Piles or Hemorrhoids are swollen and engorged veins of the lower rectum and anus. It is the commonest condition affecting the anorectum seen mostly in adults and aged population. They can confine to lower rectum only ( internal ) or anal canal( external) In majority of case both internal and external components are present. They may remain asymptomatic especially if they are mostly internal hemorrhoids.
The signs and symptoms of piles or hemorrhoids depend on their type
- Internal hemorrhoids
Most common presentation is painless bleeding. You will notice bright red blood at the end of your defecation.
As the piles grow bigger they can protrude while passing motion.
- External hemorrhoids
In addition to bleeding there will be itching and irritation and the pile mass may remain outside the anal canal. ( prolapsed piles)
Pain is not a common feature of hemorrhoids but when it is present it may be due to thrombosed pile or associated fissure.
Quite often there is a history of irregular bowel habits, constipation being more common. In elderly patients piles may be just incidental finding and the real cause of bleeding may lie elsewhere. This should be borne in mind while investigating.
When to see a doctor
While hemorrhoids are quite common, they can be very painful as well. You may want to treat the condition on its own, but if you know when to seek help, you may be able to avoid unnecessary complications associated with the condition. You should make an appointment with your doctor if you experience any of the following:
- If you experience rectal bleeding or notice bright red blood on your toilet paper
- You have persistent discomfort and pain in your anus or rectum
- Your symptoms haven’t been relieved despite taking over-the-counter medications for more than a week
- Your bowel movements are tarry or maroon in color, which can be a sign of bleeding.
You may need emergency treatment if the rectal bleeding doesn’t stop and you feel faint or dizzy.
Types of Surgery
Different surgical options are available for treating piles, with or without anesthetic:
- Coagulation therapy
- Hemorrhoidal artery ligation
When & Why should one undergo which
Each procedure is suited for specific situations:
- Banding: For treating internal hemorrhoids
- Sclerotherapy: Best for small, internal hemorrhoids
- Hemorrhoidal artery ligation: It is usually considered as an option if rubber banding fails. It is more effective than banding but it is also costlier and causes longer-lasting pain.
- Hemorrhoidectomy: It is used for large external hemorrhoids and internal prolapsed hemorrhoids or if non-surgical management has failed
- Hemorrhoidopexy: Also known as stapling, it is done for treating prolapsed hemorrhoids.
- You should include more high-fiber foods like fruits, vegetables, beans, etc in your diet.
- Avoid food like cheese, ice cream, meat, processed foods, fast foods, etc
- Drink plenty of fluids
Surgery for treating hemorrhoids is usually done on an outpatient basis and can be done within an hour, depending on the technique used.
Depending on your condition, the procedure can be performed in different ways. A typical hemorrhoidectomy involves making small incisions around the hemorrhoids. Scissors, knife, or a cautery pencil can be used for removing the hemorrhoids. Hemorrhoids can also be stapled or a rubber band can be put around it for blocking its blood flow and causing it to shrink. Other techniques involve using a laser or injecting a chemical solution for shrinking hemorrhoids.
Length of Stay
The length of hospital stay depends on the type of surgery, with stapling requiring shorter stay than open surgery.
Some side effects associated with hemorrhoid surgery include:
- Problems passing urine due to pain
- Stool leakage