Piles (Haemorrhoids) are lumps inside and around the anal region. Swollen and inflamed veins in the rectum and anus cause discomfort and bleeding. These veins may grow larger and more engorged with blood than normal. The engorged veins and surrounding tissue may subsequently produce one or more swellings (piles). Piles usually cause problems, although they may cause bleeding and discomfort. If they produce any bleeding or discomfort, you should see a doctor.

Types of piles

Internal and external piles are the two types of piles. Some individuals acquire both internal and external piles.

Internal piles are deeper and begin to develop above a point 2-3 cm within the backchannel (anal canal) in the upper or lower rectum (the last part of the large bowel that connects to the anal canal).

External piles begin closer to the surface, under a point 2-3 cm within the back passage. Despite the name, external piles aren't always seen outside of the opening of the back passage (anus). Internal piles may also grow and slide down (prolapse), causing them to hang outside of the anus.

Grades of piles

Grade I There are minor inflammations, typically inside the anus lining. They can't be seen.

Grade II piles are bigger than grade I piles but still stay inside the anus. They may be pushed out during stool passage, but they will return unassisted.

Grade III These occur outside the anus and are also known as prolapsed hemorrhoids. They may be felt hanging from the rectum, but they are readily re-inserted.

Grade IV These are unable to be put back in and must be treated. They are big and do not enter the anus.

CAUSES

• Increased pressure in the lower rectum causes piles.
• Under strain, the blood vessels surrounding the anus and in the rectum will stretch and expand or bulge, creating piles.
• Constipation that persists
• lifting high weights causes chronic diarrhea
• When passing a stool during pregnancy, you may experience straining.
• The tendency to form piles is also hereditary and increases with age.

What are the symptoms of piles?

• Itching all throughout the anus
• discomfort and pain in the vicinity of the anus
• a painful or itchy bulge or swelling around your anus leaking of feces
• bowel motions that are painful blood on the tissue after having a bowel movement
• Although hemorrhoids are unpleasant, they are not life-threatening and typically resolve on their own.

Diagnosis of piles

Doctors diagnose piles by asking about the patient's symptoms and clinical history, as well as doing a physical exam.

The anal area is examined for any bulging piles via the anal orifice during the physical examination. A rectal examination is also performed. The patient is asked to lay on his left side with his knees curled against his chest for the rectum examination. The doctor checks the walls of the anus and rectum for swellings and other abnormalities by inserting a gloved finger into the anal opening. A visual examination of the anal area and a digital rectal examination are usually used to diagnose piles.

Anoscopy, also known as proctosigmoidoscopy, is used to better view the rectum and anus and rule out other causes of rectal bleeding than piles. In this surgery, the surgeon inserts a tube through the anus into the rectum and visually inspects the area with light.

As further testing, blood tests such as hemoglobin, complete blood counts, blood coagulation studies, and liver function tests are performed.

The patient has a barium enema (injection of a radiocontrast fluid, barium sulfate, into the rectum from the anus) before the Barium X-RAY is performed to examine the whole colon.

Treatment for piles

Changes in lifestyle

• To control piles, a doctor will first suggest certain lifestyle modifications.
• Diet: Piles may develop as a result of straining during bowel movements. Constipation is the cause of excessive straining. A dietary adjustment may help maintain the stools regular and soft. Consuming extra fiber, such as fruits and vegetables, or mainly eating bran-based morning cereals, is one way to accomplish this.
• A doctor may also urge a person suffering from piles to drink more water. Caffeine should be avoided.
• Body mass index: Weight loss may help decrease the occurrence and severity of piles.
• Doctors also recommend exercising and avoiding straining to evacuate feces to avoid piles. Exercising is one of the most common treatments for piles.

Surgical options

One out of every ten individuals with piles will need surgery.

Infrared coagulation A device is used to burn the hemorrhoid tissue, also known as infrared light coagulation. This method is used to treat hemorrhoids of grades I and II.

Hemorrhoidectomy Surgical removal of the extra tissue that is causing the bleeding. This may be accomplished in a variety of methods, including a combination of a local anesthetic and sedation, a spinal anesthetic, or a general anesthetic. This kind of surgery is the most successful for fully eliminating piles, but there is a risk of consequences such as bowel obstruction and urinary tract infections.

Hemorrhoid stapling Blood supply to the hemorrhoid tissue is stopped. This is a less painful treatment than hemorrhoidectomy.