Piles Treatment

Piles or Hemorrhoids are the enlarged blood vessels present at the anus or rectum, causing bleeding and pain. They happen due to high pressure in the abdomen.

Piles are enlarged blood vessels present at the end of the anus. They look like soft lumps in that area. The blood vessels usually are present there. But they get enlarged, inflamed, and swollen due to certain conditions like pregnancy, obesity, etc. They can cause bleeding and discomfort. They are also known as hemorrhoids.

Associated Anatomy

Anus, rectum, and blood vessels.

Alternate Name

Piles are also known as Hemorrhoids.

Causes of Piles

The veins around the anus get swollen and stretched due to increased blood pressure. It caused those blood vessels to bulge and swelled to stretch under pressure and may bulge or swell. A few of the reasons for increased pressure are

• Pregnancy puts pressure on every organ in the body and increases blood pressure. It can result in piles in some pregnant women
• Constipation and diarrhea also caused strain and increased pressure
• Straining during bowel movements due to constipation
• Obesity
• Consuming a low-fiber diet can decrease bowel movement and cause constipation
• Lifting heavy weights daily
• Sitting on the toilet seat for a long duration.

Symptoms of Piles

Signs and symptoms of piles generally depend on the type. There are three types of piles.

External piles - are present just under the skin around the anus. Its signs and symptoms are

• Bleeding
• Itching and irritation around the anus
• Swelling around the anus
• Pain and discomfort

Internal piles - these are present inside the rectum. They are not visible or felt. Its signs and symptoms are

• Painless bleeding, especially during bowel movements
• A blood vessel might get pushed and fall out of the anal opening.

Thrombosed piles - when external piles bleed and clots. It can cause symptoms like

• Swelling
• Hard lump
• Severe pain
• Redness and inflammation

Typical Test Required For Piles

External piles are visible, and your doctor can see them. They do not need any special testing for diagnosis. However, for internal piles, diagnosing them might require a visual inspection and physical examination, which requires feeling around the rectum and anal canal to notice any lumps or unusual growths. Sometimes doctors may use specific instruments like a proctoscope for a clear visual.

Possible Piles Treatment

Piles most commonly do not need any medical treatment. They resolve it by themselves. But if you do not notice any improvement, then some of the piles treatments include

• Sclerotherapy - specific liquid is injected into the piles to shrink them.
• Infrared coagulation - infrared light is used to shrink the veins and cut the blood supply to the piles
• Rubber band ligation - a rubber band is tied around the piles so that they will drop.
• Hemorrhoidectomy - a surgery that cuts out the piles.
• Stapled Hemorrhoidopexy - the veins are stapled back inside the anus
• Haemorrhoidal artery ligation - the blood supply to the piles is cut using stitches to make them shrink.

Risk Factor for Piles

Some of the risk factors for piles are

• Eating low-fiber food regularly
• Eating gluten or lactose when you are gluten and lactose intolerant.
• Poor hydration
• Obesity and lack of regular exercise
• Anal injury
• Ascites - fluid accumulates in the abdomen due to liver disease.
• Certain intestinal conditions include IBD or inflammatory bowel disease (inflammation of the intestines or digestive tract).
• Rectal prolapse - when the rectum or the last part of the intestine falls out from the anal opening.

Possible Complications of Piles

Some of the possible complications of Piles can be an increased risk of infection, blockage of blood vessels, the reduced blood supply to the anal region, excess bleeding, clots, prolapse of the rectum, low hemoglobin due to bleeding (anemia), etc.

Prevention of Piles

Primary Prevention

• Eat food that has high quantities of fiber. Add more fruits, vegetables, and whole greens to every meal
• Strengthen your pelvic floor muscles, especially during pregnancy
• If you are allergic to gluten or lactose intolerant, avoid food containing them. It will reduce inflammation and decreases the risk of piles
• If you are constipated, do not strain yourself during bowel movements. Eating food with high fiber can reduce constipation.

Secondary Prevention

Secondary preventative methods are similar to primary Prevention.

• Drink lots of water
• Avoid highly processed food
• If you are constipated, do not strain. Try to use stool softeners
• Avoid lifting heavyweights
• Be active and exercise regularly
• Avoid sitting for long durations
• You can consider taking fiber supplements every day
• Go to the bathroom as soon as you feel the urge. Do not wait or try to stop the urge.

Differential Diagnosis

Other conditions that can be considered while examining the patient with piles are anal or rectal cancer, anal fissure, polyps, rectal prolapse, inflammatory bowel disease (IBD), perianal abscesses, anal fistula, etc.

Epidemiology

Piles are one of the most common anorectal-related issues.

• Studies have shown at least 50% of the population have piles at one point or the other during their lifetime by the time they reach the age of 50.
• At any point, at least 5% of the population has piles.
• It is common in both sexes.

Prognosis

Expected Prognosis

Piles can improve within a week if you take at-home precautions like using stool softeners, painkillers, high-fiber food, preventing constipation, being active, drinking water, etc. Sometimes they may cause excess bleeding, pain, and discomfort. At that point, medical treatments and procedures can remove piles easily.

Natural Progression

Most likely, piles improve without needing any medical treatment. If you are experiencing any pain or discomfort, you can get piles treatment. If they are present for a long time, without piles treatment, they can cause secondary infection, thrombosis or bleeding, unable to control the urge, pus-filled inflamed tissue, etc.

Pathophysiology

Blood vessels are usually present inside the anal and rectal regions. Increased pressure in the abdomen caused by constipation, pregnancy, etc., can put pressure on these veins and cause them to enlarge and bulge out.