HEMORRHOIDS/PILES
Hemorrhoids, also known as piles, are swollen and inflamed veins in the lower rectum and anus. They can occur either internally, inside the rectum, or externally, under the skin around the anus.
Causes
Straining during bowel movements
Chronic constipation or diarrhea
Pregnancy
Obesity
Prolonged sitting or standing
Symptoms
The symptoms of hemorrhoids can vary depending on the type and severity of the condition. Here are some common symptoms:
- Pain or discomfort
- Itching and irritation: Swelling: Hemorrhoids can cause swelling and inflammation in the anal area.
- Bleeding:
- Protrusion/bulge/lump
- Mucus discharge
Diagnosis
- Visual inspection
- Digital rectal exam
- Anoscopy/proctoscopy
- Sigmoidoscopy or colonoscopy
These tests involve the insertion of a flexible tube with a camera into the rectum and colon to examine the area in more detail.
Stages
Haemorrhoids are classified according to their size:
| Classification | Description |
| 1st Degree | Remain in the rectum |
| 2nd Degree | Prolapse through the anus on defecation but spontaneously reduce |
| 3rd Degree | Prolapse through the anus on defecation but require digital reduction |
| 4th Degree | Remain persistently prolapsed |
Treatment
The treatment of hemorrhoids depends on the severity of the condition. In most cases (85%), mild to moderate hemorrhoids can be treated with self-care measures and over-the-counter medications
Modalities
- Rubber band ligation
- Sclerotherapy
- Hemorrhoidectomy
Latest treatment options are:
- Infrared coagulation (IRC)
- Doppler-guided hemorrhoidal artery ligation (DGHAL)
- Laser treatment(hemorrhoidoplasty)
- Suture anopexy
- Stapler hemorrhodoplasy
Comparison of laser and open surgery(tabulate)
Prevention
- Increasing fiber intake and drinking more water, can help soften stools and reduce constipation.
- Avoiding prolonged sitting or standing.
- Regular exercise.
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