What are Haemorrhoids
Haemorrhoids are commonly called piles. There are many blood vessels in and around the anus and also in the lower part of the rectum. When these normal blood vessels get swollen, they stretch and cause agonising pain and discomfort. The stretching of these blood vessels is frequent when there is increased pressure during defecation while straining to move the bowel. The other factors that may be responsible for stretching of the swollen blood vessels may be chronic constipation, diarrhoea, pregnancy and ageing. Thus piles can be defined as the swollen blood vessels that get stretched under increased pressure resulting in staining of blood droplets. Haemorrhoids are painful and can be classified into two types.
Haemorrhoids are called internal when the swollen and stretched blood vessels are found to be inside the anus on rectal examination.
The haemorrhoids that are found to be under the skin around the anus on rectal examination are called external haemorrhoids.
Clinical Features and Diagnosis
The diagnosis of the haemorrhoids depends on the clinical features that are found on rectal examination. There are many other symptoms that may be confused with piles like itching, abscess, pruritis, fistula etc. So rectal examination is mandatory in the diagnosis of piles. Per digital examination of the anal canal and viewing the anal canal with the help of a proctoscope removes confusions in diagnosis of other anal conditions with haemorrhoids. If some other cause of bleeding is suspected than sigmoidoscopy should be done.
Internal HaemorrhoidsThe symptom of internal haemorrhoids is bright red blood covering the stool. Draining mucous and itching may be the other symptoms.
External HaemorrhoidsThe internal haemorrhoids at times can protrude out of the anus outside the body. This is called external haemorrhoid, and it is painful and may cause itching at times. It is also called protruding haemorhoids.
Thrombosed external HaemorrhoidThe external haemorhoid that becomes hard and painful around the anus due to the formation of blood clots is called thrombosed external haemorrhoid. It may take the shape of a lump, it is swollen and painful.
Sitz BathSitz bath several times a day in warm water for 10-12 minutes gives much relieve from pain and swelling.
Ice PacksTo reduce swellings ice packs can be used.
Local ApplicationApplication of proctosedyle ointment or other suppositaries in the affected area may be of much help.
In case of more bleeding one can start taking some iron syrup to avoid anaemia.
Medical treatments will only bring relieve to the symptoms.
SclerotherapyIn this therapy a chemical solution is injected around the blood vessels, this is done to let the haemorrhoid shrink. The main aim is to reduce the size of the haemorrhoid.
Laser coagulation and Infra red photo coagulationThese are the methods that are used to burn the heamorrhoidal tissue, to help in the permanent cure.
Anal StretchingThis is also done under General anaesthesia to stretch the anal spincter.
Rubber band ligationThis is done so that the rubber band stretches and cuts the circulation and the haemorrhoid withers away. To facilitate the withering of the haemorrhoidal tissue, the rubber band is placed around the base of the haemorrhoid inside the rectum.
Haemorrhoidectomy-This is the best method which is used to remove all types of haemorrhoids, may it be severe or extensive, chronic internal or external haemorrhoid. This is the method that brings permanent cure and removal of haemorrhoids.
The patient suffering from Haemorrhoids should stop straining during bowel evacuation. This will lessen the chances of re-ocurrence and also prevent protruding piles.
Drinking plenty of water approximately, 2 litres or more water will help soften the the stools.
Constipation should be avoided and also the straining with pressure should be stopped.
Fiber rich food should be taken like whole wheat grain, vegetables and fruits, these fiber rich food helps the bowels to move easily and prevent pressure on haemorrhoids.