Haemorrhoids (Piles)

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What are hemorrhoids?
Hemorrhoids are swollen but normally present blood vessels in and around the anus and lower rectum (end of the Large Intestine). They tend to get stretched in a manner similar to varicose veins due to an increase in pressure in them. Other factors include chronic constipation, diarrhea, ageing, pregnancy and a hereditary tendency.
Symptoms of Hemorrhoids/ Piles?
Although many people have haemorrhoids, not all experience symptoms. The most common symptom of internal haemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl.

However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful, especially during a bowel movement (thrombosed or infected haemorrhoid). Occasionally, symptoms of external haemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms within the haemorrhoid, known as thrombosed haemorrhoid.

How common are piles?

Haemorrhoids are very common. About half the population have haemorrhoids by the age 50. Haemorrhoids are also common among pregnant women. Haemorrhoids usually are not dangerous or life threatening. In most cases, haemorrhoidal symptoms will go away within a few days.

Treatment of Haemorrhoids

Initial Treatment

  • Consume a high-fibre diet which is rich in fruits and vegetables along with plenty of water for hydration. This softens the stools and increases the bulk/volume of the stools and it helps in avoiding excessive straining while passing motions.
  • Topical Treatment – Your specialists at SIGMA Gastrocare will be able to advise you with regards to treatment of piles with topical creams which would be prescribed in addition to stool softening laxatives.
  • Sitz Bath
  • Keep the Anal Area clean
  • Avoid dry toilet paper
  • Oral Anti-inflammatory Agents

Surgical Management

External Hemorrhoid Thrombectomy – Is a procedure designed to relieve the immediate pain which is caused due to the presence of an acute thrombus in the pile mass. It is generally done as an emergency procedure and it provides the maximal relief if it is done within 72 hours of developing the symptoms.

Minimally Invasive Procedures

Rubber Band ligation – One or two rubber bands are placed at the base of the hemorrhoids in an effort to cut off the blood supply and thereby the pile mass falls off within a week’s time. It is a procedure which is useful for many individuals. It can however be associated with severe pain and can be assoicated with more severe complications.

Injection Sclerotherapy – A sclerosant is a chemical substance which causes the hemorrhoids to shrink is injected into the base of the pile mass. This shrivels
the pile mass and it disappears over a period of time.

Coagulation (infrared, laser or bipolar) – Coagulation techniques use laser or infrared light or heat. They cause small, bleeding, internal haemorrhoids to harden and shrivel. While coagulation has few side effects and may cause little immediate discomfort, it’s associated with a higher rate of hemorrhoids coming back (recurrence) than is the rubber band treatment or sclerotherapy.

Surgical Procedures

Haemorrhoidectomy – In this procedure, called haemorrhoidectomy, your surgeon removes excessive tissue that causes bleeding. Various techniques may be used. The surgery may be done with a local anesthetic combined with sedation, a spinal anesthetic or a general anesthetic.

Hemorrhoidectomy is the most effective and complete way to treat severe or recurring hemorrhoids. Complications may include temporary difficulty emptying your bladder and resulting urinary tract infections.

Most people experience some pain after the procedure, which generally subsides within a few days.

Stapler Haemorrhoidectomy—This procedure, called stapled haemorrhoidectomy or stapled hemorrhoidopexy, blocks blood flow to haemorrhoidal tissue. It is typically used only for internal hemorrhoids.

Stapling generally involves less pain than hemorrhoidectomy and allows for earlier return to regular activities. Compared with hemorrhoidectomy, however, stapling has been associated with a greater risk of recurrence and rectal prolapse, in which part of the rectum protrudes from the anus. Complications can also include bleeding, urinary retention and pain, as well as, rarely, a life-threatening blood infection (sepsis).

Talk with your specialist at SIGMA Gastrocare about the best option for you.