Treatment For Piles – Various Methods Available On The Market

Types of hemorrhoidsHemorrhoids (commonly called piles) is a clinical condition characterized by enlargement of the veins in the rectum and around the anus. Patients commonly present with discomfort around the anus, with occasional pain and sometimes bleeding. It causes patients tremendous amount of embarrassment and distress. In this article, we have discussed the different methods that are available to treat piles, ranging from natural remedies and lifestyle changes, to surgical treatment for piles.

But first, we need to visit why treatment is required in the first place.

Aims of treatment – Why should piles be treated?

Treatment for piles is usually carried out only when the patient experiences symptoms, and not if they are an incidental finding on examination. Treatment options are mainly directed toward treating the pain and reducing any bleeding or swelling. Conservative (simple, non surgical) methods are adopted first, and if all fails, then minor surgery is considered.

What sort of treatment for piles options are there?

There are a number of available options on treatment for piles, and these are listed below:

1. Natural Remedies – Lifestyle Changes

One of the commonest causes for piles is the excessive straining when attempting to open bowels dues to chronic constipation. Increasing daily fluid intake, eating a high fibre diet and using stool softeners (medication) can help ease the stress and prevent piles.[list style=”checkmark”]

  • In fact, changing to a high fibre diet is considered one of the best treatment for piles. Increased fibre intake through diet can be achieved by eating foods such as bran and wholemeal bread. Psyllium seeds have also been found to be extremely effective.
  • Relaxing warm baths two to three times a day has also been found to be very effective in relieving the pain. Some people advocate the use of ‘sitz baths’, which also provide relief of pain and other symptoms. This treatment consists of sitting in the bathtub that is filled with up to 2 to 3 inches of warm water, so that only the affected area is immersed when sat in the tub. This should be performed a few times a day, and especially after opening the bowels.
  • Wear loose clothing to avoid constant rubbing on the anal region. Cotton underwear can be useful as it absorbs any moisture in the region. It is important to refrain from scratching the affected area, as it could cause pain and bleeding, and sometimes infection.
  • Prolonged straining on the toilet is not advised in patients with piles. The constant pressure on the rectum when in that position can worsen the symptoms and make the piles larger. Some doctors recommend just partial emptying of the bowels to avoid prolonged sitting posture. Occasionally, patients may have loose stools, and anti- diarrhoeal medication may be required.
  • In some patients suffering from piles, the blood in the dilated veins can become clotted, leading to occlusion of the blood vessel or ‘thrombosis’. This can be quite painful, and this pain is effectively relieved by applying ice on the area.
  • Exercise regularly and try to lose weight. Exercise helps maintain a healthy digestive system, and aids in better bowel movements.[/list]

If you like to learn more, read my post about home remedies for piles.

2. Medication

Steroid creams have been used in the treatment for piles, but they are not always effective. They can to some extent relieve itching and inflammation, but should not be used over prolonged periods of time due to their side effects.  Some patients may complain of spasms of the anus, and in such patients topical nitrates (which relax the sphincter muscles) may be helpful.

3. Simple Non Surgical Treatment For Piles

If the above treatments do not adequately treat the patient’s symptoms, certain minor surgical procedures can be performed. These are usually performed on a day case basis, and do not require admission to hospital. In order to perform these, your doctor will go through the reasons why you should have it, and any reasons why they should not be performed.

One of the commonly used piles treatment remedies is called ‘rubber band ligation’. Here, with the help of endoscopic (i.e camera) guidance, your doctor will place a tight rubber band around the base of the hemorrhoid, thus cutting off its blood supply. It then sloughs off and falls off. The procedure is relatively painless and does not require any anesthesia. Complications, if any, are rare.

Rubber Band Ligation

Another treatment for piles that is available is called electrocautery. Here, the hemorrhoid is ‘burnt off’ using a low voltage electric current. This has good results and patients experience a significant reduction in any pain following the procedure.

Sometimes, the hemorrhoids are injected with an agent that clots the vein and results in it falling off. This procedure is called sclerotherapy. Sometimes, they are frozen using cryotherapy (similar to over the counter treatments used to treat warts).

4. Surgical Treatment For Piles

Sometimes, despite attempts to treat piles either naturally or with non-surgical techniques, they can recur. In some cases, the hemorrhoids are too large but remain painless. In such cases, surgery may need to be carried out.

While going into detail regarding surgical treatment for piles is out of the scope of this article, we have included below some of the common ways piles are treated surgically.

As discussed above, some of the hemorrhoids can get clotted. These can be surgically removed, but sometimes the hemorrhoids can recur again. Removing the entire culprit vein can help prevent recurrence. This complete removal is an effective way to prevent future recurrence.

On some occasions, when all treatment has failed and the hemorrhoids are either too large or causing patients a great amount of distress, surgical removal of the piles can be performed. Only 1 in 10 patients usually require surgery. The procedure is performed under local or general anaesthetic. Laser surgery or surgical stapling of the piles is performed. Results are usually very good.

Once any of the above measures are carried out, patients will still have to observe lifestyle changes and modifications described above. In short, patients should avoid prolonged periods on the toilet, eat a high fibre diet, lose weight and maintain good anorectal hygiene.

Conclusion

Treatment for piles can be achieved in a number of different ways, starting with natural remedies to surgery. Simple lifestyle changes and natural remedies can result in dramatic improvements with a significant reduction in symptoms and an improvement in patient’s quality of life.

Image Credits (Top): Types of hemorrhoids, by WikipedianProlific and Mikael Häggström, Wikimedia Commons (Source: http://en.wikipedia.org/wiki/File:Internal_and_external_hemorrhoids.png)

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