What is PILES?

When blood vessels that are normally present around the anal region get enlarged or swollen, it is referred to as piles or haemorrhoids. Piles or haemorrhoids could be internal or external based on their location in the rectum or anal region.
Piles are normally located in clusters located most commonly at 3, 7 and 11 O’clock positions. But sometimes the pile mass is extensive and occupies the whole circumference and is termed as circumferential piles.

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What causes Piles?

Many factors are resulting in the formation of piles

  1. Constipation.
  2. Straining while passing motion.
  3. Poor fibre intake in diet.
  4. Obesity.
  5. Pregnancy wherein the enlarged uterus puts excess pressure on the rectum.
  6. Any large intraabdominal tumor causing puts excess pressure on the rectum.

What are the Symptoms of Piles ?

Symptoms can be varied depending on the type of pile.

  1. Painless bleeding which can be seen as bright red blood in the stool or after passing stool.

  2. Itching in the anal region.

  3. small soft mass felt around the anus.

  4. Pain around the anus while passing of stool.

  5. Feeling of fullness even after passing stools.

How are piles classified?

  • External piles :.

  • Internal piles :.

What are the grades of internal piles ?

  1. Grade1:This is the beginning of the piles and is confined to the rectum and not visible externally.

  2. Grade2:Here, the pile has increased in size but enters into the anal region. It can slide out while passing motion but quickly return within the anal canal after passing motion.

  3. Grade3: In grade 3, the piles mass has prolapsed outside the anus but can be pushed back into the anal canal. (has passed through the anal canal and is seen and felt outside the anus). But, the pile mass can be gently pushed back into the anal canal with the hand.

  4. Grade4:In this grade, the prolapsed pile mass is quite large and cannot be pushed back inside the anus. Hence it remains outside the anus at all times.

What is a thrombosed pile ?

  • When blood clots in an existing external pile, it becomes very painful and changes colour to dark red or maroon. This is called a thrombosed pile.

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How is Piles treated?

  • Mostly piles in majority of cases resolve on their own with small change in living habits & diet habits. In some cases, medications and laxatives help relieve the discomfort. But in the more complicated cases, surgery is needed.

What are the treatment options available for Piles?

Treating piles can be of non surgical or surgical as per the severity of the condition and as per doctor’s advice.

  1. Non surgical treatment :

  2. Sclerotherapy : This is a non surgical method , wherein a sclerosing agent is injected into the piles mass which eventually shrinks ithe pile. This can be used in selective cases.

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  3. Surgical treatment :

    1. Banding:

    2. Banding:In this procedure the pile is held with a ligator and rubberband is slided over it .Over time the pile will shrink and disappear. This cannot be done for large prolapsing piles or circumferential piles

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    3. Hemorrhoidectomy:

    4. Hemorrhoidectomy:Hemorrhoid stapling/ stapled haemorrhoidoplexy: Staplers have changed the way we look at treatment of hemorrhoids. Earlier thought to be a painful procedure requiring bed rest and long hospital stay, with stapled hemorrhoidectomy, the procedure is painless requiring no bed rest and 24 hour hospital stay.

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    5. Haemorrhoidal artery ligation:

    6. Here, using a Doppler probe , the hemorrhoidal vessel is identified and then ligated, thus shrinking the pile mass.

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