When you notice, even a small amount of blood in your stool, you obviously become worried. If we go by the popular belief, most of the people think, they are suffering from piles if they are having blood in stool. But, let me tell you, this is not always true. Although Piles (Clinically it is called Hemorrhoid) are the most common cause of blood in stool, the other common causes are Anal Fissure, Colorectal cancers, Rectal Polyps, other less common diseases like Diverticulitis, Inflammatory bowel disease etc. Let’s discuss the common causes (Hemorrhoids, Anal Fissure and Colorectal cancers) of this worrisome problem and how you can manage it scientifically, not following the myths blindly. Today, let’s start with Piles (Hemorrhoids)
Piles (Hemorrhoids): Hemorrhoids are abnormality of the vascular cushions inside the anal canal. The vascular cushions form the termination of the blood supply within the anal canal and contribute to the
maintenance of control of anal opening. Hemorrhoidal disease occurs as the result of abnormalities within the connective tissue of these cushions, producing bleeding with or without prolapse of the hemorrhoidal tissue.
Bleeding in hemorrhoids is mostly pain less. So, painless bleeding in motion or some fleshy mass (when hemorrhoidal tissue enlarges and prolapses) coming out per rectum are the two most characteristic presentation. In case of suggestive symptoms, you need to take a physician’s opinion
Management of piles can be broadly divided into Non-surgical and Surgical management. Non- surgical management comprises of diet with high fiber, Seitz bath, sclerotherapy (e.g Phenol, Almond oil), rubber band ligation and Laser therapy. Laser therapy is comparatively newer procedure. In this procedure, hemorrhoidal arterial flow feeding the hemorrhoidal tissue is stopped by means of Doppler-guided laser coagulation.
Patients who don’t recover on non-surgical management, they are candidates for surgical management. Both open and minimal access procedures are available. In these days of development in technology, the minimal access procedure (Stapled Hemorrhoidopexy) is definitely better in terms of pain, recovery and cosmesis. But for the success of treatment, the procedure should be individualized depending on the degree of hemorrhoids.