Classification of Piles:
Piles may be internal or external. Internal piles are further classified into grades:
- Grade I - No protrusion from anus.
- Grade II - Protrusion through the anus during straining and defecation, but return spontaneously.
- Grade III - Protrude through the anus with defecation or straining, but manually reduced.
- Grade IV - Protrude and cannot be manually reduced.
Piles Symptoms & Signs
In most cases, the symptoms and signs of piles have not any complications. Piles generally resolve on their own without showing any signs of seriousness after a few days and you may not even require any piles treatment.
If you are suffering from piles, you may experience the following signs and symptoms.
- After the bowel movement, you may experience that your bowels are still full
- A painful hard swelling may be felt around your anus. This hard lump may contain coagulated blood. This type of piles is known as thrombosed external hemorrhoids
- You may notice clear red blood on your stool after passing the stool
- You may experience pain while passing the stool
- The region around the anus feels sore, red, and itchy
If piles are not resolved on its own, it can possibly escalate into more serious condition.
- Extreme anal bleeding which can possibly lead to anemia
- Inability to control bowel movements or fecal incontinence
- You may experience the occurrence of anal fistula. It is a channel which is created between the inside of the anus and the skin near the anus
- You may also experience strangulated hemorrhoid where the blood supply to the hemorrhoid is cut off. It can lead to severe complications like a blood clot and infection
This time, you might be prescribed to undergo a piles operation by the doctors.
Diagnosis of Piles
At RG Stone, the doctors usually diagnose piles by conducting a physical examination. Before writing any prescription for piles treatment, the doctors will examine the anus region of the person suspected with piles.
Also, doctors may ask certain questions regarding your discomfort which includes:
- What color are the stools?
- Has your bowel movements changed recently?
- Are you experiencing a sudden weight loss?
- Has there been any mucus or blood in the stools?
- Does someone from your family have piles?
Moreover, for internal piles, a digital rectal examination may be conducted by the doctor or he/she can use a proctoscope. Proctoscope is a device which is basically a hollow tube with a light that allows the doctor to examine the anal canal thoroughly.
If the symptoms of piles are not alarming, the doctor may recommend you a colonoscopy. However, if the symptoms are serious that demonstrates any signs of colorectal cancer; then you might be prescribed to undergo piles operation.
Piles Treatment / Surgery
In past, open surgery was the only option available. But today, with minimally invasive procedures, doctors approach for patient care has revolutionized. New procedure for haemorrhoids is called 'Minimally Invasive Procedure for Piles' (MIPS), also called 'Stapler Haemorrhoidectomy'. It is less painful and ensures early recovery.
The technique uses a stapling device and takes advantage of the fact that pain-sensing nerve fibres are not present high up in the anal canal. In this procedure, the mucosa above the dentate line (containing part of pile mass) is excised and stapled with the stapler gun, thereby taking care of bleeding and prolapse.
The pile masses are compressed into a cup like cavity inside the stapler. When fired, the titanium staples cut and seal simultaneously, causing minimal bleeding. As the cut line is above the nerves, there is less post-operative pain. Also, there is no incision on the perianal skin or lower part of anal canal and the wound in the anal mucosa is also primarily closed with a stapler, thus, there is no need to do any post-operative dressing.