Hemorrhoids - Symptom, Treatment And Causes

Hemorrhoids or piles are diagnosed by swelling of veins in the lower part of anus and rectum. Due to swelling, the walls of rectum and anus are stretched and thus become irritated. Hemorrhoids are of two types: Internal and External hemorrhoids.

Internal Haemorrhoids: As the name suggests, the piles are not visible from outside. These are present deep inside the rectum, located above the pectinate line and these are covered with the cells that are present through the rest of intestines. Internal hemorrhoids are normally painless. The first sign of internal hemorrhoids is rectal bleeding. However, straining can push internalhemorrhoid and it protrudes through the anus and this can be painful.

Causes of Haemorrhoids
The swelling of hemorrhoid occurs only when the pressure in the small vessels of rectum and anus is increased and is engorged with blood. The size of the hemorrhoids is also increased. The increased pressure may be due to various factors:

• Consuming low fiber diet and pushing or straining while passing stools, thus blood vessel pressure is increased.
• Pregnancy also is a cause of swelling as there is the increased pressure of the uterus on rectum and anus.
• Sitting for long on toilet also increases pressure.
• Obesity is also a cause of hemorrhoids.
• People suffering from diarrhea, both acute and chronic.
• A person having colon cancer might have hemorrhoids.

Signs and Symptoms of Haemorrhoids:

• The most common symptoms of hemorrhoids are painless bleeding, itching in anal, swelling and feeling of the presence of lump at the anus.
• All these symptoms are associated with inflamed hemorrhoid.
• Inflamed internal hemorrhoid can cause swelling, but is painless as there are no fibers attached to veins above the pectinate line that cause pain. However, passing hard stools can scrape off the thin lining of hemorrhoid, which can cause the painless bleeding.
• Spasms of the rectum and anal muscles caused by these swollen hemorrhoidscause pain, especially when they are protruded through the anus.
• Internal hemorrhoids can form a clot or thrombose resulting in severe pain.
• The presence of has inflammation, stool,and constant moisture and these can lead to itching and burning sensation in the anus among patient of internal hemorrhoid.

Treatment of Haemorrhoids

• Diet: Haemorrhoids can be treated when individuals consume a fiber-rich diet in order to soften the stools and ease their bowel movements. Fiber-rich foods include fresh fruits, dry fruits, grains, vegetables, and cereals. About 20 to 30 grams per day of fibrous foods is recommended. Dietary fiber will help create bulk in the intestines which will help in softening of stools and ease bowel movement. Supplemental fiber available in the marketincludes psyllium husk, methylcellulose, and calcium polycarbophil. Other recommendations include increased intake of liquids and having stool softeners. Drinking enough water and liquids will prevent stool from hardening.
• Over-the-counter topical treatment: There are various products available to treat hemorrhoids, such as gels, hydrocortisone creams, ointments, foams, pads, and suppositories.
• Home remedies: Soaking anus in a warm sitz bath might also help in hemorrhoids for about 10 to 15 minutes per day. One should practice good hygiene and clean anus with warm water while showering. Avoid using soap and dry toilet paper. One can also use a cold compress on the anus.

Minimally Invasive Procedure for Hemorrhoids (MIPH)

Out of the various types of medical and surgical interventions available to treat Piles, Minimally Invasive Procedure for Hemorrhoids (MIPH) 0r painless stapler surgery is known to be very popular since it acts an alternative approach to surgical interventions made for piles.

MIPH is defined as a minimally invasive surgical technique in which a band of loose or prolapsed mucosa and sub mucosa in the rectum is excised, proximal to the piles and disrupted mucosa is fixed by ‘stapled end to end mucosal anastomosis.

This will ultimately occlude the blood supply to the superior hemorrhoidal artery above the hemorrhoidal tissue, resulting in the retraction of prolapsed mucosa back to its original anatomical position. A special circular stapler known as PPHO3 is used in the anastomosis and the whole maneuver will take around 30–45 minutes. In case you have a concern or query you can always consult an expert & get answers to your questions!

The symptoms of haemorrhoids are quite painful, annoying, and uncomfortable, whether they are internal (inside the rectum) or external (outside the rectum). Most of the people having haemorrhoids recover from the symptoms with some mild treatment options such as applying some creams and ointments, drinking plenty of water or eating a fibre diet. But if the symptoms become severe, resulting in more complications that can’t be treated with mild treatment options, then surgery is recommended.

Following are some important reasons to go for haemorrhoid surgery:

1. When haemorrhoid symptoms still persist: The most common reason why a majority of patients go for surgery is that their haemorrhoid symptoms continue even after having undergone a conservative medical treatment. The affected individuals experience pain, swelling, bleeding, and itching.
2. When serious complications develop: Some patients may develop serious complications of haemorrhoids, which may include thrombosed haemorrhoids and prolapsed haemorrhoids. When a clot (thrombus) develops in the external haemorrhoids giving a feeling of a lump near the anus, the condition is called thrombosed haemorrhoids. When internal haemorrhoids prolapse through the rectum and bulge outward from the anus due to excessive straining, the condition is called prolapsed haemorrhoids. Both these conditions cause severe irritation and can become infected. Therefore, they require a surgical treatment.
3. When haemorrhoid symptoms become worse: Some patients may experience symptoms of haemorrhoids even at the time of diagnosis. This may require immediate medical treatment including a surgery, if needed. These symptoms include anaemia (occurs due to excessive bleeding), strangulated haemorrhoid (develops when internal haemorrhoid becomes constricted due to loss of blood supply) and extreme pain.

Types of haemorrhoid surgeries:
The two most common types of surgeries performed nowadays to treat haemorrhoids include:

1. Haemorrhoidopexy: It is also called stapled haemorrhoidectomy or haemorrhoid stapling. This is used for the treatment of prolapsed haemorrhoids. During the procedure, the prolapsed haemorrhoid is surgically stapled back inside the rectum to its place and the blood supply cuts off so that the tissue shrinks.
2. Haemorrhoidectomy: Also called haemorrhoid removal, it is used for the treatment of large external haemorrhoids and prolapsed internal haemorrhoids that don’t respond to other treatment options. During the procedure, the surgeon cuts out the large haemorrhoid.

There are various factors that a doctor considers while deciding on the right surgical treatment option for haemorrhoids. The degree of the symptoms, place, type of haemorrhoids, diagnosis and the individual patient’s conditions are determined before deciding to go for a haemorrhoid surgery. Hence, it is crucial that you discuss the treatment options with a specialist to get the best possible recovery. In case you have a concern or query you can always consult an expert & get answers to your questions!

Your body starts sending signals well before a condition can assume a critical state, and hence it becomes essential to listen to your body to avoid getting into complications. Internal haemorrhoids, less painful than external haemorrhoids, can worsen over time if left untreated and can result in bleeding.

The term haemorrhoids, commonly known as piles, refer to inflamed and swollen veins in the anus and the rectum that cause bleeding and discomfort, especially during sitting and bowel movements. When the blood veins inside of the rectum become engorged and swollen, it is referred to as internal haemorrhoid.

When internal haemorrhoids take moderate to severe form, they require surgery. Here is a closer look at the surgical options available for treating internal haemorrhoids.

1. Closed hemorrhoidectomy: Closed hemorrhoidectomy is the most common surgical procedure used for treating internal haemorrhoids. In this case, excision of the haemorrhoid bundles is performed by using sharp instruments like electrocautery or scalpel or scissors, followed by complete closure of the wound with absorbable suture. Closed hemorrhoidectomy has a success rate of around 95% for treating internal haemorrhoids completely.
2. Open Hemorrhoidectomy: In this surgical procedure, hemorrhoidal tissues are excised in the same way as that of the closed hemorrhoidectomy. The only difference here is that the incision is not closed but left open. Open hemorrhoidectomy is usually performed at such locations where the closing of the wound is difficult or may have a high risk of postoperative infections. Depending on the requirement of the patient's internal haemorrhoid conditions, a combination of both closed and open hemorrhoidectomy may be carried out.
3. Stapled Hemorrhoidectomy: Stapled hemorrhoidectomy, also known as hemorrhoidopexy, is another surgical procedure where a stapling device of circular shape is used for excising a circumferential ring portion of the excess tissues of internal haemorrhoid. This procedure helps to lift the haemorrhoids back in their normal position inside the anal canal. This surgical technique is comparatively a new addition to the surgical treatment options for internal haemorrhoid treatment. Stapled haemorrhoidectomy is most widely accepted technique of haemorrhoidectomy. Advantages of this technique are: 
   • There is a minimal pain after surgery. 
   • There is minimal or no bleeding after surgery. 
   • Patients can resume their routine activities after 2-3 days. 
   • There is no external wound or scar after this surgery.
4. Rubber Band Ligation: Rubber band ligation surgery doesn’t require anaesthesia and can be performed for treating internal haemorrhoids. Here, a rubber band is used around the base area of haemorrhoid that is there inside the rectum, which helps in cutting off the blood circulation making haemorrhoid wither away within weeks. However, banding isn’t suggested for those who take blood thinners as it may increase bleeding complications.
5. Lateral Internal Sphincterotomy: In lateral internal sphincterotomy, the muscles of the inner anal sphincter are opened. This surgical procedure is for those patients with internal haemorrhoids who have high resting pressure on the sphincters. Though rarely used, this surgical method doesn't cause much pain after the operation.

A gastroenterology surgeon can determine the suitable surgery option only after a thorough analysis of one's physical health, and the condition and complications of the internal haemorrhoids. While sometimes, laparoscopic surgeries do help, for some a more traditional open kind of internal haemorrhoid surgery may become necessary. In case you have a concern or query you can always consult an expert & get answers to your questions!

The anus is a highly vascular area, and these blood vessels dilate, leading to a condition called hemorrhoids, which are external and protrude into the anus (external) or into the rectum (internal). While most hemorrhoids are self-limiting and can be managed with conservative care, about 10% to 20% of the hemorrhoids may require surgical removal.

When is surgery needed?

1. Thrombosed hemorrhoid
2. Prolapsed hemorrhoids
3. Relentless bleeding (maybe painless also)
4. Recurrent hemorrhoids

Types of surgery required
The exact location of the hemorrhoid and the severity will dictate the type of surgery required. Read on to know some of the common techniques are used to treat hemorrhoids.

1. MIPH (minimal invasive surgery for haemorrhoids): Also known as hemorrhoidopexy, it involves the use of surgical staples to keep a recurrently prolapsing hemorrhoid in place. These staples ensure they do not prolapsed again. It also cuts of blood supply, so the growth is curtailed. This is done as a same-day procedure under local or general anesthesia. This is the procedure of choice for grade 2 and grade 3 bleeding piles. It is a totally painless procedure and is widely accepted by patients.
2. Hemorrhoidectomy: It is done under general anaesthesia or spinal anaesthesia in people where conservative and in-office procedures have failed. The hemorrhoids are often large, prolapsed, and cause bleeding. This requires hospitalization and may need about a week to recover completely. This was the standard procedure earlier. It is still very useful for prolapsed large piles.

Post surgery, there could be rectal pain and discomfort. In addition, the patient should drink water adequately, eat a high-fiber diet, and use a stool softener to prevent recurrence. In case you have a concern or query you can always consult an expert & get answers to your questions!

Hemorrhoids are commonly known as piles. They are swollen blood vessels or blood clots in or around the anus and rectum. The veins are located in the lowest part of the rectum and the anus and in some instances they can swell which makes the vein walls to stretch. This, in turn, can restrict or irritate the passing of the bowel movements. Piles can be broadly classified into two general categories internal and external.

While there are many treatment plans of curing piles, nothing can come near the age-old treatments in curing piles. The treatment focuses on curing the symptoms from within and concentrates on the root cause of the problem. This makes it more efficient as far as the treatment is considered and it drastically reduces the chances of haemorrhoids from occurring again. While there are some medications as a part of treatments, it is also mandatory that one must follow a strict diet regime for the treatment to be a success. The diet rule is also very much needed for the treatment to be a success.

Let us look at the diet plan that is needed for a treatment against piles/Fistula. You can consult with your doctor to get to know more about this.

1. Breakfast: Dalia (sweet or salty depending on individual’s choice), Milk without fat, Tea, Toast, Chapati, Mix veg., Brown bread, Sprouts, Fruits like apple etc.
2. Lunch: Chapatis, Cooked mixed vegetables, Daal (cooked pulses), Boiled rice, Takra (Buttermilk), Salad prepared from onion, tomato, radish, turnip, carrots, papaya etc.
3. Evening Tea/snacks: Tea or coffee, Toasts, Dry fruits, Biscuits, roasted popcorns or any other light food item can be taken.
4. Dinner: Chapatis, cooked vegetables, Daal (cooked pulse), salad

Impartant food items you must note

1. Avoid taking curd or buttermilk in dinner.
2. At bedtime, lukewarm milk with a few drops of honey can be taken.
3. Flour with Mixed grains flour like wheat, barley, gram, soybeans etc. However, wheat flour with husk (without refining) can also be used.
4. Pulses, such as moong, masoor, gram, soybean etc. can be eaten
5. Vegetables like bottle gourd, radish, turnip, cabbage, cauliflower, raw green papaya, carrot, fenugreek leaves, chenopodium leaves, spinach leaves, tomato, potato and other green leafy vegetables.
6. Fruits such as papaya, coconut, apple, litchi, figs, watermelon, orange, guava etc. are good.
7. Liquids and juices for example coconut water, bottle gourd juice, apple juice, mixed fruit juice, aloe vera juice, trifala ras, wheat grass juice etc. can be taken
8. Dry fruits like almonds, pistachio, dried grapes etc.
9. Spices that can be consumed turmeric, coriander powder, fenugreek, cummin seeds, ajwain, saunf etc.
10. Ghee and cooking oils like Cow’s ghee, mustard oil, olive oil, groundnuts’ oil, soybean’s oil etc. can be used
11. Have plenty of fluids including water.
12. Avoid the intake of Tea and Coffee.
13. Avoid non-veg. and junk/spicy food items.
14. Avoid smoking and alcohol and also do not indulge in chewing of tobacco products.
15. Always ensure to follow the instructions of your physician strictly.

In case you have a concern or query you can always consult an expert & get answers to your questions!