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 are swollen veins in the rectum or anus. They can have a lot of possible causes, but the exact reason is still unknown. The one most common reason that researchers cite is the excessive straining during bowel movement and increased pressure on the veins during pregnancy. Some of the common signs of this condition include discomfort, bleeding, and itching. A clot can be witnessed occasionally. There could be swelling around the anus as well.

How is a pile diagnosed?
Doctors often recognize this condition just by doing a physical exam of the rectum. By lubricating the glove and inserting a finger into the rectum, a doctor can gauge any unusual growth around the rectum area. A doctor might also use a sigmoidoscopy or a proctoscopy to witness the lower portion of the colon. Apart from this, a doctor might prescribe a colonoscopy, if he fathoms that there is a possibility of colorectal cancer or a disease related to the digestive system.

Treatment of piles

Medication: In case of mild discomfort, a doctor might prescribe over-the-counter pads, ointments, creams or suppositories. Products such as these contain lidocaine, witch hazel or hydrocortisone that can relieve a person from itching and pain. One should stop consuming over-the-counter medicine, if there is no change in the condition.
Haemorrhoid thrombectomy: If a clot has appeared along with a pile in the rectum, a doctor can remove it by making an incision and draining the clot. This can fetch instant relief. The best time to do this is within 72 hours of clot formation.
Minimally invasive procedures: 
Rubber band litigation: This form of surgery involves placing of a couple of rubber band at the base of the piles to cut off blood circulation. In due course, the haemorrhoids fall off. Although this form of treatment works for many people, the patient has the risk of bleeding within few days of placing the rubber band.
Sclerotherapy: This form of treatment involves injecting a chemical into the haemorrhoid. The chemical shrinks the piles within few days. There is hardly any pain involved with sclerotherapy.
Surgical procedure:
Haemorrhoidectomy: This is the process by which a surgeon eradicates the excess tissue that might be causing the piles. The patient is sedated before performing this procedure. Some amount of pain is experienced after the procedure is over. The temporary difficulty of urination can be faced by a patient after this procedure.
Stapled hemorrhoidopexy: This surgery is only performed for internal haemorrhoids. The process involves blocking the blood supply. The process of stapling has less pain compared to a Haemorrhoidectomy. On the flip side, studies have shown that this procedure has an increased chance of recurrence of haemorrhoids.


Piles - Diagnosis and Treatment

5 Foods to eat if you suffer from Piles

Piles, commonly known as hemorrhoid is a condition that leads to pain, discomfort and irritation while passing stool. It is caused due to inflammation of the veins in the lower rectum area. Piles is of two types: internal and external, one can suffer from both simultaneously. The damage in the lower rectum area is a result of aging, chronic constipation, pregnancy, diarrhea and consuming processed food on a daily basis. Piles also lead to bleeding not just while passing the stool but anytime. It is recommended to monitor one's diet and construct a plan that helps to diminish the problem. Here are certain types of foods which can help you deal with Piles better.

Whole grains

People suffering from piles are recommended to include a lot of healthy whole grains into their diet like bran cereal, brown rice, oatmeal, whole wheat pasta. These fiber rich foods soften the stool and help reduce the pain.

Leafy green vegetables

Green vegetables are packed with antioxidants and nutrients that help with digestion. Strengthening the digestive system is important while treating piles. Broccoli, sprouts, carrots, brussels, cabbage, tomato, asparagus, cauliflower, onions, cucumber are some of the vegetables that one should consume while battling piles.

Fruits

Fruits are high in nutrients, fiber, minerals and vitamins that help to regulate the bowel movement. Fruits that can be eaten with their skin on like apples, prunes, raisins, grapes, berries are full of fiber and are very beneficial. The ones that have to be eaten without the skin are good too, for example, papaya, banana, oranges.

Beans

Beans are high in fiber content and should be included in regular meals of a piles patient. Kidney, black, lima, navy beans, black-eyed peas, legumes are some good options.

Water

Although it is not a food, water is an important ingredient when it comes to treating piles. It is advisable to drink at least 6-8 glasses of water daily which helps with the smooth functioning of the bowel movement.

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5 Foods Items You Should Eat In Piles Problem

Rarely do people ascribe Erectile Dysfunction to Hemorrhoids. Yet the correlation between the two is not far-fetched. Research has suggested that men who have suffered from Hemorrhoids in the last year are at an increased risk of developing Erectile Dysfunction. These two conditions are apparently incongruous. For someone suffering from Erectile Dysfunction, there is a lack of blood flow to the penis. For someone suffering from Hemorrhoids, there is swelling of veins inside the rectum. 

Younger people are more at risk unlike most diseases like High blood pressure, Alzheimer s diseases etc which are progressively more likely to occur in older men, this problem is more likely in younger than in older men. The study found that about 24.9% men under 40 years, who had been diagnosed with hemorrhoids in the last year, had suffered from Erectile Dysfunction. So the correlation is more prevalent in younger men than older men. According to the findings of the study, men aged 30 or less are more likely to experience Erectile Dysfunction after being diagnosed with Hemorrhoids in the last year. Moreover, men between the ages of 30-39 are twice more likely to suffer from Erectile Dysfunction if diagnosed with Hemorrhoids in the last year.

The correlation between age and likelihood of occurrence of Erectile Dysfunction due to Hemorrhoids is quite clear from these findings. The Apparent reason according to researchers in the study, localized swelling of varicose veins in the deep anus region may be responsible for some local irritation which can give rise to Erectile Dysfunction. Manage the Pain First Young men, who are suffering from Erectile Dysfunction, ostensibly arising out of the presence or history of Hemorrhoids in the past year, need to first manage the pain due to Hemorrhoids. Pain arising out of Hemorrhoids can be very difficult to put up with. A decrease in hemorrhoids pain can reduce the discomfort to some extent. Bleeding during bowel movement, intense pain during and after sitting, a feeling of itchiness or irritation near the anus etc are all indicators of hemorrhoids. If one has to habitually push hard during a bowel movement, he/she is more likely to suffer from Hemorrhoids, since the varicose veins can swell up during such hard pushing. 

The solution to alleviate pain, one can use various topical solutions containing Witch Hazel and Aloe Vera. These are anti-inflammatory herbs. Most of the anti-hemorrhoid creams contain either of these two. Apart from using topical solutions, one needs to change his dietary habits. One should abstain from foods that upset the stomach and adopt foods that soften the stool. This can help one avoid straining while moving bowels and spare the varicose veins from being inflamed. One can also benefit by practicing anal breathing which exercises the PC muscles and the anal sphincter. This could benefit both Hemorrhoids and Erectile Dysfunction.

Hemorrhoids - How It Increase Risk Of Erectile Dysfunction?

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?

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