Piles (a.k.a hemorrhoids) indicate swelling of the veins in the anus and lower rectum. Hemorrhoids can form in the rectum (internal) or beneath the skin around the anus (external).

Approximately three out of four adults have hemorrhoids from time to time. Hemorrhoids have numerous causes, but usually, the cause is not known. Fortunately, there are efficient options to treat hemorrhoids. People can also get aid with a few home treatments and a few lifestyle changes. Swollen and inflamed veins in the rectum and anus that cause discomfort and bleeding.

Hemorrhoids are usually caused by straining during bowel movements, obesity or pregnancy.

Discomfort is a common symptom, especially during bowel movements or when sitting. Other symptoms include itching and bleeding. A high-fiber diet can be effective, along with stool softeners. In some cases, a medical procedure to remove the hemorrhoid may be needed to provide relief. 

 

An estimated 1 in 20 Americans have symptomatic hemorrhoids. They affect people of all ages, genders, races and ethnicities. They’re more common as you age, affecting more than half of people over age 50. Hemorrhoids and anal fissures cause similar symptoms, such as itching, pain and bleeding. While swollen veins cause hemorrhoids, a tear in the lining of the anus causes an anal fissure. Rectal bleeding can also occur due to crohn’s disease, colorectal cancer, ulcerative colitis and other gastrointestinal disorders etc. Some tests like DRE, sigmoidoscopy, anoscopy and colonoscopy can help to find rectal bleeding or hemorrhoids. Skin tags, infections and blood clots are some complications which are common to all piles patients.  Most hemorrhoid symptoms improve within a week with at-home treatments. If hemorrhoids cause extreme pain and discomfort, a medical procedure or even surgery may help.

 

 

Causes of piles –

• Increased pressure in lower rectum
• Chronic constipation
• Chronic  diarrhea
• Lifting heavy weights
• Straining when passing a stool 

 

Symptoms of hemorrhoids- 

Symptoms normally depend on the kind of hemorrhoid.

External hemorrhoids

Symptoms might involve:

• Itching or irritation in the anal area
• Pain or discomfort
• Swelling around the anus
• Bleeding

 

Internal hemorrhoids

This usually can’t be felt or perceived, and they seldom cause distress. But in some cases, during passing stool, one may experience:

• Painless bleeding through bowel movements. 
• Pain and irritation 

 

Medical doctors grade piles on a four-point scale as grade 1, 2, 3, 4. In grade 1, growth does not cause symptoms and does not protrude out of anus. In grade 2, piles may prolapse from anus but may return inside independently. In grade 3, piles prolapses and recedes within anus with manual intervention. In grade 4 lastly, piles prolapses outside anus and the person cannot push them back in. 

 

 

Thrombosed hemorrhoids

If blood accumulates in an external hemorrhoid forming a clot, it can cause:

• Severe pain
• Swelling or inflammation
• Hard lump near the anus

It is not right to assume rectal bleeding is due to hemorrhoids because this can also occur with other diseases, including types of cancer. It is important to seek emergency care if one has large amounts of rectal bleeding, lightheadedness or dizziness.

Complications of piles-

Piles sometimes can escalate into severe conditions such as-

• Anal fistula
• Excessive bleeding causing anemia
• Fecal incontinence 
• Strangulated hemorrhoid
• Infection 

Risk factors for piles-

• Pregnancy 
• Old age
• Overweight
• Low fiber diet intake 

Diagnosis of piles- 

• Medical history 
• Physical examination of anus
• Digital rectal examination or DRE 

Hemorrhoids Treatment-

Home Cure

Hemorrhoids can often go away on their own without treatment, and symptoms like pain and bleeding may last one week or slightly longer. Simultaneously, one can practice these to ease symptoms:

• Apply medications containing lidocaine/witch hazel/hydrocortisone to the afflicted area.
• Drink lots of water.
• Increase fiber consumption through diet and supplements. 
• Soak in a warm bath each day.
• Soften stool by taking laxatives.
• Administer non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling.
• Use toilet paper/washcloth with lotion or flushable wet wipes to clean the bottom after pooping. 

 

Thus this is the home treatment of hemorrhoids. 

Other treatments

If symptoms get more serious or interfere with everyday life, medication is a must. Also, if no changes are observed after a week of home treatments, a healthcare provider may treat hemorrhoids with:

• Rubber band ligation: A tiny rubber band placed about the base of a hemorrhoid to cut off blood supply to the vein.
• Electrocoagulation: An electric current to stop blood flow to a hemorrhoid.
• Infrared coagulation: Transmitting heat to get rid of hemorrhoids by injecting a small probe into the rectum.
• Sclerotherapy: A chemical injected into the swollen vein to destroy hemorrhoid tissue.

 

Surgical treatments involve:

• Hemorrhoidectomy: Removes prolapsed internal hemorrhoids or large external ones.
• Hemorrhoid stapling: Removing internal hemorrhoid or pulling a prolapsed internal hemorrhoid back into the anus to hold it there via the stapling instrument.
• Medications: such as pain relievers, stool softeners, corticosteroids.
• Lifestyle changes to be made. 

Prevention of piles-

• Eat a high fiber diet
• Drink plenty of liquids
• Take fiber supplements
• Avoid long periods of standing or sitting
• Exercise
• Don’t strain
• Go as soon as you feel the urge 

Differential Diagnosis of Piles-

• Colorectal cancer
• Anal abscess
• Cryptitis
• Anal fistula
• Anal fissure
• Inflammatory bowel disease
• Polyps in large intestine

Fact Check:

• India reports 1 million new cases of piles every year. 
• An estimated 50-85 per cent of cases are reported among people within 45-65 years.
• More than 10 million cases total from India per year are of piles.
• Piles are not recurrent if one takes laser surgery.
• 20th November is World Piles Day to spread awareness on piles.
• It affects men and women equally.
• Piles are also called rectal lump.

PGC Resolution:

Spreading awareness and controlling cases of piles in India. Providing guidelines and information on healthy diets and measures for controlling hemorrhoids.