushed back in if the patient presses with their finger

What are Grade 4 Piles

these cannot be pushed back in and need to be treated by a doctor. They are large and stay outside the anus all the time.

External hemorrhoids are called perianal hematoma. These are small lumps that are located on the outside edge of the anus. They are very itchy and can be painful if a blood clot forms inside. Thrombosed external hemorrhoid requires medical surgical treatment.

Treatment for piles

Diet and adequate hydration are very important to maintain normal bowel movements. Piles symptoms can occur with the passage of hard stool and constipation, as well as diarrhea and frequent bowel movements. For patients with constipation, high fiber diet, adequate hydration and stool softeners may be required.

Stool softeners work by increasing the water and fat content within the stool allowing it to be passed more easily.

Medications are used to control symptoms by softening the stool, decreasing the inflammation of the hemorrhoids and treating the pain.

Inflammation can be controlled with over-the-counter creams or suppositories.

Lidocaine or hydrocortisone based ointments  help in relieving itching.

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yashpal singh
yashpal singh
05:41 17 Mar 20
Best surgeon for the fistula treatment in delhi .i got cured by his hands. With a doctor great human being also.
rahul gahlan
rahul gahlan
15:30 13 Mar 20
Thank GOD. That i came across with Dr bhanot who redeemed me of my prolonged lipoma problem which i have beeen... suffering from last 5 years.. There were a few lipoma ls that were removed within half an hour without any discomfort and pain. Highly professional and efficient... KUDOS to the doctor.. Thanks u sir.read more
Tulu Sahu
Tulu Sahu
06:56 13 Mar 20
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shiv pratap singh chauhan
shiv pratap singh chauhan
03:40 20 Feb 20
Fantastic staff n very experienced doctor......A true non- invasive hospital for lipoma removal.Recommended to... all👍👍👍👍👍👍read more
GANESH KUMAR SANKE
GANESH KUMAR SANKE
07:20 13 Feb 20
I Consulted Dr.Ashish Bhanot for lipoma treatment.they have removed without Scar and stich.And Treatment was... painlessI advice to the people who are suffering from lipoma, please contact Dr.Ashish Bhanot Sir for better treatment.This kind of treatment is available only Here.Thank you Sir for Such a sweet gesture from your team.read more
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Shivendra Kumar
04:37 08 Feb 20
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jeev 09
jeev 09
07:14 07 Feb 20
Dr.Ashish Bhanot is very good & helpful, I have done multiple lipoma treatment with him, his procedure will give you... negligible scars which is a good thing, couple of hours downtime to recover.Whoever is suffering from lipoma, i would recommend Dr. Ashish. He is best.read more
Shekib Ahmad
Shekib Ahmad
11:03 18 Jan 20
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