Hemorrhoids, also known as piles, are swollen veins or blood vessels, which can be internal (located inside rectum) or external (located outside rectum). They might be managed by increasing fluid intake and a high-fiber diet. Sometimes, Hemorrhoids might get infected and irritated to an extent that they require surgical removal.

Causes of Hemorrhoids:

Hemorrhoids are caused by increased pressure in blood vessels around the anus, causing them to swell and inflame which might be caused by a number of reasons.

Prolonged constipation

Chronic diarrhoea

Obesity

Aging

Pregnancy as it increases pressure on pelvic blood vessels

Weight lifting

Family history of Hemorrhoids

Persistent cough

Vomiting repeatedly

Sitting continuously for a very long period of time.

Symptoms of Hemorrhoids:

Some of the common symptoms of Hemorrhoids are:

Internal Hemorrhoids might bleed painlessly after bowel movement, but are problematic if they bleed too heavily.

External Hemorrhoids might also bleed after bowel movement, but often become irritating and painful.

External Hemorrhoids can lead to blood clots inside the vessel, which can cause severe pain. Proper treatment for such Hemorrhoids involves  incision and drainage  procedure.

Itchy and sore bottom.

A lump hanging off the anus.

Types of Hemorrhoids:

The type of Hemorrhoids decides the course of action for treatment.

First degree Hemorrhoids are small swellings which develop on inner lining of anus, being invisible from outside.

Second degree Hemorrhoids are larger swellings which might come out of the anus during bowel movement before disappearing inside again.

Third degree Hemorrhoids are lumps hanging off the anus which can be pushed back inside.

Fourth degree Hemorrhoids are larger lumps hanging down from the anus but cannot be pushed back inside.

Surgeries without Anesthesia:

Banding or rubber band ligation involves using a tight band around the base of Hemorrhoid to cut off its blood supply. It takes two or more procedures to be performed about two months apart.

Having the best success rate for small and internal Hemorrhoids, sclerotherapy involves injecting a chemical into Hemorrhoids, causing them to shrink and stop bleeding.

Coagulation therapy or infrared photocoagulation uses infrared light (heat or extreme cold) to retract and shrink the Hemorrhoid and is usually performed along with an anoscopy.

Hemorrhoidal artery ligation (HAL) or transanal hemorrhoidal dearterialization (THD) locates blood vessels causing Hemorrhoids to close them off.

Surgeries with Anesthesia:

Hemorrhoidectomy is used for large and external Hemorrhoids which do not respond to non- surgical intervention. So, they are cut out. Anesthesia can be general, regional, or local in this procedure. It takes longer time to recover completely.

Hemorrhoidopexy or stapling requires general, regional, or local anesthesia, and is used to treat prolapsed Hemorrhoids. A surgical staple cuts off the blood supply to Hemorrhoids to make the tissue shrink and reabsorb. It takes relatively less time for a full recovery.

Post- Surgical Care:

Some of the post care instructions are as follows

Painkillers might be prescribed for rectal and anal pain.

Consumption of a high-fiber diet prevents constipation and recurrence of Hemorrhoids.

Staying hydrated helps a lot.

Avoid heavy weight lifting and pulling.

Sitz bath helps to deal with post- surgical discomfort.

Seek medical help if having painful urination, fever, or dizziness.

Non-surgical Management of Hemorrhoids:

Hemorrhoids can be managed non-surgically by reducing strain in and around the anus.

Consuming a high fiber diet including cereals, fruits, vegetables, pulses, nuts, seeds, etc.

Consuming healthy fluids like water but avoiding alcohol and caffeinated drinks.

No delaying the emptying of the bowels.

Preventing constipation.

Weight management to lose excess body weight.

Regular exercise.

Take Away:

Hemorrhoids, if not severe, can be managed non- surgically. But if they get very painful and severe, surgical intervention through a number of techniques might be required; each one of them being safe, depending upon the severity of the situation.

Surgery For Hemorrhoids - What Should You Know?

Piles or Haemorrhoids is a disorder characterized by bleeding from anal opening during defecation. This bleeding can be in the form of drops or spurts. If untreated; mass protruding out from rectum is noticed. Initially this Pile mass gets reduced by itself but later on it progresses further so manual reduction of Pile mass becomes necessary. Later on these pile masses come out even on coughing sneezing, walking etc. Depending of their site of origin; these are divided in to internal and external Piles. 

How can you tell if you have Piles? 
Painless bleeding is the first sign of Piles. If it is not treated at this stage Pile mass protrudes out from Anal opening. The symptoms of piles are  

Internal Piles: 

In first stage, painless bleeding is the only symptom of Piles. 
In second stage, pile mass protrudes out from Anus during defecation which gets reduced by itself. In late second stage; Pile mass needs to be reduced manually. 
In third stage; Pile masses again come out after manual reduction. During sneezing coughing and walking also pile mass come out. 
External piles: A solid/ semi-solid lump in the anal region which becomes prominent while passing stools is the external haemorrhoid. When inflamed it constitutes of coagulated blood these are known as external haemorrhoids. 

Why do Piles occur? 
Piles occur when pressure in the lower rectum increases unduly. Due to this undue pressure, the blood vessels in the anus and rectum become swollen and bulge out. The causes behind this undue increase in pressure are  

Chronic diarrhoea 
Chronic constipation 
Pregnancy 
Lifting heavy weights 
Putting too much pressure while passing stool 
The Ayurvedic Approach To Piles Treatment- 
The ayurvedic approach to treating piles is a mix of exercise, lifestyle changes, diet, supplements and medication. The primary cause of piles being constipation, a large portion of the treatment is focused on improving the patient s digestive health and bowel movement. 

Haritaki churna is recommended to soften stool. 
Fibre rich foods like green leafy vegetables salads should be consumed in adequate quantity. 
To soften the stools, foods like papaya, amalaki, and figs are advised. 
A regular ayurvedic colon cleanse is very beneficial to keep the digestive system in good condition. Some other measures you should adopt are  

Take plenty of liquids like water, butter milk fruit juices etc. Butter milk is specially beneficial in Piles. 
Do regular Exercise 
Avoid sedentary lifestyle. 
Along with this Kshar Karma is done at week or 10 days interval. In this treatment specialized Ayurvedic medicine is applied on Pile masses. Kshar Karma stops bleeding and suppresses Pile masses. When these measures do not work and the Pile masses are big enough to remain inside and protrude out often; Ksharsutra ligation of Pile mass is recommended. 

In this treatment; Ksharsutra   a medicated thread is ligated at the root of Pile masses. Medicine released from thread blocks the blood supply of pile mass and Pile mass sheds off within 5-7 days. No hospitalization or bed rest is required in this treatment. Patient can continue his daily routine activities as usual. So Ayurvedic Kshar Karma and Ksharsutra are quite effective in treating Piles in all its stages and Piles can be treated completely without surgery.

An Ayurvedic Approach To Piles Treatment!

Homeopathy is the best alternative to avoid surgery specially, in the cases of piles, fissure, fistula. There are many cases that were recommended operation but with homeopathy not only they were treated successfully but the surgery was also not done.

Piles or haemorrhoids cause severe bleeding in the anal region due to an abnormal enlargement of the rectal veins. The bleeding occurs as a result of a sudden increase in pressure in the rectal area. The haemorrhoids which tend to grow in the exterior part of the anus tends to be severe painful as compared to the internal haemorrhoids (which are invisible and grows in the interior portion of the rectal area).

The major causes of haemorrhoids are genetic factors, pelvic tumours, excessive alcohol consumption, obesity, lack of regular physical exercise, undiagnosed and chronic gastric disorders like dysentery, diarrhoea or constipation and a significant increase in the weight of the uterus during pregnancy.

The sign of piles might include intense pain and irritation in the rectal area along with the presence of blood in the faeces and abnormal swelling of the affected area. If taken in a prescribed dosage, homeopathy can be very effective in curing piles. The most beneficial homeopathic preparations for piles are:

Nux vomica: This homeopathic preparation is useful in curing piles which display symptoms of extreme aggressiveness and intolerance to cold weather. If piles are caused due to excessive intake of spicy foods and alcohol or cigarettes, this homeopathic preparation can work as an effective cure.
Hamamelis: This preparation is useful to cure piles which show symptoms of blood in the faeces along with a sensation of discomfort and contusion.
Ratanhia: This preparation provides a remedy for severely painful hemorrhoids (which causes complications during excretion). Symptoms include severe pain which stays for several hours after excretion along with a burning sensation. It may be relieved with the help of cold water.
Graphites: If you suffer from the symptoms of chronic constipation, frequent skin eruptions and recurrent instances of menstrual anomalies in females along with piles, this homeopathic medication can provide effective cure to you.
Aesculus Hippocastanum: This homeopathic preparation provides an effective remedy for non-bleeding hemorrhoids along with the symptoms of severe back pain and pain in the anal regions.
Arsenic Album: This homeopathic preparation can prove effective in curing piles with the symptoms of a burning sensation during any forms of physical movement. If the hemorrhoids bleed extensively and are bluish in color, this homeopathic preparation can be beneficial in such cases.

Homeopathic Treatment for Piles

Hemorrhoids can be very painful and are impossible to ignore. They can be defined as internal or external swollen veins. In some cases, making a few lifestyle changes such as eating fiber-rich foods and drinking plenty of water may be enough to relieve the problem. In other cases, surgery may be required. Surgery for hemorrhoids depends on the severity of the case. There are many different types of surgeries that may be performed.

Banding
Banding or rubber band ligation is a surgical process used to treat internal hemorrhoids. This involves placing a tight band around the hemorrhoid base to cut off its blood supply. This procedure does not involve the use of anesthesia.

Sclerotherapy
This is also used to treat internal hemorrhoids. It involves injecting a particular chemical into the hemorrhoid that makes the hemorrhoid shrink and keeps it from bleeding. This procedure does not involve the use of anesthesia.

Coagulation therapy
Coagulation therapy is also referred to as infrared photocoagulation. The procedure involves the use of infrared light and extreme heat and cold. The aim here is to help the hemorrhoid shrink and retract. It may be performed with an anoscopy. An anoscopy is a procedure that allows the doctor to look inside the rectum with the help of a scope. This procedure does not involve the use of anesthesia.

Hemorrhoidal artery ligation
Hemorrhoidal artery ligation (HAL) or transanal hemorrhoidal dearterialization (THD) is often used to remove hemorrhoids. It involves using an ultrasound to locate the swollen blood vessels and then closing these off. This procedure does not involve the use of anesthesia.

Hemorrhoidectomy
Large external hemorrhoids can be treated with a hemorrhoidectomy. Internal hemorrhoids that have prolapsed and are not responding to other forms of treatment can also be treated with this procedure. The procedure is performed while the patient is under general anesthesia or local anesthesia. The hemorrhoids are then cut off surgically. Hospitalization may be required for a few days after this procedure.

Hemorrhoidopexy
This procedure is also known as stapling and may be performed while the patient is under local or general anesthesia. It is typically used to treat prolapsed hemorrhoids. During the procedure, the doctor staples the prolapsed hemorrhoid to the walls of the rectum and cuts of the blood supply to the affected vein. By doing this, the tissue is allowed to shrink and be reabsorbed into the body. As compared to a hemorrhoidectomy, stapling is less painful and has a quicker recovery time. 

Surgical Treatment Of Hemorrhoids!

Piles, fistula and fissures are the most common problems affecting the rectum and the anus. Both the rectum as well as the anus has a very rich vascular supply. There could be swelling of these blood vessels or tearing which can lead to the above conditions. Read on to know additional details about each of these conditions. 

Piles: In simple words, swollen blood vessels of the anal region are called piles. It can be internal or external, depending on how far it is from the anal canal. If it is located farther inside the anal canal, it is called internal piles.

Causes:

Chronic constipation, where the person has to strain to pass stools
Smoking and genetics can also lead to piles.
Symptoms: Starts off as painless bleeding, which happens in drops after bowel movement; the swelling happens much later. They can continue to grow and develop blood clots.

Treatment:

In the early stages, once identified, simple topical medications for symptom relief are sufficient.
Diet should be rich in fiber, with fruits and vegetables
Increased water consumption
Surgery if the disease has reached the stage of blood clots
Prevention is advised if there is a family history by consuming a fiber-rich diet and maintaining hydration
Fistula: When an infected anal gland bursts into the anal canal, it constantly discharges pus into the anal canal and becomes a fistula. Hygienic toilet habits can help in preventing fistulas.

Symptoms:

A constant wet feeling in the anal area, due to pus discharge.
This would be intermittent, and there would be periods with no discharge.
There could be a foul smell due to pus discharge.
Diagnosis and Treatment:

Identifying the exact location is important as surgery may be required.
An ultrasound scan or an MRI is usually done.
Newer techniques like Video Assisted Anal Fistula Treatment (VAAFT) are used. This locates the piles accurately and uses electric current to seal it with staples and surgical glue.
Conventional surgery is also used for economic or accessibility reasons.
Fissures: These cracks anywhere in the length of the anal canal are extremely common.
Symptoms

Very painful and the person may not want to go to the toilet
Rarely bleeding is also seen, maybe in very small amounts
Treatment:

Over 90% of the fissures do not require surgery
Switching to a high-fiber diet and improving hydration will help in managing these symptoms.
Topical relief can be provided by medications.
When they are recurrent, a procedure known as lateral sphincterotomy is done. This is an outpatient procedure and provides immediate relief.
Though one condition can lead to another, in most people, there is a strong genetic component, and working towards prevention is highly recommended.

Piles, Fistula and Fissures - Can Ayurveda Help You?

Is Constipation the Only Cause of Piles? + It's Symptoms

Piles, which are also called hemorrhoids, refer to the swelling of the veins near the anus and rectum, which get irritated during bowel movements, causing pain and bleeding during stool motions. The veins near the rectum or the anus may rupture during strained bowel movements and thus, cause the blood to come out with the stool. This can be very painful for the patient and has a very disruptive effect on their lives.

Causes of Piles

There may be many causes for piles or hemorrhoids and the cause may vary from patient to patient. Let's have a look at a few of them.

Straining when passing a stool - This is by far the most common reason for piles and this is what causes the irritation on the veins or causes them to rupture

Chronic Constipation: People suffering from chronic constipation due to gastrointestinal problems may also suffer from piles due to putting pressure constantly to relieve themselves.

Lifting a heavy weight or doing strenuous work: This can also put physical stress on the anus or rectum and cause swollen veins, which may then rupture during the passage of stool.

Pregnancy - Pregnancy causes many hormonal changes in the body and the strain may also result in piles.

Symptoms of Piles

Some of the symptoms of piles or hemorrhoids are:

- Painful bowel movements, which hurt the rectum or the anus, accompanied by general tenderness within the region
- Bleeding or seeping of a bright red color blood onto the stool on the toilet or even on toilet paper
- Itching in the anal areas, which may be continuous or intermittent
- A swelling or lump near the anus, which is painful
- A mucus-like discharge from the anus

There may be one or more factors present in particular cases and if there is a pain in the rectal area, it is best to get it checked out by a doctor as soon as possible.

If you would like to consult with me privately, please click on 'Consult'.

Is Constipation the Only Cause of Piles? + It's Symptoms

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