External Piles: External Hemorrhoids/Piles are located under the skin around the anus. External piles may itch and bleed. Sometimes blood may pool in them and form a clot/thrombus near anus that can cause severe pain, swelling and inflammation. Thrombosed piles (Clotted piles) usually are not serious though they can cause unbearable pain sometimes, if the pain is unbearable blood clot can be removed which relieves the symptoms.

What are the symptoms of Hemorrhoids/Piles?

The most common symptom of internal Hemorrhoids/Piles is bright red blood on stool, or in the toilet bowl after a bowel movement.

Internal Hemorrhoids/Piles that are not prolapsed are usually not painful.

Prolapsed Hemorrhoids/Piles often cause pain, discomfort, and anal itching.

Excessive straining, rubbing, or cleaning around the anus may make symptoms, such as itching and irritation, worse.

Symptoms can go away within a few days, and some people with Hemorrhoids/Piles never have symptoms.

What causes Hemorrhoids/Piles?

Swelling in the anal or rectal veins causes Hemorrhoids/Piles. Several factors may cause this swelling, including:

• Genetic

• Prolonged sitting on toilet

• Obesity or weight gain

• Straining around the anal area while passing stool

•  lack of fiber in the diet

• Sitting on the toilet for long periods of time

• Chronic constipation or diarrhea

• Inadequate intake of water

• Lack of exercise or heavy weight lifting and stress

• Pregnancy and aging

• Other contributors like irritable bowel syndrome, laxative abuse and hypothyroidism.

Another cause of Hemorrhoids/Piles is the weakening of the connective tissue in the rectum and anus that occurs with age.

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• Pregnancy can cause Hemorrhoids/Piles by increasing pressure in the abdomen, which may enlarge the veins in the lower rectum and anus. For most women, Hemorrhoids/Piles caused by pregnancy disappear after childbirth. Sitting on the toilet for long periods of time

• Sitting on the toilet for long periods of time

How are Hemorrhoids/Piles diagnosed?

• Medical history is taken into consideration. For eg.  People suffering from constipation are more vulnerable to piles

• The diagnosis is done by physical examination and rectal examination.

• Anoscopy or colonoscopy may be advised.

How to prevent Hemorrhoid/piles?

• Eat high-fiber foods like oranges, Lentils, oatmeal and Broccoli

• Drink six to eight glasses of water each day

• Stay active to help prevent constipation

• Avoid long periods of sitting, particularly on the toilet

How are Hemorrhoid/piles treated?

• Medical management

Grade I piles & Grade II piles can be treated with medicines. Dr Mir Asif Rehman, one-of-the best doctor in Gurgaon, treats patients with symptomatic piles initially with increased fiber-rich diet and adequate fluid intake. If such dietary modifications do not eliminate symptoms in patients with first & second grade piles, then conservative medical therapy including ointments and avoidance of non-steroidal anti-inflammatory drugs (NSAIDs) and spicy or fatty foods is advised. If diagnosed early, piles treatment can be done with above mentioned methods.

• General Treatment

Stapler Surgery for piles, also known as Stapled haemorrhoidectomy or stapled hemorrhoidopexy:

To treat piles, stapler surgery is very effective. It is typically used only for internal Hemorrhoids/Piles.

The procedure involves blocking of blood flow to haemorrhoidal tissue.

It requires anesthesia.

This procedure is slowly falling into disrepute because of high complication rates.