Piles or Haemorrhoids
Piles (Hemorrhoids) are swollen veins in the lower rectum or anus, similar to varicose veins. Hemorrhoids can be internal (inside the rectum) or external (under the skin around the anus). They are common and can cause discomfort, pain, itching, and sometimes bleeding during bowel movements.
Management of Piles (Hemorrhoids)
1. Conservative/Home Treatment (for mild cases):
These steps often help manage or reduce symptoms of mild hemorrhoids:
• Increase Fiber Intake: Eating a high-fiber diet (fruits, vegetables, whole grains) helps to soften stools, reducing the risk of straining during bowel movements.
• Aim for 25-35 grams of fiber per day.
• Consider fiber supplements like psyllium (e.g., Metamucil) or methylcellulose (e.g., Citrucel).
• Stay Hydrated: Drinking plenty of water (at least 8 glasses a day) helps to prevent constipation and maintain soft stool consistency.
• Avoid Straining: Don’t strain during bowel movements, as this can worsen hemorrhoids.
• Sitz Baths: Sitting in a warm bath (Sitz bath) for 10-15 minutes several times a day, especially after bowel movements, can help reduce pain, itching, and inflammation.
• Topical Treatments: Use over-the-counter creams, ointments, or pads that contain ingredients like:
• Hydrocortisone (to reduce inflammation)
• Witch hazel (to soothe and shrink hemorrhoids)
• Lidocaine (for numbing the area)
• Cold Compresses: Applying ice packs to the anal area for 10 minutes can help reduce swelling and discomfort.
• Stool Softeners: Using stool softeners or laxatives (e.g., docusate) to ease bowel movements can prevent straining.
2. Medical Treatment (for moderate to severe cases):
If home treatments don’t provide relief or if the hemorrhoids are more severe, a doctor may recommend one of the following procedures:
• Rubber Band Ligation: A small rubber band is placed around the base of the internal hemorrhoid to cut off its blood supply, causing it to wither and fall off.
• Sclerotherapy: A chemical solution is injected into the hemorrhoid tissue, shrinking it.
• Infrared Coagulation: Infrared light is used to create scar tissue, cutting off the blood supply to the hemorrhoid, causing it to shrink. (eg Rafaelo Procedure)
• Electrotherapy: Electrical currents are applied to shrink the hemorrhoid.
3. Surgical Treatment (for severe or recurrent hemorrhoids):
For large, painful hemorrhoids, or if other treatments fail, surgery may be required:
• Laser Piles Surgery or Hemorrhoidectomy: This is the surgical removal of hemorrhoids and is often the most effective treatment for large or severe hemorrhoids. It’s done under anesthesia.
• Stapled Hemorrhoidopexy: This is a minimally invasive procedure where a circular stapling device is used to reposition and cut off the blood flow to internal hemorrhoids, causing them to shrink.
• Doppler-Guided Hemorrhoidal Artery Ligation: The surgeon uses ultrasound to locate the blood vessels supplying the hemorrhoids and ties them off, reducing blood flow and shrinking the hemorrhoid.
Preventive Measures:
• Diet and Hydration: Continue a high-fiber diet and drink plenty of water to avoid constipation.
• Exercise: Regular physical activity helps promote healthy digestion and prevent constipation.
• Avoid Sitting for Long Periods: Long periods of sitting, especially on the toilet, can put pressure on the veins in the anus and rectum.
• Don’t Delay Bowel Movements: Respond promptly to the urge to go to the bathroom. Holding in bowel movements can lead to harder stools and straining.
Proper management of hemorrhoids involves lifestyle changes and, when necessary, medical or surgical interventions. Early treatment can often prevent more severe cases from developing.