Piles or haemorrhoids is one of the most common ailments today. It is a varicose and often inflamed condition of the veins, inside or just outside the anal canal. In external piles, there is a lot of pain but not much bleeding. In the case of internal piles, there is discharge of dark blood. In some cases the veins burst and this results in what is known as bleeding piles.
Hemorrhoids, commonly referred to as piles, are characterized by the enlargement of blood vessels that may occur within the anal and lower rectal regions. They share similarities with varicose veins and can manifest either inside the rectum or beneath the skin surrounding the anus. It is entirely normal to possess blood vessels in the anal area, as they play a vital role in maintaining continence. However, the condition known as hemorrhoids can develop when these blood vessels undergo enlargement, potentially leading to various symptoms. The precise cause of hemorrhoids remains unclear, but they are closely linked to heightened pressure within the blood vessels located in and around the anal region. This increased pressure can result in the swelling and inflammation of blood vessels within the rectal passage. In contemporary times, a significant number of individuals are grappling with this ailment, primarily attributable to changing lifestyles and unhealthy dietary practices. Regrettably, if you find yourself experiencing this distressing condition, we strongly recommend seeking treatment from the highly skilled healthcare professionals at Atharv Hospital, who adhere to international standards of care.
Hemorrhoids, commonly known as piles, are a prevalent condition affecting a substantial portion of the population, estimated to be in the range of 20-50%. Fortunately, a diagnosis of piles usually doesn’t raise significant concerns. There are four primary types of piles:
Internal Piles – These are located deep within the anus and are not visible externally. Internal piles result from the protrusion or extension of the rectum or anus walls.
External Piles – Manifesting as visible bumps around the anus, external piles can be observed by a doctor during a clinical examination.
Prolapsed Piles – When internal piles swell and protrude from the anus, they are categorized as prolapsed piles.
Thrombosed Piles – Thrombosed piles may occur both externally and internally when a pool of blood clots leads to severe pain.
According to Goligher’s classification, piles have been classified into the following four grades:
Grade 1 – In this stage, anal cushions of tissue and blood vessels may bleed but do not prolapse.
Grade 2 – Piles at this grade prolapse during straining but typically retract on their own.
Grade 3 – This stage involves prolapsed anal cushions that necessitate manual repositioning into the anal canal.
Grade 4 – Piles at this advanced stage remain prolapsed at all times.
For individuals in Grades 3 and 4, surgical intervention is recommended by an experienced doctor or surgeon of a reputed hospital like Atharv Hospital. Laser surgery is one of the highly regarded surgical options, and consulting with your healthcare provider is advisable for further guidance.
Diagnosing hemorrhoids may involve various examinations to ensure an accurate assessment. Initially, a visual inspection of your anus can often provide sufficient information for diagnosis. However, for confirmation and to evaluate any potential abnormalities within the anus, your doctor may conduct a digital rectal exam. During this procedure, a lubricated, gloved finger is gently inserted into your rectum. Depending on your individual risk factors for gastrointestinal conditions, your healthcare provider may recommend additional tests such as anoscopy, sigmoidoscopy, or colonoscopy. These tests employ a small camera to thoroughly assess the anus, rectum, or colon for any irregularities.
In each of these tests, a fiber-optic camera is housed within a small tube, which is carefully inserted into your rectum. This camera provides a detailed and close-up view of the rectum, allowing your doctor to thoroughly examine the hemorrhoid and any associated concerns.
Atharv Hospital adopts multiple treatment options for managing piles depending on patients’ conditions and the severity of the problem. Some of the common pile treatments include:
Medications – Over-the-counter medications such as creams, ointments, and suppositories can effectively reduce swelling, alleviate discomfort, and relieve the pain associated with piles.
Sclerotherapy – This treatment addresses internal piles through an outpatient procedure that involves injecting a chemical solution into the affected area within the anal region. This process gradually causes the piles to shrink. Sclerotherapy is typically considered when home remedies and over-the-counter medicines have proven ineffective, primarily for grade 1 or 2 piles that are in the early stages of piles.
Rubber Band Ligation – This is the most common procedure in which a small rubber band is placed at the base of the hemorrhoid to restrict its blood supply, ultimately causing it to wither away. This process is usually performed in a hospital and is generally recommended for larger piles. Atharv Hospital is a reputed hospital performing this pile treatment with great success.
Hemorrhoidectomy – Hemorrhoidectomy offers a minimally invasive solution for removing both internal and external piles and it is the most effective treatment for all types of piles. It involves the complete removal of the hemorrhoid. This approach is primarily employed for managing large and severe piles that cannot be effectively treated through lifestyle adjustments or medications.
All open, laser, and stapler surgeries are effective options performed for the treatment of different grades of piles. Let us differentiate these three distinct piles treatment options.
Open surgery is effective for Grade IV piles in which enlarged hemorrhoids are removed using instruments like a scalpel, scissors, or a laser. It is generally performed under general anesthesia and requires one or more incisions to locate and remove the hemorrhoids. In the open surgery, the wound is left open after the surgery to avoid any chance of bruises and stitches complications.
Stapling is a recently developed technique that is effective for the grade III status of piles. The doctor performs this procedure under general anesthesia to remove some of the enlarged hemorrhoids and then the remaining tissues are stapled to the lining of the anus again. In this procedure, small incisions are made to insert the stapler to remove and reposition the hemorrhoidal tissue. This surgery has quick recovery time and has reduced postoperative pain.
Laser treatment is effective for Grade II and Grade III piles. It is a painless treatment procedure, as there are no cuts or stitches and patients can resume work within 48 hours. The laser surgery is performed under local anesthesia and laser energy is delivered through a probe. It completely cures, as hemorrhoids are vaporized or coagulated using laser energy. Patients only need to abide by the post-surgery instructions suggested by the doctor.
It is possible to treat piles without the need for surgery. The treatment often begins with lifestyle modifications, medications, and conservative measures. Find below some alternative treatment options:
Medication – If your piles exhibit only mild symptoms, then the doctor may suggest the use of over-the-counter medications. Pain relievers, creams, pads, and ointments can provide relief by soothing the swelling and redness in the anal area. It’s important to note that these medications alleviate symptoms but do not cure the underlying condition.
Dietary Changes – Your doctor can advise you to incorporate a fiber-rich diet with plenty of fruits, vegetables, and whole grains. This helps soften stools, making them easier to pass and reducing strain during bowel movements.
Hydration – While suffering from piles patients are recommended to stay well-hydrated to prevent constipation, which worsens piles.
Topical Treatments – Over-the-counter creams, ointments, and suppositories containing ingredients like witch hazel or hydrocortisone can provide relief from itching and discomfort.
Warm Baths – Piles patients are advised to soak in a warm bath can ease pain and inflammation.
Avoid Straining – People suffering from piles should be gentle during bowel movements and avoid straining.
Regular Exercise – Physical activity promotes healthy digestion and reduces the risk of constipation, so hemorrhoid patients should exercise regularly.
Stool Softeners – In some cases, your doctor may recommend stool softeners to ease passage.
Lifestyle Habits – Pile patients should maintain a healthy weight and avoid prolonged sitting on the toilet.
After undergoing piles surgery, similar to any surgical procedure, you may encounter specific side effects, including pain, bleeding, infection, fecal incontinence, and constipation. The potential side effects of a hemorrhoidectomy are as follows:
Pain – Post-surgery, you can expect soreness and heightened sensitivity in the anal area.
Bleeding – Minor bleeding is a common occurrence after the procedure, especially within the initial 48 to 72 hours. Blood in stool or on underwear, particularly during bowel movements, may occur.
Infection – Surgical procedures inherently carry a risk of infection, which can be exacerbated if stools come into contact with the surgical site.
Fecal Incontinence – Some individuals may experience temporary, moderate stool incontinence alongside pain, which typically resolves during the recovery phase.
Constipation – Severe constipation is a frequent post-operative issue following piles surgery. It may result from anal constriction or tissue injury. Moreover, apprehension of painful bowel movements can contribute to functional constipation.
It’s crucial to recognize that the severity of these side effects varies among individuals. Management may be necessary for bleeding and pain at the surgical site, which are the most common complications following piles surgery. Always consult your healthcare provider for personalized guidance during your recovery.
The most effective treatment option for hemorrhoids depends on the severity and individual circumstances. In many cases, mild to moderate piles can be managed successfully with non-surgical approaches such as dietary changes, increased fiber intake, adequate hydration, and over-the-counter medications. However, for more advanced or persistent cases, minimally invasive procedures like rubber band ligation or laser surgery are safer, quicker, and more effective surgical options. Laser surgery is a minimally invasive surgical procedure used to treat piles that is a safe, quicker, and less painful procedure resulting in minimum bleeding. It is regarded as the most effective treatment due to its high success rate, quick healing, and lower risk of recurrence, and because of minimal postoperative discomfort. It’s crucial to consult with an experienced doctor at Atharv Hospital, who can assess your specific condition and recommend the most appropriate treatment for you.
Laser treatment for piles is an outpatient procedure carried out employing a focused laser beam to diminish or eliminate affected tissue while preserving nearby healthy tissue. This approach is favored over traditional surgery due to its non-invasive nature, involving the precise targeting of laser beams to cauterize and eliminate the blood vessels responsible for piles. Administered under local anesthesia, laser treatment carries minimal risk and discomfort compared to general anesthesia, ensuring fewer associated side effects for the patient.
After laser piles treatment patients are advised to keep the following considerations in mind:
People suffering from piles at first recommended making changes in their food habits and hence they are recommended to include and avoid certain food items.
Following surgery, the anal region will be highly sensitive, and it’s essential to prioritize relaxation during the initial weeks. Adhering to post-operative care instructions from your healthcare provider is crucial. Find below some general recovery tips:
Maintains Anal Hygiene – After each bowel movement, you need to either take a shower or use a sitz bath, a warm water bath, which provides relief to the anal area. This promotes healing and reduces pain, itching, and irritation. While cleaning with wet tissues is acceptable, avoid excessive wiping.
Limit Physical Activity – Gradually get back into physical activities over a few days. Avoid heavy lifting, strenuous activities, and exertion for at least two to three weeks. Stay mobile and incorporate light walking without excessive strain.
Follow Medication Regimen – Abide by your doctor’s instructions regarding prescribed medications, including pain relievers, antibiotics if prescribed, and stool softeners or laxatives to prevent constipation.
Apply Cold Compresses – Alleviate swelling and discomfort by periodically applying a cold compress to the anal area for short intervals. Ensure the ice pack is wrapped in a cloth or towel to protect your skin.
Use Proper Seating – When sitting, employ a cushion or a donut-shaped pillow to minimize pressure on the surgical site.
Dietary Considerations – Temporarily reduce consumption of junk, spicy, and oily foods following piles surgery. These dietary adjustments can help regulate bowel movements, preventing constipation or diarrhea, which may hinder the healing process.
Piles can lead to the following potential complications if left untreated or unmanaged:
Thrombosis – This occurs when a blood clot forms within a swollen hemorrhoid, causing severe pain and swelling.
Bleeding – Piles can bleed, resulting in bright red blood in the stool or on toilet paper. Recurrent bleeding can lead to anemia over time.
Prolapse – Hemorrhoids may protrude outside the anus during bowel movements and may require manual repositioning.
Strangulation – Prolapsed hemorrhoids can become trapped outside the anal opening, leading to a lack of blood supply, extreme pain, and tissue death.
Infection – Scratching or irritation of hemorrhoids can introduce bacteria, leading to infections.
Anal Fissures – Persistent straining during bowel movements can cause tears in the anal lining, leading to additional discomfort and bleeding.
Anal Fistulas – In rare cases, chronic inflammation from untreated hemorrhoids can contribute to the development of an abnormal tunnel between the anus and the skin.
Fecal Incontinence – Chronic hemorrhoid issues can affect anal sphincter function, potentially resulting in difficulty controlling bowel movements.
Prompt medical attention and appropriate management can help mitigate these complications associated with piles.
Atharv Hospital based in Pune is revered as the most trusted hospital for the treatment of piles. Served by highly experienced and talented healthcare professionals, the hospital aims to provide world-class treatments for piles as well as other health problems. The hospital’s mission is to provide international standards of healthcare through qualified healthcare professionals at an affordable price. The hospital has been the recipient of several awards and accolades such as the Maharashtra Gaurav Award, Best Chikitsak Award, Healthcare Excellence Award, etc. that remain a testament to their exceptional service to mankind. Some of the prominent reasons to choose this hospital for piles treatment include:
A medical history followed by visual examination of the anus is usually enough. However, a digital examination and Proctoscopy (a scope is inserted to examine the anal canal) is done to confirm the diagnosis. At times a Barium study or Colonoscopy may be advised if your doctor suspects any other cause of bleeding that needs to be ruled out.
Dr. Sandeep Agarwal, Director of Atharva Hospital is undoubtedly the best doctor for piles treatment, he has introduced no cut, no Suture, no wound surgery for treatment of piles by Biological Electrical Impedance Auto-measurement technology that is performed within 10-15 minutes, thereby relieving patients from years long suffering from piles.
Hemorrhoids can often be managed effectively without surgery through lifestyle changes, dietary adjustments, and medications. While these measures can provide long-term relief, they may not offer a permanent cure, as underlying factors can contribute to recurrent episodes. Surgical options may be considered for severe or persistent cases.
Atharv Hospital in Pune, Maharashtra is the best place for specialized treatment for hemorrhoids with top-notch equipment and highly advanced medical technologies.
Bleeding piles, while typically not life-threatening, should be taken seriously. They can indicate underlying issues and may lead to complications like anemia. Consult a healthcare professional for proper evaluation and management to address the cause of bleeding and prevent potential complications.
Not all bleeding piles require surgery. Initial treatment usually involves lifestyle changes, dietary modifications, and medications. Surgery may be considered for severe or persistent cases that don't respond to conservative measures or if there are complications like thrombosis or excessive bleeding. A healthcare provider can recommend the most suitable treatment approach.
The best surgery for bleeding hemorrhoids is the surgery performed using BEIM technology that makes hemorrhoid tissue hard and dry without carbonization. The surgery time is only 10-15 minutes and patients are relieved from the years-long suffering from piles.
It’s like taking a small nap! All you will feel is a small needle prick during your preparation for the procedure. The entire surgery takes about 30 minutes.
You will normally be able to start drinking water shortly after the procedure and can start eating as soon as you are hungry. You will be able to get out of bed a few hours after surgery. You are likely to have some pain after the procedure that is easily controlled with painkillers. You can expect a small amount of bleeding and wearing a pad will protect your clothes from getting soiled.
If your operation is planned as a day care procedure you can go home as soon as the effect of the anaesthetic has worn off, you have passed urine and you are comfortable, eating and drinking. Since a general anaesthetic is used, it is advisable that a responsible adult take you home and stay with you for 24 hours.Before you are discharged you will be advised about post-operative care, painkillers and laxatives.
You will normally open your bowels within 2-3 days of your operation. This may be uncomfortable at first and there could be a sense of ‘urgency’ (need to rush to the toilet). You may notice mild blood loss after each bowel movement but this will gradually reduce over the next few days. Maintain hygiene, and wash and keep the operation site clean. It is important to maintain a regular bowel movement that should be well formed but soft. You may need to take prescribed laxatives for 2-4 weeks. Eating a high fibre diet and increasing water/fluid intake will help.