Piles (Haemorrhoids) Surgery / Treatment Overview

Hemorrhoids, also know as piles are swollen veins in lower part of rectum and anus. They can be either external or internal. Internal hemorrhoids develop within anus or rectum, whereas external hemorrhoids develop outside anus, also known as piles.

Hemorrhoids contain blood vessels, tissue, muscle and elastic fibers. Internal hemorrhoids are located between 2 and 4 cms above opening of anus and are the most common, whereas external piles occur outside edge of anus.


One Can Experience Following Symptoms :

  • Irritation and pain around anal region.
  • Painful lump or selling near anus
  • Post bowl movements blood can be seen
  • Fecal leakage
  • Extreme itching
  • Infection at site
  • Excessive bleeding, leading to anemia
  • Anal fistula, wherein a channel is created between the surface of skin near anus and inside anus.

Piles Are Further Classified In Four Grades :

  • Grade I : Small inflammation / swelling inside lining of anus, usually not visible.
  • Grade II: They are little large than grade I piles. They normally come out when passing stool and return unaided.
  • Grade III: Also known as prolapsed piles and seen outside anus. One can recognize hanging from rectum but they can be re-inserted.
  • Grade IV: Such piles cannot be pushed inside and need treatment or surgery. Usually large and remain outside anus.


  • Due to chronic constipation
  • Sitting for long periods especially on toilet
  • Family history of hemorrhoids
  • Straining during bowl movements
  • Pregnancy
  • Chronic diarrhea
  • Due to heavy weight lifting
  • Standing for long time without any break may develop haemorrhoids


Diagnosing internal hemorrhoids should include examination of rectum and anal region :

  • Digital rectal examination : A lubricated finger is inserted in rectum and findings are noted ( Viz, any unusual growth is seen )
  • Visual Inspection : Internal hemorrhoids are usually soft to e felt during rectal examination, so doctor will examine lower portion of colon and rectum with a proctoscopy or sigmoidoscope.
  • External hemorrhoids are anyways visible, so no need to perform any such inspection.
  • Colonoscopy : Colonoscopy is required to examine entire colon,if patient have :
    • Symptoms related to digestive system disease.
    • Any risk factor for colorectal cancer etc.


Doctor usually prescribes over the counter creams, ointments or medicines to patients having mild discomfort. These products temporarily relieve pain and itching.

Surgical Treatment

Hemorrhoidectomy : This is the most effective way to treat severe and recurring hemorrhoids. Procedure is done under spinal or general anesthesia. One can feel some pain post surgery which usually subsides after taken pain killers. Soaking in a warm bath will also helps.

MIPH ( Stappled Hemorrhoidectomy) : This is minimally invasive technique to treat hemorrhoids. Stapler is used to treat heomorrhoids, wherein the blood flow is blocked to hermorrhoidal tissue. This is an effective procedure for internal hemorrhoids. Stappling procedure have less pain as compared to normal hemorrhoidectomy and allows quick recovery and better results. One should consult the specialist before undergoing procedure best suited for him/her.

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