Haemorrhoids (Piles) Treatment in Punjabi Bagh, West Delhi

About Piles (Hemorrhoids)

Piles, medically known as hemorrhoids, are swollen veins in the lower rectum or anus, similar to varicose veins that occur in the legs. They develop when the blood vessels in this area become inflamed or stretched due to increased pressure. Piles are common, affecting nearly half of adults over 50, and can cause discomfort, pain, itching, or bleeding. While they are often linked to lifestyle factors such as constipation, prolonged sitting, or a low-fiber diet, underlying medical conditions may also contribute.

Piles can be internal (inside the rectum), external (under the skin around the anus), or mixed (both internal and external). The severity can range from mild irritation to significant swelling requiring medical intervention.

Types of Piles (Hemorrhoids)

Piles are classified based on their location and severity:

1. Internal Hemorrhoids: Located inside the rectum and usually painless. They may bleed during bowel movements and are graded from I to IV based on severity:

• Grade I: Swelling within the rectum, no prolapse.
• Grade II: Prolapse outside the anus during bowel movements but retract spontaneously.
• Grade III: Prolapse that requires manual pushing back into the anus.
• Grade IV: Permanently prolapsed and cannot be pushed back, often requiring surgical intervention.

2. External Hemorrhoids: Develop under the skin around the anus. They can be painful, especially when a blood clot forms (thrombosed hemorrhoid), causing severe swelling and discomfort.

3. Mixed Hemorrhoids: Contain features of both internal and external hemorrhoids and may cause bleeding, pain, and swelling simultaneously.

Signs & Symptoms of Piles (Hemorrhoids)

Symptoms vary depending on the type and severity of hemorrhoids:

• Bleeding: Bright red blood on toilet paper, in the toilet bowl, or coating the stool. Usually painless.
• Pain or Discomfort: Especially with external hemorrhoids or thrombosed piles. Pain can increase during bowel movements or sitting.
• Swelling or Lump: Around the anus, which may be tender to touch.
• Itching and Irritation: Due to mucus discharge or skin irritation from prolapsed hemorrhoids.
• Mucus Discharge: May cause a feeling of incomplete evacuation or dampness around the anus.
• Prolapse: Internal hemorrhoids may protrude outside the anus, causing discomfort or hygiene issues.

Causes of Piles (Hemorrhoids)

Piles occur due to increased pressure on rectal veins or weakened supporting tissue. Common causes include:

• Chronic Constipation: Straining during bowel movements stretches rectal veins, promoting hemorrhoid formation.
• Diarrhea: Frequent loose stools irritate the anal region, increasing risk.
• Pregnancy: Increased abdominal pressure from the growing uterus can enlarge rectal veins. Hormonal changes also contribute.
• Sedentary Lifestyle: Prolonged sitting, particularly on the toilet, can increase rectal vein pressure.
• Obesity: Extra body weight adds pressure to the pelvic and rectal veins.
• Heavy Lifting: Frequent lifting of heavy objects strains the abdominal and rectal veins.
• Low-Fiber Diet: Diets lacking fiber cause harder stools, leading to straining and hemorrhoid formation.
• Aging: Weakening of supportive tissues around the anus and rectum with age increases vulnerability.

Risk Factors of Piles (Hemorrhoids)

• Age: Tissue elasticity decreases with age, increasing susceptibility.
• Pregnancy & Childbirth: Elevated hormone levels and pressure during delivery exacerbate risk.
• Obesity: Extra weight increases rectal vein pressure.
• Family History: Genetic predisposition to weak vein walls or connective tissue.
• Chronic Straining: From constipation, diarrhea, or frequent heavy lifting.
• Prolonged Sitting: Jobs or habits requiring long sitting periods, especially on the toilet.
• Low Physical Activity: Weakens bowel function and circulation, contributing to constipation.

Diagnosis of Piles (Hemorrhoids)

• Medical History Review: The doctor evaluates symptoms, bowel habits, dietary factors, and family history.
• Physical Examination: Includes inspection of the anal region to detect external hemorrhoids or prolapsed internal hemorrhoids.
• Digital Rectal Exam: The doctor may insert a gloved finger to feel for internal hemorrhoids or abnormalities.
• Anoscopy: A small tube with a light allows direct visualization of internal hemorrhoids.
• Proctoscopy / Sigmoidoscopy: Used for more detailed inspection of the rectum and lower colon, especially if bleeding is present, to rule out other conditions.

Treatment Options for Piles (Hemorrhoids)

Treatment depends on type, severity, symptoms, and complications.

Conservative Management:

• Dietary Changes: High-fiber diet including fruits, vegetables, and whole grains to soften stools.
• Hydration: Drinking 2-3 liters of water daily to prevent constipation.
• Topical Medications: Creams, ointments, or suppositories to reduce inflammation and pain.
• Sitz Baths: Warm water baths several times a day to relieve discomfort.
• Pain Relief: OTC medications like acetaminophen or ibuprofen.

Minimally Invasive Procedures:

• Rubber Band Ligation: A tight band is placed around the base of internal hemorrhoids, cutting off blood flow, causing it to shrink and fall off.
• Sclerotherapy: Injection of a chemical solution to shrink internal hemorrhoids.
• Infrared Coagulation: Uses heat to reduce hemorrhoid size.
• Laser Therapy: Minimally invasive laser treatment to remove or shrink hemorrhoids.

Surgical Intervention:

• Hemorrhoidectomy: Surgical removal of large or severe hemorrhoids, typically for Grade IV or recurrent cases.
• Stapled Hemorrhoidopexy: Stapling procedure for prolapsed internal hemorrhoids, reducing blood flow and repositioning tissue.

Prevention: Lifestyle and dietary changes are key to preventing recurrence, including high fiber intake, adequate hydration, regular exercise, and avoiding prolonged sitting or straining.