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.