Hemorrhoids are commonly known as piles. In this disease, the vein in the lower area of rectum swell like lumps and stretch so much that it causes rectal bleeding. The patient usually sees the bleeding while passing stool. Piles are one of the common causes of painless rectal bleeding. The disease gets diminished by itself when the swelling around the rectal region decreases. In the majority of cases it is not a dangerous condition as it gets treated by itself but sometimes may lead to severe blood loss. It can be very hazardous for those patients who have anti-coagulation disorders.
Causes of Haemorrhoids:
There are various causes of hemorrhoids. The following are some of the common causes:
- Increased straining during defecation: The most common cause. When there is an increase in pressure around the lower region of rectum, then the flow of the blood inside the veins increases and causes swelling. This swelling causes hemorrhoids.
- Pregnancy: It is also a cause for Haemorrhoids. During pregnancy, the region around the uterus is enlarged, which causes pressure on the lower abdominal vessels, leading to piles. Pregnant women have more chances to suffer from Haemorrhoids. It resolves after delivery of the baby.
- Low fibre diet: Eating fibre diets keep the bowel functioning in a balanced manner. The deficiency of fibrous food causes constipation leading to increased pressure during defecation leading to piles.
- Chronic Liver disease may also lead to hemorrhoids.
- Secondary to other colorectal problems for e.g rectal tumors, etc.
Symptoms of Haemorrhoids:
There are two types of Haemorrhoids – Internal (common) and external (Less common). We may face the following symptoms:
- Painless bleeding per rectum is the hallmark symptom
- Blood on toilet paper after wiping
- Tissue blogging outside the anus
- Feeling pain while pooping
- Burning sensation while strolling
- External Haemorrhoids
It is a type of Haemorrhoids in the skinny region around the anus; this region has more pain-sensing nerve supply; thus, external Haemorrhoids are painful.
Some common symptoms of external Haemorrhoids are:
- Pain in the anus region
- Bleeding while stooling
- Itching on the anus area
- Swelling in the anus region
- Bit of skin remains after swelling
Treatment of Haemorrhoids:
The following treatment methods are useful for the treatment of Haemorrhoids:
- No special treatment: Most of the time, Haemorrhoids go away on their own. The doctor can only give medicine to reduce the pain and to lower a few symptoms.
- Conservative Management: Eating fibrous food, using laxatives, and reducing constipation lower down the symptoms of Haemorrhoids. It is very important to avoid constipation as straining during defecation may cause the recurrence of hemorrhoids. Some of the examples of fibrous food include fruits, vegetables, and grains. Drinking more water and fluids also makes some relief.
- Sclerotherapy: For small hemorrhoids with persistent bleeding, a sclerosant is injected directly into the hemorrhoids. It is a painless and OPD procedure.
- Surgical treatments: If the hemorrhoids are large, are coming out of the rectum, become irreducible or strangulated, produce persistent bleeding even after conservative management, they need surgical excision called Hemorrhoidectomy. There are multiple methods of hemorrhoidectomy, ranging from open to stapled hemorrhoidectomy.
- Banding: A relatively newer procedure where a specialized rubber band is applied around the hemorrhoids.
Dr. Pranay Gourav | Consultant – General Surgery | Narayana Multispeciality Hospital, Barasat