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?

How to Manage Piles at Home and with Medication

Piles or hemorrhoids can be a debilitating disorder of the rectum and anus where passing stool becomes painful. It is the swelling of the veins in the anus and the rectum, which may then be bruised by hard stool passing through it or due to excessive pressure being put on it. This can be a very painful and embarrassing condition for many people to go through.

Remedies for piles at home

There are many remedies that you can try at home to reduce the pain and swelling and even reduce the hemorrhoids themselves over time. Let's look at a few of the options.

Radish for treatment: In this treatment, a radish should be crushed and mixed with appropriate amounts of milk to form a thick paste, which is to be applied on the anus twice daily, and washed off after 15 minutes. This should relieve the symptoms in a few days.

Cumin seeds paste: You can take a tablespoon of cumin seed powder, make it into a paste after adding water and then put it on the affected area. After leaving it for 15 minutes or so, it should be washed away with water. Repeating this twice daily will help with the symptoms and reduce pain.

Diet: Lack of a balanced diet can be problematic for those with piles, and thus, it is recommended that enough roughage such as green leafy vegetables and fruits are included in the diet as well.

Figs: Dried figs are also another great weapon against piles. Soaking some dried figs in warm water overnight and then having them in the morning is known to be good for smooth bowel movements, thus, relieving pressure on the rectal veins.

Some Ayurvedic Medications that May Prove Effective with Piles:

Some of the specific ayurvedic medication that are known to be helpful in treating piles are:

Hareetaki: This is the fruit peel of Harad and if taken with 1 cupful of jaggery, it can reduce the symptoms of constipation as reported by many patients.

Castor oil: Mixing a small teaspoon of castor oil with a glass of milk can also help soften the stool and reduce the stress on the rectal walls.

Nagakesara: This is also an ayurvedic medicine, which is usually prescribed as oral medication three times daily and has proven its effectiveness many times over.

Abhayarishta: 30 ml of this ayurvedic herb is also given to patients after food with equal parts water and has been known to be very effective.

Kasiaditaila: This is an oil, which should be applied externally and it can help reduce the inflammation and itching caused by piles.

10 Best Home Remedies to Treat Piles  - Natural Treatment

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

Piles are uncomfortable and painful. It can also be embarrassing and for this reason, many people delay their treatment. Piles usually affect middle aged people but at times, it can also affect younger men and women. Chronic constipation is one of the most common factors that can trigger piles. This is a condition where the veins near the anal opening in the rectum get inflamed. Any pressure that is put on the rectum puts pressure on these veins which may lead them pain and bleeding.

Luckily this is not a condition you need to live with and it can easily be treated with Ayurveda. Ayurveda approaches the treatment of this disease in multiple ways through dietary and lifestyle changes, medication, exercises and even massage therapy. It has negligible side effects and the potential to greatly improve the quality of your life even if you already have painful piles.

Dietary changes: Preventing constipation can prevent the development of piles. Hence, include plenty of fiber in your daily meals and cut down on starchy food. Adding sesame and mango seeds can also help prevent constipation. Fruits like jambul, papaya and dried figs are natural stool softners and should be eaten regularly.
Lifestyle changes: Along with eating the right food it is also essential to drink plenty of water. This helps the digestive system work smoothly. Avoid sitting in the same position for extended periods of time and only use soft, cushioned seats. Set aside at least an hour every morning for regular exercise such as walking, swimming, cycling or yoga. Certain yoga positions such as the downward facing dog and seated twist can make the process of eliminating waste easier. Scheduling a colon cleanse once in a while can also help treat piles.
Medication: Ayurvedic medication is based on herbs which have negligible side effects. Nagakesara is one such herb that is used to treat piles associated with bleeding. Haritaki and jimikand are two Ayurvedic herbs that can also help regulate your digestive system and treat piles. Abhayarishta is another herb that is often prescribed to treat piles. Kasiaditaila is an Ayurvedic medication that can be applied externally to help shrink piles and manage itching. It can also help relieve pain and bleeding. 
Though they have no major side effects, Ayurvedic medication should never be self-prescribed. Consult a qualified Ayurvedic doctor who will be able to prescribe the right medication in the right dosage for your problem.

How Ayurvedic Remedies Are Good For Piles?

Do you bleed or feel pain during bowel movements, or the skin around your anus feels sore or itches? Or maybe there's a lump in or around your anus, or you feel as if your bowels haven't emptied completely? Then you may be suffering from piles. Piles or hemorrhoids are essentially swollen veins and muscles in your anal canal or around your anus. And they may stay inside your anus or come outside depending on the severity of the affliction.

Often, piles can be successfully treated with high-fiber diet, proper hygiene, and topical medicines or ointments. But in situations where non-surgical methods don't achieve desired results, surgery becomes the only option. And this may be particularly necessary for those suffering from large painful or bleeding hemorrhoids. The different surgical options are given below:

Hemorrhoidectomy - In this procedure, the surgeon makes incisions around the anus to remove the piles formations. Local or general anesthesia is offered during the operation, and you can usually return home on the same day. After the procedure, the area might require stitches and commonly remains very tender and painful for quite some time.
PPH or Procedure for Prolapse and Hemorrhoids - This method is minimally invasive and makes use of a stapler-like machine for repositioning the hemorrhoids and cutting off their blood supply. So eventually, the piles shrink and die without blood supply and your pain diminishes greatly. With this process, you can expect a faster recovery, less itching and bleeding, and minimal complications, if any.
Laser - An accurate and special laser beam is used in this method, to burn off the hemorrhoids.
Rubber Band Ligation - This procedure can be used for areas with fewer pain receptors. In this, a rubber band is tied around the base of hemorrhoid to stem the blood supply and destroy the affected tissue.
Sclerotherapy - This method involves the injection of a chemical solution around the blood vessel which supplies the hemorrhoid tissues, to shrink and kill them. Though non-invasive methods are preferred by many since they create less pain, hemorrhoidectomy may provide more long-lasting benefits. Here are some other aspects you need to consider regarding piles surgery:
Risks - Infection, bleeding, reaction to anesthesia, trouble with urination, fecal incontinence are some of the risks involved, though the surgery is usually quite safe.
Ways of treating pain - Pain, especially during and after a bowel movement, can be an issue for several days after the surgery. But it can be dealt with by taking prescribed pain medications, stool softeners, and soaking in a warm bath. Recovery can take up to 3 to 6 weeks after the procedure.
Avoiding recurrence - Following a high-fiber diet, maintaining good hygiene, taking lots of fluids, and avoiding straining or constipation can prevent piles from coming back.

What You Should Know About Piles Surgery

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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