Piles – Causes, Symptoms, Treatment and Prevention

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Piles, also known as hemorrhoids, is a collection of tissues that are swollen and inflamed that grows in the anal region. Piles may vary in size and can be found inside (internal hemorrhoids) or outside (external hemorrhoids) the anus.

The prevalence of piles is estimated to be 50-85% around the world and in India, 75% of the population is estimated to suffer from piles.

Piles develop when the tissues protecting the anal region get inflamed and the anal passage becomes thin, stretched and irritated when passing bowel movement. 

Causes of Piles

The causes of piles include:

  • Genetics predisposition to piles
  • Pregnancy
  • Chronic constipation
  • Chronic diarrhea
  • Lifting heavy weights
  • Lack of fiber diet and less fluid intake
  • Sedentary Lifestyle
  • Stress
  • Straining during bowel movement
  • Obesity
  • Previous bowel surgery
  • Anal intercourse

Signs and Symptoms of Piles

Some of the common symptoms of piles are:

  • Intense itching around the anus
  • Painful or itchy swelling or lump near the anus
  • Painful bowel movements
  • Bleeding from your anus during or after bowel movements
  • Irritation and pain around the anus
  • Leakage of stool

Conditions of Piles that may need medical intervention

  • Excessive bleeding in stool leading to anemia
  • Infection in and around the anal region
  • Fecal incontinence
  • Strangulated hemorrhoids

Grades of Piles

There are 4 grades of piles or hemorrhoids:

  • Grade I: There are small inflammations, usually inside the lining of the anus. They are generally not visible.
  • Grade II: In this grade, the piles are larger than in grade I, but also remain inside the anus. They may get pushed out during the passing of stool.
  • Grade III: This stage of piles are also known as prolapsed hemorrhoids, and appear outside the anus. You may feel them protruding out from the rectum, but they can be easily re-inserted.
  • Grade IV: These cannot be pushed back in and need immediate treatment. They are large and remain outside the anus.

Diagnosis of Piles

Consult a doctor when you see you have the symptoms as mentioned above. He will perform a physical examination of the anal region. In case of external piles, the doctor may be able to see them. To check for internal piles, the doctor performs certain tests of the anal canal and rectum. 

  • Rectal Examination – The doctor inserts a gloved and lubricated finger into the rectum to check for any unusual growths. 
  • Visual inspection – The doctor examines the lower portion of the colon and rectum using anoscope or sigmoidoscope. 

Treatments of Piles

Ayurveda Treatment for Piles

Ayurveda aims to balance the doshas – pitta, vata, and Kapha. It is always recommended to consult a doctor before going for Ayurvedic medicines (Bhaishajya chikitsa) or surgical treatment (Sastra chikitsa). Ayurveda medicines for piles include:

  • Pippali
  • Arshkalp Vati
  • Guggulu
  • Amalaki
  • Vacha
  • Haritaki
  • Vidanga
  • Black pepper
  • Haridra
  • Trikatu
  • Varuna
  • Ginger root

Kshar Sutra Therapy is another Ayurvedic technique where kshar sutra is put at the roots of piles tissues and are tied together. The blood supply to the piles is cut off which allows the piles to shed off in a few days. Before you decide to opt for the treatment, it is important to consider the risks and benefits of the procedure and have a discussion with the doctor. 

Surgery for Piles
  • Banding: The doctor places one or two elastic bands around the base of the piles, cutting off its blood supply. After a few days, the piles fall off. This is effective for treating hemorrhoids of all grades, except grade IV hemorrhoids.
  • Sclerotherapy: Medicinal solution is injected into the tissues to shrink the hemorrhoids. Hemorrhoid eventually shrinks up in a few days. This is effective for grade II and III piles and is considered a better procedure than banding.
  • Laser coagulation: This is also known as infrared light coagulation, where a device is used to burn the hemorrhoid tissue. This technique is used to treat grade I and II hemorrhoids, mostly internal piles.
  • Hemorrhoidectomy: The excess tissue that is causing the bleeding is surgically removed. This is performed in different ways and maybe done under local anesthetic or a general anesthetic. This surgery is most effective for complete removal of the piles, but there are potential complications including difficulties while passing stools as well as urinary tract infections.
  • Laser surgery for piles is preferred over open surgery as it is minimally invasive. There are several benefits of laser surgery over traditional surgery as the recovery is quicker and easier and the patient can resume work within 2-3 days after the surgery.
  • Hemorrhoid stapling: In this process, a surgical staple is used to fix hemorrhoid back into place inside the rectum. The blood supply is stopped to the hemorrhoidal tissues. This procedure is usually less painful than open surgery for piles.

However, there is an increased risk of piles recurrence and rectal prolapse, in which part of the rectum pushes out of the anus. This process cannot treat external piles.

Home Remedies for Piles
  • Diet: Dietary changes can help regulate stool and keep you away from constipation. It involves eating more fiber such as fruits, vegetables, bran-based cereals and more liquid intake.
  • Exercise: Obesity is also a reason for piles. Reducing those extra pounds can reduce the severity of piles. The exercises include:
    • Brisk walk
    • Deep breathing
    • Pelvic floor exercises
  • Over-the-counter medication: Medication includes creams, ointments and painkillers to soothe swelling and burning in the anal region. Using witch hazel or numbing agents as topical treatments can also help in reducing the swelling.
  • Laxatives: Laxatives can help loosen stools and reduce straining during a bowel movement.
  • Soak in warm water: After every bowel movement, soak your anal parts in warm water or take a warm water bath for 10-15 minutes, two to three times a day.

Where can you find the piles specialists?

  • Piles specialists in Delhi NCR
  • Piles specialists in Hyderabad
  • Piles specialists in Chennai
  • Piles specialists in Pune
  • Piles specialists in Bangalore
  • Piles specialists in Mumbai
  • Piles specialists in Lucknow
  • Piles specialists in Kanpur
  • Piles specialists in Ludhiana
  • Piles specialists in Nagpur
  • Piles specialists in Bhubaneswar
  • Piles specialists in Gwalior
  • Piles specialists in Bhopal
  • Piles specialists in Chandigarh
  • Piles specialists in Patna
  • Piles specialists in Agra
  • Piles specialists in Jaipur
  • Piles specialists in Kolkata

Complications of Piles

The complications of piles include: 

  • Bleeding during bowel movement
  • Anemia
  • Severe pain while passing stool
  • Blood clot
  • Gangrene (Dead tissue caused by an infection or lack of blood flow)

Prevention of Piles

To keep piles at bay, it is important to keep stools soft so that they are easy to pass. Therefore, to reduce symptoms of piles, here are some preventive measures: 

  • Eat high-fiber food
  • Drink plenty of water or increase liquid intake
  • Do not strain during bowel movement
  • Talk to doctor about fiber supplements to soften stool
  • Do not ignore the sudden urge to visit the washroom
  • Exercise
  • Avoid sedentary lifestyle

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