Haemorrhoids
Haemorrhoids are varicosities in the anus in relation to the venous plexuses formed by radicles of radical veins. Clinically known as piles.it is the swelling of blood vessels near the anal opening. An increased pressure on these blood vessels due to any reason, causes them to enlarge and swell, thus forming lumps which are occasionally felt at the anal opening.
Types :
Internal
External
Interno-External
Causes :
Primary: when no obvious cause
- Familial
- Upright Posture
Secondary
- Portal Hypertension
- Pregnancy
- Straining for stool, Diarrhoea, Constipation
- Malignancy of anal canal
- Pelvic tumours
Symptoms :
Painless drop by drop bleeding. Splash in pan- bright red and fresh-occurs during defecation, mucous discharge, itching around anus, pain occurs due to prolapse, infection or spasm.
Degree of Piles
- 1st degree: piles bleed but does not comes out.
- 2nd degree: piles that prolapse during defecation, but returns spontaneously.
- 3rd degree: piles prolapsed during defecation, can be replaced back only by manually.
- 4th degree: piles that are permanently prolapsed.
Diagnosis
- Proctoscopy demonstrates position of piles
- Sigmoidoscopy / Colonoscopy: should be done if patient above 45 yrs. of age presents with p/r bleeding.
Complication :
Ulceration
Haemorraghe
Strangulation
Thrombosis
Gangrene
Infectionleads to suppuration and abscess formation
Treatment :
Dietary and lifestyle modification
Nonoperative / Office procedures
Operative haemorrhoidectomy
Conservative: the main aim of this treatment is minimizing the straining at stool which can be achieved by diet-high fiber in the diet, increase liquid intake. Daily exercise, Sitz bath, if necessary stool softeners, drugs -analgesics.
Office treatment / Nonoperative treatment :
- Injection treatment is consisting of injecting the irritating drug into the submucosa in order to decrease vascularity and increase fibrosis of pile mass. sclerotherapy- in 1st and 2nd-degree hemorrhoids.
- Rubber band ligation: Barron’s banner is used to slip tight elastic bands on the base of a pedicle of each hemorrhoid. Bands cause ischemic necrosis if piles, which sloughs off in 10 days. in 1st and 2nd degree hemorrhoids and in some circumstances 3rd-degree hemorrhoids it is used.
- Laser therapy: in this procedure laser rays are passed in piles to burn it, which leads shrinkage of pile mass this is useful in 1st and 2nd-degree piles.
- Other less used nowadays treatment includes cryotherapy, DGHAL, Infrared coagulation.
Surgical treatment :
Indications of surgery
- 3rd and 4th degree haemorrhoids with severe symptoms.
- Conservative or nonsurgical treatment fails.
- Patient preference.
- Presence of anorectal conditions requiring surgery.
- Fibroses piles
- Interno external piles with well-defined external pile mass.
Types of surgery :
Standard haemorrhoidectomy
- The triangularly shaped hemorrhoid is excised down to underlying sphincter muscle. Wound can be closed or left open
Stapled haemorrhoidectomy
- Has been developed as an alternative to standard haemorrhoidectomy
Contact Us
Piles cure clinic in Pune is one of the leading and well-known providers of various advanced and painless treatments of Anorectal disorders and problems like piles, Fistula, Fissures, pilonidal sinus and so on, get treatment from best piles doctor in pune
Call Us
Location
- Ramkrishna hospital, Laxmi Chambers, 1536, Tilak Rd, Ramashram Society, Perugate, Sadashiv Peth, Pune- 411030
- Citi care hospital, Shubham gallery, next to chroma, near pimpri bridge, Pimpri- 411018