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What Are Hemorrhoids And Who Gets Them?
Hemorrhoids are swelling in the rectum or anal area that may protrude through the anus on straining. They usually contain enlarged veins and are most common in people over the age of 50 but these days young people are also suffering.

What Are The Symptoms?
Hemorrhoids can often be felt as a swelling in the area of the anus. There may be soreness, bleeding, discharge or itching.

What Causes Hemorrhoids?
We don't know for sure, but hemorrhoids are often found in people who either sit or stand a lot or who have low fiber diets or poor bowel habits. Straining during stools and sitting for long duration also causes haemorrhoids.

Are Hemorrhoids Preventable?
No one knows for sure. Avoid straining or extensive sitting on the toilet. A diet rich in fluids, fruits, vegetables and fiber is desirable. If symptoms develop, see your doctor without delay.

How are Piles diagnosed?
A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool occurs. Bleeding is often due to haemorrhoids but may also be a symptom of other digestive diseases, including colorectal cancer. The doctor will examine the anus and rectum to look for swollen blood vessels that indicate haemorrhoids and will also perform an examination with a gloved, lubricated finger to feel for abnormalities. A hollow, lighted tube, known as a proctoscope, is also often used to look for internal haemorrhoids and examine the lining of the rectum. To rule out causes of gastrointestinal bleeding above the rectum, the doctor may examine the rectum and lower colon (sigmoid) with a rigid or flexible tube known as a sigmoidoscope.

Are There Different Kinds Of Hemorrhoids?
Yes. "Internal" hemorrhoids develop inside the anus. The most common symptoms are bleeding during bowel movements or protrusion through the anus upon straining. "External" hemorrhoids develop around the anus and can be very painful, especially if a blood clot develops within them. They can be felt as a firm lump or lumps around the anus.

How Are Hemorrhoids Treated?
Medical treatment : Measures to reduce symptoms include:
1.Warm baths (Hot Sitz Bath) several times a day in plain water for about 10 minutes.
2.Application of a haemorrhoidal cream or suppository to the affected area for a limited time
3.Prevention of a recurrence of haemorrhoids is aimed at changing conditions associated with the pressure and straining of constipation. Doctors will often recommend increasing fibre in the diet. Eating the right amount of fibre results in softer, bulkier stools. A softer stool makes emptying the bowels easier and lessens the pressure on haemorrhoids caused by straining. Eliminating straining also helps prevent the haemorrhoids from protruding. Good sources of fibre are fruits, vegetables and whole grains. In addition, doctors may suggest a bulk stool softener or a fibre supplement such as psyllium (ispaghula) or methylcellulose. Several brands containing these plant-based preparations are available.

  1. Non surgical methods may be used to remove or reduce the size of internal haemorrhoids. These techniques include:
  2. Rubber band ligation a rubber band is placed around the base of the haemorrhoid inside the rectum. The band cuts off circulation, and the haemorrhoid withers away within a few days.
  3. Sclerotherapy a chemical solution is injected around the blood vessel to shrink the haemorrhoid. Techniques used to treat both internal and external haemorrhoids include: 3.Laser heat (laser coagulation) or Infrared Photo coagulation ( IRC) uses special devices to block the circulation of haemorrhoidal tissue.

The doctor can perform most of these procedures during a visit to the hospital surgical out-patient department.

Surgical Methods :

  1. Haemorrhoidectomy : Cutting and tying of Piles under anaesthesia. Hospital stay of 2-5 days is required. Post operatively there is pain and recovery takes about 2 to 4 weeks.
  2. Stapler Haemorrhoidectomy : Latest but still controversial. Needs a stapler which is disposable and costly. Needs hospital stay and anaesthesia.

What Is Rubber Band Ligation?
In this a very small band made of rubber is applied by a special applicator. It is good in a small proportion of patients but it has high failure rates. The disadvantage are slipping of bands, severe pain and bleeding.

What Is Infrared Coagulation?
Infrared Coagulation (IRC) is the most useful office treatment for hemorrhoids and is preferred over other methods because it is fast, well-tolerated by patients, and virtually problem-free. A small probe contacts, the area above the hemorrhoid, exposing the tissue to a burst of infrared light for about one and half second. This coagulates the veins above the hemorrhoid causing it to shrink and recede. The patient may feel a sensation of heat very briefly, but it is generally not painful. Therefore anesthetic is usually not required.

Are There Any After Affects?
No. Most patients return to a normal lifestyle the same day. There may be slight spot bleeding and little pain a few days later. Heavy straining or lifting should be avoided and aspirin should not be taken for a few days.

How Many Visits Are Required for the treatment?
Usually one. Many patients have more than one hemorrhoid. But with IRC you need just a single 30 minutes sitting.

Will The Hemorrhoids Come Back or recur?
Millions of patients have been treated with IRC. Experience tells us that hemorrhoids treated with IRC generally do not recur. A sensible diet, moderate exercise and proper bowel habits will also help. An expert who is experienced gives you the best results.

What are the charges for IRC procedure ?
The cost varies according to the severity of piles and ranges between Rs.4000 - 8000/-

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