Piles or Hemorrhoids (or Haemorrhoids) are vascular cushions, i.e. swollen veins in the anus, anal canal and lower rectum, similar to varicose veins. It is a common condition in adults. It develops due to various causes related to increased pressure in the anal canal and the lower rectum.
Causes for piles:
- Straining while passing motion
- Sitting for a longtime on the toilet bowl
- Chronic constipation
- Chronic diarrhea
- Pregnancy
- Low-fiber diet
- Heavy weight lifting
Types of piles:
- External: noted in the skin around the anus
- Internal: noted within the anal canal and lower rectum
- Others: Thrombosed piles or Perianal hematoma
Piles can present as:
- Painless bleeding during bowel movements
- It is usually self limiting and can be managed with medications
- If it is large amount and persistent, then it is a medical emergency and requires urgent attention
- Prolapsing or protruding anal lump
- Anal pain or discomfort
- Anal itch or irritation
Treatment:
- Dietary modifications
- Defecation habit modifications
- Lifestyle modifications
- Medications
- Intervention:
- If the piles are medium, then the above are required and we may offer rubber band ligation of piles
- If the piles are large and prolapsing, then the above are required and the patient will require surgery
- There are different techniques for piles surgery: conventional or diathermy hemorrhoidectomy, ligasure hemorrhoidectomy, stapled hemorrhoidectomy, etc.
- We will discuss with the patient about the option that suits the best.
