Piles (clinically termed as hemorrhoid) are common clinical entity. The most common symptom of piles is per rectal bleeding (bright red blood) after you empty your bowel. The blood may be noticed on the toilet tissue, in the toilet pan or coating the stools. A pile can hang down and you can feel it like a mass. Usually, it can be pushed back inside with your fingers, but in the late cases it remains outside your anus, when it is termed as “External pile”. Small internal piles are usually painless. Larger piles may cause a mucous discharge, some pain, irritation and itch. The discharge may irritate the skin around the anus. You may have a sense of fullness in the anus, or a feeling of not fully emptying your back passage when you go to the toilet. Depending on the symptoms piles can be broadly divided into four gradings-
Grade I- Only per rectal bleeding, no mass
Grade II- Mass comes out with besides bleeding, but goes back inside spontaneously
Grade III- Mass doesn’t go back of its own. You will have to push it inside.
Grade IV- Mass is prolapsed outside anus and doesn’t go back
When the blood supply to the pile ceases, it causes a condition “Thrombosed Piles”- where it is extremely painful. In most of the cases, you need urgent evacuation of the same by surgery.
If you have any of these suggestive symptoms, please take a consultation from your surgeon. Piles can be cured without surgery in the initial stages. But in some of the cases of grade II onwards, surgery is the only resort. In the days of minimal access surgery nowadays, Stapled hemorrhoidopexy by an experienced minimal access surgeon is a highly effective surgery. This procedure involves, the removal of abnormally enlarged hemorrhoidal tissue, followed by the repositioning of the remaining hemorrhoidal tissue back to its normal anatomic position.The lower 4cm of anal canal is pain sensitive. Hence, any procedure done in that area is painful. The beauty of stapled hemorrhoidopexy is that the surgery happens beyond that 4cm. So, it is less painful than the open surgery