Piles, also known as hemorrhoids are varicose or dilated veins in the anal and rectal areas. External hemorrhoids come from the veins that are in and just above the
anus. They are outside of the anus and covered with skin, and may be
more painful because skin has more pain nerve fibers.
Piles, also known as hemorrhoids are varicose or dilated veins in the anal and rectal areas.
External hemorrhoids come from the veins that are in and just above the anus. They are outside of the anus and covered with skin, and may be more painful because skin has more pain nerve fibers. Most can be treated by keeping the area clean, but avoiding hard scrubbing. External hemorrhoids can thrombose, meaning that blood inside can clot, causing a painful and swollen lump. If pain is not severe, then sitz baths and analgesics may be enough until symptoms get better. However, if very painful, a surgeon can take the blood clot out, or remove the whole pile. Another treatment is a cream made with nifedipine (usually used as a blood pressure and heart medicine). It decreases the pain and inflammation, and may even preclude the need for surgery.
Internal hemorrhoids are deeper inside the rectum and are covered with mucous membrane (similar to the tissue that’s inside of the cheeks). First and second degree internal piles may bleed, but stay inside the rectum, or prolapse out during bowel movements and return by themselves afterwards. Third degree piles prolapse out but can be put back in manually. Common treatments include:
Sclerotherapy, in which a substance, usually a sterile oil is injected to create scar tissue that keeps the pile from prolapsing out.
Rubber band ligation, in which one or more rubber bands are placed around a second or third degree pile to cut off its blood supply.
Infrared photocoagulation which causes hemorrhoids to scar over.
Hemorrhoidectomy, or surgery to remove the piles. Used especially for fourth degree piles which are usually big and permanently prolapsed out.
All types of piles should be treated with increased fiber and water in the diet to keep stools soft and easier to pass.
