HAEMORRHOIDS, PILES, BAWASEER
 
What are Piles

Pile is the common term used for disease called haemorihords characterized by formation of outgrowths of blood vessels (veins) of anal canal. These outgrowths may remain inside the anal canal or may protrude out. Piles in common Hindi is also called 'bawaseer.'
Understanding the medical lingo

Haemorrhoidectomy:It means the surgical removal of the haemorrhoids.
First degree haemorrhoids:These are haemorrhoids which do not protrude out of the anal opening.
Second degree haemorrhoids: These are those haemorrhoid which protrude out of the anal opening on straining or defecation but go inside once the straining is over.
Third degree haemorrhoids: These are hemorrhoids which are permanently protuding out of the anal opening.
The various presentations of Piles

Piles may present in two ways
Factors contributing towards Piles
Signs and symptoms of Piles
Physical examination and investigations
Visual and digital examination:It is usually carried out before the other examinations. Unless the pile is protruding out it will not be seen. A local examination of anal region is done followed by examination of anus by inserting a finger (per rectum examination).

Proctoscopy
Sigmoidoscopy
Possible complications of Piles
Modalities of Haemorrhoid management

Nonoperative Treatment
This mode of treatment is recommended when the cause of piles is some other condition except for the cause being cancer. The bowels are controlled by water absorbing colloids. Various creams are available for insertion into the rectum at night and before defecation.

Active Treatment It consists of any of the following methods:
Operative Treatment

Surgery: The surgical procedure to remove the hemorrhoids is called haemorrhoidectomy. Procedure is simple, and patient is discharged with in 2-3 days. The recommendations for the operative procedure are the following conditions:
    Permanently prolapsed haemorrhoids (third-degree haemorrhoid) When the nonoperative procedures fail. When the hemorrhoids are fibrosed.
Prevention and precaution
FAQ
Q.What is the age at which piles can occur?
A.Piles can occur at all ages. It is uncommon in children, and occurs only because of some diseases of liver or other complications. Incidence of piles increases, particularly, after age 40.
Q. What is the treatment and subsequent management?
A. Piles are removed surgically by a procedure called haemorrhoidectomy. Alternate procedures include injection of phenol & almond oil into piles, elastic banding of piles, cryosurgery, and photocoagulation. To prevent recurrence patient is advised to avoid spicy and greasy foods, take lots of water and salads, and avoid constipation. The patient should not strain during defecation.
Q. What are the factors that are associated with increased risk of getting piles?
A. Family history of piles
    Chronic constipation
    Prostate enlargement leading to chronic straining while passing urine
    Cancer of rectum
    Pregnancy
Q. Are there any non-surgical methods of treatment?
A. The main treatment of piles is surgical. The non-surgical methods are only for temporary relief. They cannot cause the regression of the piles. They are usually used when there is a secondary cause of piles e.g. pregnancy.
Q. Can haemorrhoids be a symptom for other conditions?
A. Haemorrhoid can be a symptom of other disease. They are cancers of the rectum, straining during urination due to causes like urethral narrowing or prostate enlargement, and pregnancy