piles

Piles are hemorrhoids that become inflamed. Hemorrhoids are masses, clumps, cushions of tissue in the anal canal - they are full of blood vessels, support tissue, muscle and elastic fibers.

Piles can be of various sizes and may be internal (inside the anus) or external ones (outside the anus). Typically, internal piles occur from 2 to 4cm above the opening of the anus. External piles (perianal hematoma) occur on the outside edge of the anus. The internal ones are much more common

.Hemorrhoids are "A varicose condition of the external hemorrhoidal veins causing painful swellings at the anus."

Internal Hemorrhoids are "Dilated veins beneath the mucous membrane within the sphincter."

External Hemorrhoids are "dilated veins forming tumors at the outer side of the external sphincter."

piles may experience the following symptoms:

• A hard lump may be felt around the anus. It consists of coagulated blood, called a thrombosed external hemorrhoid. This can be extremely painful
• After going to the toilet, a feeling that the bowels are still full
• Bright red blood when doing a bowel movement
• Itchiness in the anus area
• Mucus discharge when emptying the bowels
• Pain while defecating
• The anus area may be red and sore
• When passing a stool the person may strain excessive
• Internal hemorrhoids - they are classified into four grades:
  • Grade 1 - there are small inflammations, usually inside the lining of the anus. They are not visible.
  • Grade 2 - larger than Grade 1 hemorrhoids, and also inside the anus. When passing a stool they may get pushed out, but soon return.
  • Grade 3 - often called 'prolapsed hemorrhoids'; these appear outside the anus. The patient may feel them hanging out. They can be pushed back in if the patient presses with his/her finger.
  • Grade 4 - these cannot be pushed back in and need to be treated by a doctor. They are large and stay outside the anus all the time.
  External hemorrhoids - called perianal hematoma. These are small lumps that are located on the outside edge of the anus. They are extremely itchy and can be painful if a blood clot forms inside (thrombosed external hemorrhoid). Thrombosed external hemorrhoid requires medical treatment straight away

• the treatment options for piles?

  Diet - piles can be caused by too much straining when doing bowel movements, which is the result of constipation. A change in diet can help keep the stools regular and soft. This involves eating more fiber, such as fruit and vegetables, or even switching your cereal breakfast to bran.
  
  Water is the best drink, and the patient may be advised to increase his/her water consumption. Some experts say too much caffeine is not good.
  
  Body weight - if the patient is obese, losing weight may help reduce the incidence and severity of hemorrhoids.
  
  Simple things you can do yourself:

  • Try not to strain when you go to the toilet
  • Use moist toilet paper instead of dry
  • Rather than rubbing the anus area when cleaning after going to the toilet, pat instead to avoid irritation if you already have piles

  Ointments, creams, pads and other OTC medications - there are some over-the-counter (OTC) medications which help soothe the redness and swelling around the anus area. Some of them contain witch hazel, hydrocortisone, or some other active ingredient which can relieve symptoms of itching and pain.
  
  It is important to remember that they do not cure piles, they only treat the symptoms.
  
  Corticosteroids - these can reduce inflammation. However, usage must not exceed about six to seven days.
  
  Painkillers - ask your pharmacist for suitable painkilling medications, such as acetaminophen (Tylenol, paracetamol).
  
  Laxatives - the doctor may prescribe one if the patient suffers from constipation.
  
  Banding - the doctor places an elastic band around the base of the pile inside the anus, cutting its blood supply. After a few days the hemorrhoids fall off. This can work for Grades 2 and 3 hemorrhoids.
  
  Sclerotherapy - a medicine is injected into the vein to make the hemorrhoid shrink - the hemorrhoid eventually shrivels up. This is effective for Grades 2 and 3 hemorrhoids, and is a useful alternative to banding.
  
  Infrared coagulation - also referred to as infrared light coagulation. Used for Grades 1 or 2 hemorrhoids. A device burns the hemorrhoid tissue.
  
  Surgery - used for particularly large piles, or Grades 3 or 4 hemorrhoids. Generally, surgery is used if other procedures were not effective. 

  • Hemorrhoidectomy - the excess tissue that is causing the bleeding is surgically removed. 
  • Hemorrhoid stapling - blood flow is blocked to the tissue of the hemorrhoid. This procedure is usually less painful than hemorrhoidectomy.