Hi. I want to talk about my beloved wife. She was suffering from haemorrhoids with extreme pain and the doctors did surgery but now after 3 months she is again suffering from early internal hemorrhoids and she again has pain she take various medicines but still she is in pain. What can I do please tell me.

Dr. Sajeev KumarGeneral Physician32yrs exp

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Most people use the term piles if they see any bold in motion, which may be just mild from minor injury in the excretion pathway resulting from constipation, or fistula or gastroenteritis and see in blood is NOT piles, in all cases. Piles are haemorrhoids that become inflamed. Haemorrhoids are masses, clumps, cushions of tissue in the anal canal - they are full of blood vessels, support tissue, muscle and elastic fibers. Piles can be of various sizes and may be internal (inside the anus) or external ones (outside the anus). Typically, internal piles occur from 2 to 4 cm above the opening of the anus. External piles (perianal hematoma) occur on the outside edge of the anus. The internal ones are much more common. Symptomatic haemorrhoids affect at least half the population at some time in their lives before the age of 50. In the majority of cases, piles are effectively treated with over-the-counter medications, a good fluid intake, and by following a diet high in fibre. In severe cases, the piles may have to be surgically removed. About 10% of patients who go and see their doctor about piles eventually require surgical intervention. Internal haemorrhoids are classified into four grades. ?Grade 1 - there are small inflammations, usually inside the lining of the anus. They are not visible ?Grade 2 - larger than grade 1 haemorrhoids, but also inside the anus. When passing a stool, they may get pushed out, but return unaided ?Grade 3 - often called 'prolapsed haemorrhoids'; these appear outside the anus. The patient may feel them hanging out. They can be pushed back in if the patient presses with their finger ?Grade 4 - these cannot be pushed back in and need to be treated by a doctor. They are large and stay outside the anus all the time. External haemorrhoids are called perianal hematoma. These are small lumps that are located on the outside edge of the anus. They are very itchy and can be painful if a blood clot forms inside (thrombosed external haemorrhoid). Thrombosed external haemorrhoid requires medical treatment straight away PILES OCCUR when the blood vessels around the anus and in the rectum will stretch under pressure and may swell or bulge. Inflamed veins (haemorrhoids) can develop when pressure increases in the lower rectum. This may be due to: ?Chronic constipation9 ?Chronic diarrhea10 ?Lifting heavy weights11 ?Pregnancy12 ?Straining when passing a stool. 13 The tendency to develop haemorrhoids may also be inherited. The risk of developing piles grows with age Treatments for piles In the majority of cases, piles resolve on their own without the need for any treatment. Treatments can help significantly reduce the discomfort and itching that many patients experience. Diet - piles can be caused by too much straining when doing bowel movements, which is the result of constipation. A change in diet can help keep the stools regular and soft. This involves eating more fiber, such as fruit and vegetables, or switching your cereal breakfast to bran. Water is the best drink, and the patient may be advised to increase his/her water consumption. Some experts say too much caffeine is not good. Simple things you can do yourself to help prevent piles: 10 ?Try not to strain when you go to the toilet ?Avoid laxatives ?Exercise. Ointments, creams, pads and other OTC medications - there are some over-the-counter (OTC) medications which help soothe the redness and swelling around the anus area. Some of them contain witch hazel, hydrocortisone, or some other active ingredient which can relieve symptoms of itching and pain Surgery - used for particularly large piles, or grades 3 or 4 haemorrhoids. Generally, surgery is used if other procedures were not effective. Sometimes surgery is done on an outpatient basis - the patient goes home after the procedure. 

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