Piles

What is Piles?

Piles, also known as hemorrhoids, are swollen veins in the rectum or anus that can cause discomfort, itching, and bleeding. They can be internal, external, or protrude outside the anus. Piles are a common condition, affecting millions of people worldwide. The symptoms can range from mild to severe, and may include pain during bowel movements, swelling, itching, and bleeding. They can be caused by constipation, pregnancy, poor diet, or other factors. Treatment options usually involve lifestyle changes, such as dietary modifications and increased fiber intake, as well as medical treatments like creams, ointments, or surgery in severe cases.

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Symptoms & Diagnosis

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In most cases, the symptoms of piles are not serious and resolve on their own.

An individual with piles may experience the following symptoms:

• painful lumps in and around the anus
• itching and discomfort around the anus
• discomfort during and after passing stools
• bloody stools

Piles can escalate into a more severe condition. These include:

• excessive anal bleeding, possibly leading to anemia
• infection
• fecal incontinence
• anal fistula
• strangulated hemorrhoid, in which anal muscles cut off blood supply to the hemorrhoid

However, many people with piles may not experience any symptoms.

When to contact a doctor

A person should seek medical assistance if their piles persist for more than one week Trusted Source of home treatment or if they experience consistent bleeding from their rectum.

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Treatment

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The best treatment for piles will depend on:

• how severe they are
• how much the symptoms affect your life

How do you get rid of piles?

There are plenty of piles treatments that can relieve your symptoms. Below are the main treatments for piles.

Medicines for treating piles

Below are some medicines for piles – always read the instructions, and check with a doctor if you have any concerns.

• Fibre supplements such as ispaghula husk (eg Fybogel) can soften hard poo.
• A mild laxative such as lactulose can make poo easier to pass.
• Over-the-counter painkillers, such as paracetamol, may help to ease any pain from piles. Avoid opioid-based painkillers (such as codeine). These can cause constipation.
• Haemorrhoid creams, ointments, and suppositories may ease any pain and itchiness from piles. Some contain a local anaesthetic, such as lidocaine. Only use these for a few days as they may affect the sensitivity of your skin.
• Products containing corticosteroids, such as Anusol HC and Proctosedyl, may reduce swelling and pain. Don’t use these for more than a week as they can damage the skin around your anus. Most are available over the counter and others on prescription.

Non-surgical treatments for piles

Piles will usually go away on their own but, if they don’t, you might need a day case procedure at hospital. Non-surgical treatments include the following.

• Banding: a small elastic band is put around the pile, reducing the blood supply. The pile will die and fall off after a few days.
• Sclerotherapy: an injection of an oily solution into your piles, which will make them shrivel up.
• Infra-red coagulation: an infrared light is used to cut the blood supply to your piles and make them shrink.
• Bipolar diathermy and direct current electrotherapy treatment: In this procedure, heat or an electrical current is used to destroy the pile.

Your doctor will let you know the benefits and risks of each procedure and which is the best option for you.

Surgery for piles

Most people don’t need an operation to treat piles. But if you do, there are different types of surgery for piles, which include the following.

• Haemorrhoidectomy: pile removal surgery.
• Stapled haemorrhoidopexy: the area of tissue with piles are attached higher up your anal canal and stapled in place. Your piles then won’t come out your anus anymore and will shrink.
• Haemorrhoidal artery ligation operation (HALO): the blood supply to the piles is cut off, which makes them shrink.

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After Treatment

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• Blood on toilet paper
• It's normal to see some blood on toilet paper after a procedure, but there shouldn't be a lot of bleeding. If you see a lot of bright red blood or blood clots, you should go to the emergency room immediately.
• Mucus discharge
• Within a week of the procedure, you might notice mucus discharge, which usually means the hemorrhoids have fallen off.
• Ulcers
• Ulcers can form at the site of the banding, but they usually heal without treatment.
• Pain
• Most people say the pain is gone after two weeks, but it might be six to eight weeks before you can resume strenuous exercise or manual labor.

Some non-surgical treatments for piles include:

• Banding: A small elastic band is placed around the pile to reduce blood supply, causing it to die and fall off after a few days. In about 80% of cases, this technique cures the piles, but they can come back in about 20% of cases. You can try banding again if the piles come back, and you can reduce the chances of them coming back by avoiding straining on the toilet and constipation.
• Sclerotherapy: An oily solution is injected into the piles to make them shrivel.
• Infra-red coagulation: An infrared light is used to cut off blood supply to the piles, causing them to shrink.
• Bipolar diathermy and direct current electrotherapy: Heat or an electrical current is used to destroy the pile.

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Patient Reviews

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