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Piles are inflamed collections of tissue in the anal area. Piles appear in the lowermost part of the anus and can cause significant pain and discomfort. Piles that can be felt bulging near the anal opening are known as external piles. On the other hand, piles on the inner part of the anus that cannot be felt are termed internal piles.
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MBBS, MS-General Surgery, M.CH- Urology
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As the name suggests, piles that grow internally and cannot be seen are known as internal piles. They are more like protrusions inside the anus, on the walls of the anal canal. Internal piles are classified into four grades:
External piles are lumps on the outer region of the anal area. External piles can be felt by the patient or visible to the patient or a doctor. You may also feel these as water-filled swellings around the anal opening. With external piles, you can experience symptoms like anal itching, one or more hard and tender lumps near the anus, and pain near the anal area, primarily while sitting.
Doctors diagnose piles by enquiring about the patient's symptoms and clinical history and by conducting a physical examination. During the physical examination, the anal area is examined for any bulging piles through the anal orifice.
A rectal examination can also be performed to diagnose piles. During the rectal examination, the patient lies on his left side with knees folded onto the chest. The doctor inserts a gloved finger through the anal orifice and inspects the walls of the rectum and anus for swellings and other abnormalities.
Anoscopy or proctosigmoidoscopy is done to visualize the rectum and anus further and rule out causes of rectal bleeding other than piles. In this procedure, the surgeon inserts a tube into the rectum through the anus and examines the region using a light. In addition, blood tests such as hemoglobin, complete blood counts, blood coagulation studies, and liver function tests are also conducted as additional tests.
Doctor's treatment plan for piles depends on the severity of the symptoms. Some of the ways to treat piles include:
Piles will usually go away on their own, but if they don't, you might require a medical procedure to deal with the issue. Non-surgical options to treat piles include:
Surgery is the most effective method to treat piles. It is used to relieve symptoms of piles and when other treatments haven't worked or the piles keep bleeding. There are various types of surgery for piles, which include the following.
Hemorrhoidectomy - A hemorrhoidectomy is surgery to remove internal or external piles that are extensive or severe. Hemorrhoidectomy can be of two kinds- Open hemorrhoidectomy and close hemorrhoidectomy. Under close hemorrhoidectomy, the hemorrhoidal tissue is excised, and the wound is stitched closed with the help of absorbable sutures that will not have to be removed later.
Open hemorrhoidectomies are not performed as commonly as closed procedures. During an open hemorrhoidectomy, the incision is not stitched closed. However, in some possibilities, it may be temporarily packed with gauze, which will be removed within the first 24 hours.
Stapled Hemorrhoidectomy - In this surgery, the surgeon will attach the tissue area with piles higher up the anal canal and staple it. The piles won't come out of your anus anymore and will shrink.
Hemorrhoidal artery ligation operation (known as HALO) - During this procedure, arteries in the anal canal are closed to restrict the blood supply to the piles. Sometimes an ultrasound probe will be used to help locate the arteries and guide the surgeon during the procedure.
Laser surgery - In this procedure, a laser will be inserted into the anal canal to eliminate the terminal branches of superior and inflamed piles arteries. The patient will have no surgical incision scar on the anus in this surgery.
A proctologist or colorectal surgeon is a specialist medical doctor trained in the branch of medicine dealing with the diseases of the anus, rectum, and sigmoid colon. Thus, a proctologist can easily and effectively diagnose and treat piles. Here are some things you need to consider before selecting your doctor for piles treatment in India:
It is important for a proctologist to earn a bachelor's degree and qualify for the Medical College Admission Test (MCAT). After qualifying for MCAT, it is crucial to get admission to medical school and graduate with a medical degree. After graduation from medical college, it is necessary for a proctologist to get a Medical Doctor or M.D. degree. 8 years of education and training are required to become a proctologist. For a potential proctologist, training sessions through residencies and fellowships are also required.
When selecting a proctologist for your piles treatment in India, considering their experience is essential. A well-experienced proctologist will ensure that the procedure chosen to treat piles is suitable and yields the desired result. In addition, it is essential to know how long your doctor has been in practice and how many successful cases of piles they have performed.
Knowing if your doctor has been sanctioned by a professional licensing board should be an essential part of your search.
Some of the skills and qualities that a proctologist is expected to possess include:
In most areas, you can contact the medical licensing authority and ask to run a search for any disciplinary cases taken against your doctor. In addition, if you know anyone who is a patient of that doctor, ask them for their honest opinion of the care and attention they are receiving.
Qualifications of medical specialists who can treat piles include:
When you start to see that blood stains or blood is coming along with the stool during a bowel movement or when you have already been suffering from piles for over a week, and it did not improve after you have tried home remedies. you should consult with a proctologist as soon as possible.
In addition, you should contact a medical professional for immediate help when you see that you are having large amounts of rectal bleeding, faintness, lightheadedness, etc.
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