OVERVIEW
Enlarging or bulooning haemorrhoids that is inside or around the anus or along with anal canal is called piles. Haemorrhoid is swollen veins around the anus.
Haemorrhoids are for protects the anal passage to become too big due to inflammation. That is the reason the vein walls become stretched or irritated during bowel movements. In such cases the haemorrhoids became piles.
Any age group people can be affected by piles. According to studies people above 45 years of age usually get affected.
Most of the cases piles did not need any treatments, it will goes gradually by itself.
There are internal piles and external piles.
Internal Piles: In the case of internal piles it is located within the rectum and not visible by eyes or touch. It can be identified by one symptom that is bleeding.
Internal piles are four different types.
- Level 1: Small haemorrhoids within the lining of the anus.
- Level 2: Haemorrhoids that lie within the anus and are bigger than the Level 1 haemorrhoids.
- Level 3: It known as ‘prolapsed haemorrhoids’. It appears outside the anus. The patient can able to push them back in by pressing against.
- Level 4: These type haemorrhoids needed surgery. It cannot be pushed back and it will stay outside of the anus until surgery.
External Piles: This type of piles located around the anus under skin. So the pain and bleeding will be more.
Number of factors affects external piles. Those includes, increased pressure because of obesity, pregnancy, sitting or standing for long, straining on the toilet, coughing, sneezing, vomiting, and holding the breath while straining to do strenuous physical labour.
SYMPTOMS
- Dark red bleeding from the anus during bowel movement.
- Severe pain during bowel movements
- Painful swelling or a lump near anus.
- Itching in anal area.
- Mucous discharge will be there from anus.
- Surrounding area of anus becomes red and sore.
DIAGNOSIS
The doctor will perform a visual examination of your anus to diagnose piles. A digital rectal exam is enough to find out the sign of piles within the anus. Sigmoidoscopy an additional test that can be suggest bye your doctor to diagnosis piles. A sigmoidoscopy is nothing but a small fibre optic camera fitted with a small tube and inserted into your rectum to diagnosis internal haemorrhoids.
TREATMENT
Normal piles are not require any treatment. Usually it will go by itself. Treatments requires when the grade or level of piles increased.
The treatment of piles varies. It depends on its type. Internal haemorrhoids, Level 1 and 2 is usually require only medicines and good food diet. The diet includes fruits and veggies that enriched with fibre contents. prolapsed haemorrhoids is also treated with medicine and healthy diet but some cases surgical intervention required when symptoms are severe. In the case of level 4 internal piles the surgery is mandatory. In treatments of external piles the doctors usually suggest hemorrhoid creams and ice packs to reduce the size of piles. If tits too severe, then doctor will suggest any one of the following surgery.
- Haemorrhoids removal.
- By the use of an infrared photo, laser, or electrical coagulation to burn out tissue that affected by piles.
- sclerotherapy to eliminate varicose veins which could be the cause of piles
- If piles is because of varicose veins then sclerotherapy is used to eliminate the varicose vein.
SURGERY
If piles are severe then there is no other option, you have to remove the piles through surgery. This surgery of piles is known as haemorrhoidectomy.
The surgery will start only after given the anaesthetic. The surgeon will take ECG in case you are a heart patient or suffering any blood pressure problem before the surgery.
To brief in surgery, the anus will open by using surgical equipments and the doctor clear the haemorrhoids with a scalpel. If any open wounds are there then internal stitches are used to close the wounds. Once the surgery is completed then the anus will be closed.
There are different types of surgeries.
- Haemorrhoidectomy – It is a surgical procedure to remove piles.
- Stapled haemorrhoidopexy – In this surgery, the surgeon will attach the area of tissue with piles higher up the anal canal and staple it in place. After this surgery piles then won’t come out the anus anymore and will shrink.
- Haemorrhoidal artery ligation operation (HALO) – During this procedure, arteries in your anal canal are stitched to limit the blood supply in to the piles. An ultrasound probe will used to help find the arteries and guide the surgeon during surgery.