Piles, also known as hemorrhoids, are swollen and inflamed blood vessels ( cushions) in the rectum and anus. They can cause discomfort, pain, and sometimes bleeding, especially during bowel movements. Piles are classified into two main types
1. Internal Hemorrhoids: These develop inside the rectum and are usually painless but can cause bleeding. In severe cases they may protrude out of the anus, called prolapsed hemorrhoids.
2. External Hemorrhoids: These form under the skin around the anus and can be painful and can bleeding and can cause (thrombosed hemorrhoid), causing swelling, pain, and sometimes a lump near the anus,
Combined or mixed when both internal and external are present at the same time
How are graded:
They are graded by taking history and clinical examination.
- Grade I: The growth does not cause symptoms and does not protrude out of the anus.
- Grade II: The piles may prolapse from the anus but return inside independently.
- Grade III: The piles prolapse and only recede within the anus with manual intervention.
- Grade IV: when the prolapsed mass doesn’t recede into the rectum.
What are Common Symptoms:
- Pain or discomfort in the anal region while sitting, defecation.
- Itching or irritation around the anus usually mistaken for worms
- Swelling or small to large lump near the anus
- Bright fresh red blood drips after a bowel movement
- Mucus discharge after passing stool causing irritation.
What are the Causes of Piles:
- Chronic constipation or frequent stool
- Straining during bowel movements
- Sitting for long periods, especially on the toilet
- Pregnancy (due to increased pressure in the pelvic area)
- Obesity
- improper diet
- family history plays an important role.
Treatment Options:
- Lifestyle changes:A high-fiber diet, increased water intake, and regular exercise can help reduce symptoms in early stages
- Topical treatments: Creams, ointments, and suppositories can relieve discomfort and reduce inflammation in early stages.
- Minimally invasive procedures: For more severe cases, treatments like rubber band ligation, sclerotherapy, or infrared coagulation may be recommended.
- Surgery: In cases where other treatments have failed, a hemorrhoidectomy or hemorrhoidopexy open or laser might be necessary.