Piles Treatment in Bhubaneswar
Piles, also called haemorrhoids, are swollen veins and cushions of tissue in the lower rectum and around the anus. They can cause bleeding, pain, itching, swelling or a lump near the anus. Many cases improve with simple measures, and surgery is needed only for some. Dr. Kasturi Bharadwaj, a general and laparoscopic surgeon and an Associate Professor at IMS & SUM Hospital, offers consultations for piles treatment in Bhubaneswar. This page explains the symptoms, grades and treatment options, and when bleeding needs further tests.
What are piles?
Piles form when the veins and supporting tissue in the lower rectum and anal canal become swollen. They may be inside the rectum (internal) or under the skin around the anus (external). Common contributing factors include chronic constipation, straining during bowel movements, long periods of sitting on the toilet, pregnancy, obesity, heavy lifting and ageing.
Piles are very common and are usually not dangerous, but the symptoms can affect daily life. Other conditions can cause similar symptoms, so a proper examination matters.
Symptoms of piles
- Bright red blood on the stool, on toilet paper or in the pan, often without pain
- A lump or tissue that comes out of the anus during or after bowel movements
- Itching, irritation or a feeling of fullness around the anus
- Pain or discomfort, especially with external or thrombosed piles
- Mucus discharge or difficulty keeping the area clean
Bleeding is not always piles
Bleeding from the rectum can also be caused by conditions other than piles, including anal fissures and growths in the colon or rectum. You should have bleeding examined by a doctor, particularly if it is new, repeated, or comes with a change in bowel habit, weight loss, anaemia or a family history of bowel cancer. Tests of the lower bowel may be advised, as described under GI endoscopy and colonoscopy.
Seek urgent medical care if
- Bleeding is heavy or does not stop
- You feel dizzy, faint or very weak
- You have severe pain, fever, or a rapidly enlarging, painful swelling at the anus
Types of piles
- Internal piles: They develop inside the rectum and often cause painless bleeding.
- External piles: They form under the skin around the anus and can cause swelling and discomfort.
- Thrombosed piles: A blood clot forms inside an external pile, which can cause sudden, severe pain and a firm, tender lump.
- Prolapsed piles: Internal piles that slip down and protrude outside the anus.
A lump or tissue protruding from the anus is not always a pile, and a more extensive prolapse of the rectum is a different condition discussed under rectal prolapse surgery.
Grades of internal piles
- Grade I: The piles bleed but do not come out of the anus.
- Grade II: They come out during a bowel movement and go back in on their own.
- Grade III: They come out and need to be pushed back in by hand.
- Grade IV: They stay outside and cannot be pushed back.
The grade helps your doctor choose the treatment, but symptoms, your age and your overall health matter as much.
Treatment options for piles
Treatment depends on the type, grade, symptoms and your general health. Many people never need an operation.
Lifestyle and diet. A diet rich in fibre, enough fluids, regular exercise, and not straining or sitting for long periods on the toilet help to soften stools and reduce symptoms.
Medicines. Stool softeners, fibre supplements, pain relief, and creams or ointments may be prescribed to ease symptoms. Warm sitz baths can also give relief.
Procedures for selected piles. For internal piles that do not respond to the measures above, options include rubber band ligation and injection (sclerotherapy). These are usually done as short procedures.
Surgery. Larger, prolapsing or persistent piles may require a surgical procedure, depending on their type, grade, symptoms and the patient’s overall health. Options may include haemorrhoidectomy or other procedures for selected patients. Each technique has its own benefits, limitations and risks. Your surgeon can explain which options are appropriate for your condition.
Piles that are accompanied by an abscess or a fistula are managed differently, and those conditions are described under fistula treatment and perianal abscess drainage.
How piles are evaluated
At the consultation, the doctor asks about your symptoms, bowel habits and diet, and examines the anal area, usually including a gentle internal examination. A short scope examination (proctoscopy or anoscopy) may be done to look at the lining. Depending on the symptoms and examination findings, blood tests may be recommended to assess possible blood loss or anaemia. Further examination of the colon may be advised for some patients based on their age, medical history, symptoms and risk factors.
What to expect if a procedure or surgery is advised
You will be told which treatment is suggested and why, what the alternatives are, and what the risks are, and you will be asked for consent. Depending on the procedure, it may be done under local, spinal or general anaesthesia. Pre-operative tests and a bowel preparation may be needed in some cases. Whether you go home the same day depends on the procedure and how you recover. The duration of the procedure varies with the method and the extent of the piles.
Recovery and aftercare
Recovery depends on the treatment you have had and on your general health. Common advice includes:
- Take medicines as prescribed
- Eat a high-fibre diet and drink enough fluids to keep stools soft
- Avoid straining and prolonged sitting on the toilet
- Use warm sitz baths if your surgeon advises them
- Keep the area clean and dry
- Avoid heavy lifting until your surgeon says it is safe
- Attend your follow-up visits
- Contact your doctor if you develop heavy bleeding, fever, severe pain, difficulty passing urine, or swelling that is increasing
Some bleeding and discomfort after a procedure can be expected, and your surgeon will tell you what is normal for your treatment and when you can return to work.
Risks and possible complications
Piles treatment is commonly performed, but all treatments carry some risk. These can include:
- Bleeding
- Pain
- Infection
- Difficulty passing urine for a short time
- Swelling or skin tags
- Delayed healing
- A narrowing of the anal canal (uncommon)
- Problems with control of stool or gas (uncommon)
- Piles coming back
Your surgeon will explain the risks relevant to the treatment recommended for you.
Preventing piles from coming back
No treatment can guarantee that piles will not return, but these habits can lower the chance:
- Eat enough fibre-rich foods such as vegetables, fruit, pulses and whole grains
- Drink enough water through the day
- Do not strain or delay going to the toilet, and avoid sitting for long periods on it
- Stay physically active and manage your weight
- Treat constipation or diarrhoea early
FAQs
Piles develop when pressure in the lower rectum rises and the veins and supporting tissue swell. Common contributors are chronic constipation, straining, long periods of sitting on the toilet, pregnancy, obesity, heavy lifting and ageing.
Many piles improve with diet and lifestyle changes, medicines and, for some, minor procedures. Surgery is generally kept for piles that are large, prolapsing or keep causing symptoms despite other treatment.
No. Fissures and growths in the rectum or colon can also cause bleeding, so new or repeated bleeding should be examined by a doctor.
Some pain after surgery is expected, and it differs between procedures and between patients. Pain relief is planned for each patient.
It depends on the treatment. Minor procedures usually mean a shorter recovery than surgery, and your surgeon will tell you what to expect in your case.
Yes, they can. Good bowel habits, enough fibre and water, and avoiding straining reduce the chance.
No. Suitability depends on the type and grade of piles and other findings, and your surgeon will advise whether it is appropriate.
A diet with plenty of fibre, such as vegetables, fruit, pulses and whole grains, along with enough fluids, helps keep stools soft. Follow any specific advice given by your surgeon.
Seek urgent care for heavy or continuing bleeding, dizziness or fainting, severe pain, fever, or a rapidly enlarging painful swelling at the anus.
Eat enough fibre, drink enough water, avoid straining and long periods on the toilet, stay active, and treat constipation early.