Piles Treatment in Sharjah
What are Piles/ Haemorrhoids?Piles, also known as Haemorrhoids, are vascular cushions that produce symptoms when they become enlarged, inflamed, thrombosed, or prolapsed. There are two types of piles.
1- Internal Haemorrhoids/PilesThey are situated above the dentate line (which is an imaginary line that separates the upper 2/3rds and the lower 1/3 of the anal canal). Internal piles are usually not painful and do not cause a lot of discomfort. The most common symptom is painless bleeding.
2- External Haemorrhoids/ PilesExternal hemorrhoids are situated below the dentate line. Since the anal canal below the dentate line is richly innervated, the formation of hemorrhoids causes significant pain.
What causes piles?Piles or Haemorrhoids have been associated with increased pressure in the lower portion of the rectum, decreased venous return and loss of elasticity causing inflamed, engorged and thrombosed vascular cushions. Risk factors associated with the development of hemorrhoids are as follows: • An improper diet such as a diet low in fibre resulting in excessive straining during passing stools. • Chronic diarrhoea or constipation- prolonged sitting is believed to cause a relative decrease in venous return. • Pregnancy – usually resolved after giving birth. • Obesity. • Family history of piles/hemorrhoids. • Spinal cord injuries. • Improper Posture. • Increased prevalence with increasing age. • Inflammatory bowel disease, Crohn/Ulcerative colitis.
What are the Signs and Symptoms?• Bleeding – bright red bleeding on stools during bowel movements. This can be observed in tissue paper or the toilet bowl. • Pain – during a sitting or bowel movement. • Swelling around the anus associated with or without severe itching. • Single or multiple lumps near the anus which might be painful to touch.
How do you Diagnose Piles?Clinical Visual Inspection • Advanced piles (3rd or 4th degree) can be seen on visual inspection. Digital Rectal Examination (DRE) • The health professional introduces a lubricated, gloved finger into the rectum to feel for piles or growths. DRE is done to rule out any other causes of rectal bleeding such as rectal prolapse, fissures, fistula or carcinoma of the rectum. Proctoscopy This is the best investigation done to confirm the presence of piles. A camera is introduced into the rectum and the walls of the rectum are observed. Grading of hemorrhoids is essential for appropriate management. • Sigmoidoscopy (viewing the sigmoid colon with an endoscopic camera) and a colonoscopy (viewing the colon with a camera) is also done to rule out any other cause of rectal bleeding.
Treatment and Management Options PreventionLifestyle modifications
- Increasing the intake of dietary fibers and low fat.
- Increasing fluid intake
- Weight loss – in case of obesity
- Toilet Habit Retraining-Avoid straining in the toilet.
- Use moist towelettes or wet toilet paper (to keep the anal area clean)
- Ensure the anal area is clean by bathing or showering every day and dry the anal region well.
- Get plenty of exercises.
- Avoid sitting for long hours while in the toilet.
- It is used as the first line of treatment for first and second-degree hemorrhoids.
- most commonly used sclerosing agent such as sodium tetradecyl sulphate is injected above the dentate line.
- The sclerosis agent induces an inflammatory reaction and that causes the mass to shrink.
- Success rate – 88% of patients with first degree piles feel improvement,
- Complications are rare. But prostatitis, prostatic abscess, epididymal-orchitis can occur if the sclerosing agent is placed too deeply.
- Performed for first and second-degree hemorrhoids.
- A rubber band is placed strategically to reduce the blood supply to the hemorrhoids. This causes it to slough off and heals within 5-7 days.
- Success rate – 60%-80%
- Performed for non-prolapsing symptomatic hemorrhoids.
- This is the most effective treatment for 3rd and 4th-degree hemorrhoids.
- Haemorrhoidectomy is also done for second-degree hemorrhoids where non-operative treatment has failed, interno-externo hemorrhoids, and thrombosed hemorrhoids.