Causes of Piles
Pressure in the lower rectum is the leading cause of Piles. Dr Purnendu Bhowmik, a piles specialist in Kolkata, explains that when the blood vessels in the rectum and around the anus expand under pressure, it swells and bulges, forming piles.
Conditions which facilitate the development of Piles are –
- chronic constipation
- chronic diarrhoea
- heavy weight lifting
- straining while defecating
- family history of piles
A piles doctor will usually ask these five questions to evaluate whether a person may have piles –
- Do any of your close relatives have piles?
- Have you noticed any blood or mucus in the stools?
- Did you go through a recent weight loss?
- Have your bowel movements changed recently?
- What colour are your stools?
Upon asking these questions, if the doctor suspects piles, a physical examination will be carried out.
- Digital Rectal Examination (DRE) – During a DRE, a doctor will gently insert a lubricated, gloved finger inside the anus and feel for any abnormalities.
- Proctoscope – A proctoscope is a hollow tube with a light at the end. It lets the doctor examine the anal canal up close.
- Colonoscopy – A doctor might recommend a colonoscopy if you have piles and present signs and symptoms suggesting another digestive system disease or colorectal cancer.
There are many treatment options for piles, says Dr Purnendu Bhowmik, the best piles surgeon in Kolkata.
Upon piles diagnosis, a doctor will initially recommend some lifestyle changes to manage the symptoms.
Diet: Constipation is one of the primary causes of piles. Therefore, a change in diet will keep stools soft and facilitate bowel movement. This involves eating more fibre such as fruits and vegetables, or primarily eating bran-based breakfast cereals.
Water consumption should also be increased and it is best to avoid caffeine.
Bodyweight: Losing weight helps reduce the severity of piles. Doctors, therefore, recommend exercising as one of the leading therapies for piles.
Over the counter medications like painkillers, ointments, creams, and pads can help manage piles symptoms. If a person suffers from constipation, laxatives will also be prescribed by the doctor.
- Banding: An elastic band is attached at the base of the haemorrhoid to cut off its blood supply. The haemorrhoid falls off on its own after a few days. The procedure is effective for treating all haemorrhoids that are less than grade four.
- Sclerotherapy: The procedure is an alternative to banding and is effective for grade two and three haemorrhoids. The methods include the injection of a medicine into the haemorrhoid to make it shrink.
- Haemorrhoidectomy: In this procedure, the excess tissue causing the bleeding is surgically removed. The surgery is done through a combination of a local anaesthetic, a spinal anaesthetic, or a general anaesthetic. This procedure is the most effective for completely removing piles. However, there are risks of complications involved like difficulty with passing stools and urinary tract infections.
- Haemorrhoid stapling: The method aims to cut off blood flow to the haemorrhoid tissue. Compared to haemorrhoidectomy, this procedure is usually less painful. However, it increases the risk of piles recurrence and rectal prolapse (part of the rectum pushes out of the anus).
- Laser piles surgery: This method involves the use of a device to burn and shrink the haemorrhoid tissue. Laser Piles Surgery is used to treat grade one and two haemorrhoids.