Piles Treatment | Hemorrhoids Treatment

What are piles?
Piles, also known as hemorrhoids, are collections of tissue in the anal canal which are inflamed and swollen. They may be found inside or outside the anus, normally located 2-4 cm above the anal opening. The size of piles/hemorrhoids can vary.
Causes of Piles
The usual cause of piles is increased pressure in the lower rectum. Due to pressure, the blood vessels surrounding the anus will stretch causing it to swell and thus forming piles. Many factors contribute to the occurrence of piles, which include chronic diarrhea, chronic constipation, straining for bowel movements, pregnancy, etc.
Symptoms of Piles
- Pain during passing of stools.
- Bright red blood after passing stools.
- A hard lump that could possibly be painful felt around the anus.
- Itchy, red, and sore area around the anus.
In severe cases, the symptoms of piles can include:
- Infection
- Excessive anal bleeding. This results in anemia.
- Involuntary loss of bowel control, called fecal incontinence.
- Anal fistula – a tunnel created from the skin surface near the anus to the inside of anus.
- Strangulated hemorrhoid. This happens when the blood supply to the hemorrhoid is stopped. Complications of a strangulated hemorrhoid include infection or blood clot.
Classification of Piles
Based on severity, piles can be classified into:
- Grade I – Small inflammations, which are not visible, usually staying inside the anus.
- Grade II – This remains inside the anus, but the size will be larger than Grade I piles. During passing of stools, the piles are pushed out, but returns back spontaneously.
- Grade III – Grade III hemorrhoids appear outside the anus. It gives a feeling of hanging from the anus, but can be pushed back into the rectum.
- Grade IV – Treatment of Grade IV hemorrhoids is necessary as it cannot be pushed back. They are usually large and appear outside the anus. They are also known as prolapsed hemorrhoids.

The doctor performs Digital Rectal Examination (DRE) for the diagnosis of piles. Proctoscope may also be used, which is a hollow tube with light at its tip. Proctoscope helps the doctor visualize the anal canal up close. Small tissue samples may be taken, which are sent to lab for analysis.
Treatment for Piles
Piles may resolve on their own without any treatment, but treatments help in reducing the discomfort associated with piles. Some preventive measures that can be taken include:
- Drinking lots of fluids and having plenty of fiber intake to keep the stools soft
- Gently pushing the piles back inside
- Exercising regularly
- Cutting down caffeine and alcohol intake in order to avoid constipation
- Take warm bath to ease the itching and pain
- Keep the anal area clean and dry.
Surgical treatment may be necessary in some cases and the options include:
- Banding, which is the placement of an elastic band around the base of the pile. The purpose of placement of an elastic band is to stop the blood supply to the hemorrhoid, and within a few days the hemorrhoid falls off.
- Infrared coagulation, usually used to treat Grade I and II hemorrhoids, is a method where the hemorrhoid tissue is burned off with a device.
- Sclerotherapy, usually used in Grade II and III hemorrhoids, is a treatment method where medicine is injected to make the hemorrhoid shrink and eventually the hemorrhoid resolves.
- Hemorrhoidectomy or surgical removal of the hemorrhoid tissue. This is very effective in completely resolving piles. There is disadvantage of postoperative pain in this modality.
- Stapled hemorrhoidectomy. It often better benefits than surgical procedure with absence of pain. No wound is made outside. A full circle of hemorrhoidal tissue is removed, so chances of recurrence in the form of secondary hemorrhoids is reduced. This procedure is also known as keyhole procedure for hemorrhoids.
Piles Treatment in Kochi
Here at Keyhole Clinic, we offer Piles Treatment in Kochi and we have surgeons with experience of more than 25 years in General and Laparoscopic Surgeries.
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