Haemorrhoids

Background

Haemorrhoids are also most commonly known piles. These are swollen veins in your anus or lower rectum. They act like cushions in the lowers part of rectum and help in maintaining the continence of the the process of defecation. Haemorrhoids can develop internally or externally i.e. inside the rectum or the skin around the anus. Three out every four people can have haemorrhoids at some point in their lives. 

Causes and risk factors of  Haemorrhoids 

Haemorrhoids are dilate bunch of veins  in anal canal and rectum developed due to certain physiological and pathological causes. This makes them susceptible to irritation. This can be caused by various reasons.

  • Straining during bowel movements due to underlying constipation. 
  • Sitting and straining  for long period of time during toilet
  • Obesity 
  • Pregnancy 
  • Eating low fibre diet
  • Regular heavy lifting causing straining of lower pelvic muscles. 

 Symptoms and signs of haemorrhoids

The most common complaint and symptoms are:

  • Swelling and feeling lump at the anus
  • Anal pain and itching
  • Bright red blood is visible after a bowel movement
  • Pain occurs during the passing of stool
  • The area around anus is red, itchy and sore
  • Infection and excessive anal bleeding may also occur leading to anaemia
  • Inability to control stools 

Diagnosis and investigations 

A visual examination of your anus may be enough to diagnose haemorrhoids. To check for abnormalities in anus your doctor will do  examination known as digital rectal exam and proctoscopy. 

If any abnormality is felt a test called sigmoidoscopy is done by using a small camera to diagnose internal haemorrhoids. This will give the exact clear view of your rectum. Depending upon the grade and severity of the disease the surgeon will recommend you appropriate treatment. 

Treatment for Haemorrhoids

Depending upon the severity of condition the treatment can be done using medications/ out patient procedures / surgery

Medical management 

  • To minimise the pain, soak your lower body in a warm tub for at least 10 mins every day. 
  • If you feel constipated or you are passing hard stool then try to add fibre supplements to your diet or take the help of laxatives and stool softeners. 
  • Over the counter haemorrhoid creams and painkillers can help you to overcome discomfort and ease of your pain. Practice good hygiene by cleaning your anus with warm water. Avoid using soap or dry or rough toilet paper. 
  • Eat high fibre diet , drink Luke warm water and avoid constipation to prevent recurrences. 

Out patient Procedures 

These procedures are usually performed in low grade haemorrhoids though with development of better techniques these procedure are used less frequently. We will recommend you to get any of the procedures done under care of specialists only. 

Rubber Band Ligation: Here an elastic band is placed around the base of the pile cutting off its blood supply. After few days the haemorrhoid falls 

Sclerotherapy: Medicine is given to make the haemorrhoid shrink. This is an alternative to banding.

Infrared Coagulation: A device is used to burn haemorrhoid tissue. 

Surgical procedures 

These procedures require admission and performed under anaesthesia. They remain the gold standard solutions for long standing haemorrhoids. 

Haemorrhoidectomy: The excess tissue that is causing bleeding is surgically removed. This type of surgery is most effective for completely removing piles. This conventional technique is usually done by traditional method of open surgery. 

Stapler haemorrhoidectomy : This technique is performed using specialised gun called as stapler device which removes the excess haemorrhoid tissue. This is relatively very  painless  procedure and does not give any scar. Patients can go home next day . 

Laser haemorrhoidectomy : The technique is performed using laser probes and is day care procedure but requires anaesthesia. Laser burn the excess tissue and promote healing of residual tissue with time.

To consult with best team of General and  minimal access surgeons  available at  The Surgeons House (SHL) in different global locations, please click this link for more details. 

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