Piles (Hemorrhoids) Treatment in Delhi, India

Haemorrhoids or piles are a condition where the veins of the anal canal experience a lack of blood flow, causing them to engorge and swell. Everyone has haemorrhoids, and these vessels can get irritated due to age, chronic constipation/diarrhoea, spending too long on the toilet or increased intra-abdominal pressure. When they start hampering everyday life, it is time to seek help.

There are four different types of haemorrhoids people can experience. These are:

1. Internal Haemorrhoids: These cannot be felt generally due to the lack of nerve endings in the anal canal. Their presence can be seen as blood in stool, in the pot or on toilet paper.
2. External Haemorrhoids: These can be seen and felt in and around the anus. They can be itchy and uncomfortable and may bleed upon irritation. Clots in the haemorrhoid are not uncommon and may cause discomfort and swelling.
3. Prolapsed Haemorrhoids: These are haemorrhoids that enlarge and bulge out of the anus. There are stages to prolapsed haemorrhoids, and grades to classify them.
4. Thrombosed: Here, a haemorrhoid has a clot within the vein that supplies it with blood. They aren’t dangerous but can be painful.

There are four stages of piles, formally called “grades”. These grades are:

1. Grade 1 - At this stage, haemorrhoids remain inside the rectum and are not visible externally. They might cause minor discomfort, itching, or bleeding during bowel movements.
2. Grade 2 - Haemorrhoids tend to prolapse (come out of the anus) during bowel movements but return to their original position afterwards. Bleeding, itching, and discomfort are common symptoms at this stage.
3. Grade 3 - These haemorrhoids prolapse upon pressure and have to be pushed back in by the patient. They might stay outside the anus and can cause significant discomfort, pain, bleeding, and itching.
4. Grade 4 - This is the stage where the prolapse permanently stays outside the anus and needs treatment or surgery (called a hemorrhoidectomy). They may lead to considerable pain, bleeding, itching, and difficulty in hygiene maintenance.

Some reasons why one may develop haemorrhoids include:

• Pregnancy: During pregnancy, increased pressure on the pelvic area can lead to the development of haemorrhoids. The growing uterus and hormonal changes can be contributing factors.
• Obesity: Excess body weight can put additional strain on the rectal and anal areas, making it more likely for haemorrhoids to develop.
• Lack of Fiber in the Diet: A diet low in fibre can lead to constipation, increasing the risk of haemorrhoids. Fibre helps soften the stool, making it easier to pass.
• Chronic Constipation and Diarrhoea: Both chronic constipation and frequent bouts of diarrhoea can irritate the rectal area and contribute to haemorrhoid formation.
• Prolonged Toilet Sitting: Sitting on the toilet for an extended period, especially when straining during bowel movements, can increase the pressure on the rectal veins, potentially leading to haemorrhoids.
• Age: As individuals get older, their risk of developing haemorrhoids increases. This is due to the weakening of the connective tissues in the rectal and anal area.
• Lifting Heavy Weights: Straining while lifting heavy objects can lead to increased abdominal pressure, which can, in turn, strain the veins in the rectal area.
• Prolonged Sitting or Standing: Jobs or lifestyles that involve long hours of sitting or standing without breaks can also contribute to the development of haemorrhoids.

Patients are at risk of developing haemorrhoids because of:

• Age
• Pregnancy
• Lifting/Holding/Carrying heavyweights
• Not having enough fibre in the diet.
• Gastrointestinal diseases, chronic constipation/diarrhoea

Some signs of haemorrhoids are:

• Itchy Anus: Haemorrhoids can lead to persistent itching in the anal area, often caused by irritation and inflammation.
• Bleeding: One of the most noticeable signs is blood in the toilet bowl after a bowel movement, on toilet paper, or even within the stool. This bleeding can range from minor spotting to more significant amounts.
• Pain: Haemorrhoids can be painful, especially during sitting or bowel movements. This discomfort may vary in intensity.
• Hard or Tender Lumps: Some individuals may feel stiff or tender lumps near or on the anus. These lumps are often swollen blood vessels associated with haemorrhoids.

Haemorrhoids can generally be diagnosed by considering a patient’s medical history and physical exams. Sometimes, they are also diagnosed through a digital rectal exam, which amounts to feeling for them by using a gloved, lubricated finger. External haemorrhoids are observable, but for internal haemorrhoids, doctors may look inside the intestinal tract using different tests.

Typical Tests

Some diagnostic tests that help doctors find if a patient suffers from haemorrhoids are anoscopy, sigmoidoscopy, and colonoscopy. These procedures make use of a scopeto see the intestines, colon, rectum, and anus. Anoscopy and sigmoidoscopy do not require anaesthesia or sedatives, but a colonoscopy may require some sedatives or anaesthesia.

There are various methods of managing haemorrhoids. Haemorrhoids treatment includes a combination of at-home care and, if necessary, medical procedures & surgeries. Procedures and surgeries are for cases where there is a disruption in a person’s everyday activities. Sometimes, when haemorrhoids get bad, it becomes difficult to sit. Thus, it is necessary to seek appropriate help from medical doctors to help patients go back to their regular lives.

Common Procedures for Piles Treatment

• Rubber Band Ligation - The surgeon binds the base of the haemorrhoids with rubber bands to cut off the blood supply. The haemorrhoids fall off in a week, making it an effective treatment plan. The chance of recurrence is less than 5%.
• Infrared Coagulation - It uses infrared light to heat a blood vessel and cut off the blood supply.
• Electrocoagulation - This treatment method uses an electric current that causes the proteins in the affected tissue to coagulate/clot, thus killing the tissue.
• Sclerotherapy - One can consider haemorrhoids to be the varicose veins that affect the bottom. Similarly to varicose veins, a solution is injected into the affected area to shrivel the veins, which eventually become scar tissue.

Surgical Procedures for Piles Treatment

• Hemorrhoidectomy - When haemorrhoids reach grade 3 or 4, it can become challenging to perform daily activities. A hemorrhoidectomy cuts out the affected haemorrhoid tissue, and the leftover tissue is repositioned to the original anatomical area.
• Hemorrhoidopexy - This involves removing internal haemorrhoids. It is used to pull a prolapse back into the anus and is held in place with staples or sutures. This is also known as Stapled Hemorrhoidectomy.

Some ways to prevent haemorrhoids are:

• Consume a high fibre diet.
• Do not lift/hold/carry excessive weights.
• Do not sit for long periods on the toilet.
• Do not wipe or rub too hard when using toilet paper.

Haemorrhoids generally resolve on their own when a patient takes appropriate at-home care. They go away in a week on their own but when they cause disruption in daily activities, it is imperative to see a doctor for treatment or surgery.

Max Hospitals stands out as a top choice for Piles treatments in Delhi, offering unmatched care for those seeking solutions. Here’s why Max Hospitals is the preferred choice for piles:

World-Class Medical Expertise 

At the core of Max Hospitals lies a dedicated team of highly experienced specialists and medical professionals specialising in the treatment of piles. With a remarkable history of successful procedures, they bring a wealth of knowledge, expertise, and dedication to ensure every patient has the best chance of recovery.

Comprehensive Patient Care 

Dealing with piles is not just a medical journey but an emotional one as well. Recognizing this, Max Hospitals offers comprehensive care. From initial consultations and well-being programs focused on pile management to ongoing support post-treatment, patients and their families are always embraced by a compassionate and supportive team.

Reputation and Trust

Having built a legacy in healthcare, Max Hospitals has become synonymous with successful pile treatments in Delhi and beyond. Our consistent results and patient-centric approach have earned us the trust of both individuals seeking relief from piles and referring physicians.

Accessibility

Strategically located, Max Hospitals ensures that top-tier pile care is easily accessible. With branches in key cities across India, we have extended a beacon of hope for countless individuals seeking relief from the discomfort of piles.

Choosing Max Hospitals for Piles means embarking on a journey of hope supported by expertise, cutting-edge technology, and genuine care.

1.  Are there any effective home remedies for treating haemorrhoids?

Home remedies include soaking in warm water (sitz baths), applying cold packs, using over-the-counter creams or ointments, increasing dietary fibre, staying hydrated, practising good hygiene, and avoiding excessive straining during bowel movements. Such measures are effective only when piles are in the initial stage.

2. Can over-the-counter creams and ointments help with haemorrhoid relief?

Yes, over-the-counter creams and ointments that contain ingredients like hydrocortisone or witch hazel can provide temporary relief from itching, pain, and swelling associated with haemorrhoids. Patients should be careful; some of these medications can cause local allergic reactions/rash.

3. What are the potential side effects of using topical haemorrhoid treatments?

Potential side effects of topical haemorrhoid treatments may include skin irritation, redness, burning, and allergic reactions.

4. How do suppositories work for haemorrhoid treatment?

Suppositories are inserted into the rectum and work by delivering medication directly to the affected area.

5. Are there any effective non-surgical procedures for treating haemorrhoids?

Yes, non-surgical procedures like rubber band ligation, sclerotherapy, and infrared coagulation are commonly used to treat haemorrhoids.

6. When is surgical intervention necessary for haemorrhoid treatment?

Surgical intervention may be necessary for severe or recurring haemorrhoids that don't respond to conservative treatments. Surgery is also recommended for thrombosed haemorrhoids (haemorrhoids with blood clots) and large external haemorrhoids.

7. Is it necessary to change one's diet to prevent or treat haemorrhoids?

Yes, dietary changes can help prevent and treat haemorrhoids. A high-fibre diet can soften stools, which can help prevent haemorrhoids from forming or worsening.

8. How long does it take for haemorrhoids to heal?

The healing time for haemorrhoids depends on the severity of the condition and the treatment used. In mild cases, symptoms may resolve within a few days with conservative treatment. Severe cases might take several weeks to heal, and surgical procedures may require several weeks of recovery time.

9. Are there any risks or complications associated with haemorrhoid treatments?

Potential complications may include bleeding, infection, scarring, incontinence, and difficulty urinating. However, these risks are relatively low, and most people experience successful outcomes with treatment.

10. Can pregnancy cause or worsen haemorrhoids, and how are they treated during pregnancy?

Yes, pregnancy can cause or worsen haemorrhoids due to the increased pressure on the pelvic veins. Conservative measures like increasing fibre and fluid intake, taking warm baths, and using topical treatments are generally safe during pregnancy.

11. Is it possible for haemorrhoids to come back after treatment?

Yes, haemorrhoids can come back after treatment, especially if the underlying cause (such as constipation) is not addressed. Following a healthy lifestyle and taking steps to prevent constipation can help reduce the risk of recurrence.

12. What are some strategies for managing pain and discomfort associated with haemorrhoids?

Strategies for managing pain and discomfort associated with haemorrhoids include using over-the-counter creams or ointments, taking warm baths, applying cold packs, using a cushion or doughnut-shaped pillow to sit on, avoiding prolonged sitting or standing, and practising good hygiene.

13. When should I consult a healthcare professional for haemorrhoid treatment?

You should consult a healthcare professional if you experience persistent symptoms of haemorrhoids, have rectal bleeding, have a lump near the anus, experience severe pain or discomfort, or if conservative treatments do not provide relief. Your healthcare professional can diagnose the condition and recommend appropriate treatment options.

14. Is there a loss of bowel control after piles or hemorrhoid surgery?

No, loss of bowel control is not a typical outcome of piles or haemorrhoid surgery. In most cases, surgery is performed to alleviate the symptoms and complications of haemorrhoids, and it should not result in a loss of bowel control.

15. Do piles go away on their own?

Piles, or haemorrhoids, can sometimes go away on their own, especially if they are mild or caused by temporary factors such as constipation. However, more severe or chronic haemorrhoids may require treatment to alleviate symptoms and prevent complications.

16. How do I know if I have piles?

Symptoms of haemorrhoids may include anal itching, pain, bleeding during bowel movements, and a lump or swelling around the anus. If you experience these symptoms, it's advisable to consult a healthcare professional for a proper diagnosis and treatment options.

Reviewed by Dr. Vishwas Sharma - Director, Laparoscopic / Minimal Access Surgery, General Surgery, Department of General Surgery and Robotics on 17 Jan 2024.

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