Piles - Symptoms and Treatment

Piles - Symptoms and Treatment

Piles are hemorrhoids that become inflamed. Hemorrhoids are masses, clumps, cushions of tissue in the anal canal - they are full of blood vessels, support tissue, muscle and elastic fibers.

Piles can be of various sizes and may be internal (inside the anus) or external ones (outside the anus). Typically, internal piles occur from 2 to 4cm above the opening of the anus. External piles (perianal hematoma) occur on the outside edge of the anus. The internal ones are much more common.

Symptoms for piles

A symptom is something the patient feels and describes, such as a pain, while a sign is something everybody can see, such as a rash.

In most cases piles are not serious and go away on their own after a few days. In fact, a considerable number of people with hemorrhoids do not experience any symptoms and do not even know they have them.

An individual with piles may experience the following symptoms:

• A hard lump may be felt around the anus. It consists of coagulated blood, called a thrombosed external hemorrhoid. This can be extremely painful

• After going to the toilet, a feeling that the bowels are still full

• Bright red blood when doing a bowel movement

• Itchiness in the anus area

• Mucus discharge when emptying the bowels

• Pain while defecating

• The anus area may be red and sore

• When passing a stool the person may strain excessively

Treatment for piles

In the majority of cases, piles resolve on their own without the need for any treatment. Treatments can help significantly reduce the discomfort and itching that many patients experience.

A good doctor will initially recommend some lifestyle changes.

Diet - piles can be caused by too much straining when doing bowel movements, which is the result of constipation. A change in diet can help keep the stools regular and soft. This involves eating more fiber, such as fruit and vegetables, or even switching your cereal breakfast to bran.

Water is the best drink, and the patient may be advised to increase his/her water consumption. Some experts say too much caffeine is not good.

Body weight - if the patient is obese, losing weight may help reduce the incidence and severity of hemorrhoids.

Simple things you can do yourself:

• Try not to strain when you go to the toilet

• Use moist toilet paper instead of dry

• Rather than rubbing the anus area when cleaning after going to the toilet, pat instead to avoid irritation if you already have piles

Ointments, creams, pads and other OTC medications - there are some over-the-counter (OTC) medications which help soothe the redness and swelling around the anus area. Some of them contain witch hazel, hydrocortisone, or some other active ingredient which can relieve symptoms of itching and pain.

It is important to remember that they do not cure piles, they only treat the symptoms. Do not use them for more than seven consecutive days - longer periods may irritate the anus area and cause skin thinning. Unless advised to by your doctor, do not use two or more medications simultaneously.

Corticosteroids - these can reduce inflammation. However, usage must not exceed about six to seven days.

Painkillers - ask your pharmacist for suitable painkilling medications, such as acetaminophen (Tylenol, paracetamol).

Laxatives - the doctor may prescribe one if the patient suffers from constipation.

Banding - the doctor places an elastic band around the base of the pile inside the anus, cutting its blood supply. After a few days the hemorrhoids fall off. This can work for Grades 2 and 3 hemorrhoids.

Sclerotherapy - a medicine is injected into the vein to make the hemorrhoid shrink - the hemorrhoid eventually shrivels up. This is effective for Grades 2 and 3 hemorrhoids, and is a useful alternative to banding.

Infrared coagulation - also referred to as infrared light coagulation. Used for Grades 1 or 2 hemorrhoids. A device burns the hemorrhoid tissue.

Surgery - used for particularly large piles, or Grades 3 or 4 hemorrhoids. Generally, surgery is used if other procedures were not effective. Sometimes surgery is done on an outpatient basis - the patient goes home after the procedure, or he/she may have to spend the night in hospital.

• Hemorrhoidectomy - the excess tissue that is causing the bleeding is surgically removed. This can be done in various ways. It may involve a combination of a local anesthetic and sedation, a spinal anesthetic, or a general anesthetic. This type of surgery is the most effective in completely removing piles, but there is a risk of complications, which can include difficulties passing stools, as well as urinary tract infections.

• Hemorrhoid stapling - blood flow is blocked to the tissue of the hemorrhoid. This procedure is usually less painful than hemorrhoidectomy. However, there is a greater risk of hemorrhoid recurrence and rectal prolapse (part of the rectum sticks out of the anus).