What treatment are available to cure piles?

1. What treatment are available to cure piles? What is Piles ? "Hemorrhoids" are like Cushions, composed of arteriole- Venus channels & Connective tissues, in anal canal, which helps in regulation or control of stools. Due to excessive stress sometimes they become pathological or "Piles “with symptoms of Swelling & inflammation. Condition is known as "Varicose Veins inflammation" in ano-rectal region. Banding treatment: Banding is the most commonly used procedure, especially for grade 2 and 3 piles. It may also be done to treat grade 1 piles which have not settled with the simple advice and treatment outlined above. This procedure is usually done by a surgeon in an outpatient clinic. A hemorrhoid is grasped by the surgeon with forceps or a suction device. A rubber band is then placed at the base of the hemorrhoid. This cuts off the blood supply to the hemorrhoid which then dies and drops off after a few days. The tissue at the base of the hemorrhoid heals with some scar tissue. Banding of internal piles is usually painless, as the base of the hemorrhoid originates above the anal opening in the very last part of the gut where the gut lining is not sensitive to pain. In about 8 in 10 cases, the piles are cured by this technique. In about 2 in 10 cases, the piles come back at some stage. (However, you can have a further banding treatment if this occurs.) Piles are less likely to come back after banding if you do not become constipated and do not strain on the toilet (as described above). A small number of people have complications following banding, such as bleeding, infection or ulcers forming at the site of a treated hemorrhoid, or urinary problems. www.indiapiles.com Page 1

2. Injection sclerotherapy Phenol in oil is injected into the tissues at the base of the piles. This causes a scarring (fibrotic) reaction which obliterates the blood vessels going to the piles. The piles then die and drop off, similar to after banding. Infrared coagulation/photocoagulation This method uses infrared energy to burn and cut off the circulation to the hemorrhoid, which causes it to shrink in size. It seems to be as effective as banding treatment and injection sclerotherapy. for first- and second-degree piles. Diathermy and electrotherapy This uses heat energy to destroy the piles. They appear to have similar success rates as infrared coagulation and the risk of any complications is low. DO PILES HAVE GRADES / TYPES? There are two main Types of hemorrhoids: internal and external. Internal hemorrhoids are not sensitive to touch, pain, stretch, or temperature, while external hemorrhoids are covered by skin that is very sensitive. When talking about hemorrhoids, one needs to understand the meaning of 'Prolapse'. The anal cushions are normally fastened in the sphincter by muscles and tissue. In case too much pressure is applied, as on straining, the system of securing these cushions is damaged. Subsequently, they protrude outside the anus and this protruding mass is called the Prolapse Internal hemorrhoids are thus graded by the degree to which they have prolapsed into: Grade 1 : Slightly enlarged hemorrhoid tissue with no Prolapse. Grade 2 : Prolapse that protrudes on pressure but goes back on its own Grade 3 : Prolapse that needs to be manually pushed in by the patient Grade 4 : Prolapse that constantly remains on the outside and does not go back even on manual repositioning. At this stage they are usually painful. www.indiapiles.com Page 2

3. What are the surgical options? Hemorrhoidectomy (the traditional operation) An operation to cut away the hemorrhoid(s) is an option to treat grade 3 or 4 piles or for piles not successfully treated by banding or other methods. The operation is done under general anesthetic and is usually successful. However, it can be quite painful in the days following the operation. Stapled Haemorrhoidopexy A circular stapling gun is used to cut out a circular section of the lining of the back passage (anal canal) above the piles. This has the effect of pulling the piles back up the back passage. It also has the effect of reducing the blood supply to the piles and so they shrink as a consequence. Because the cutting is actually above the piles, it is usually a less painful procedure than the traditional operation to remove the piles. Haemorrhoidopexy artery ligation The small arteries that supply blood to the piles are tied (lighted). This causes the hemorrhoid(s) to shrink. www.indiapiles.com Page 3