Piles

Piles (or Haemorrhoids) are a very common ailment that may affect men or women at any age. These are caused due to continuous high pressure in the veins. Other causes include constipation, excessive straining during bowel movements and persistent diarrhea. Family inheritance is also seen. Women are more susceptible to piles in pregnancy as the pressure from the growing uterus restricts the blood flow in the pelvis. Lifestyle factors also have a contributory effect.

Classification:

• Piles may be internal or external. Internal piles are further classified into grades:
• Grade I – No protrusion from anus.
• Grade II – Protrusion through the anus during straining and defecation, but return spontaneously.
• Grade III - Protrude through the anus with defecation or straining, but manually reduced.
• Grade IV – Protrude and cannot be manually reduced.

Symptoms

The symptoms include itching, irritation, pain, aching, bleeding, and tender outgrowth(s).

Diagnosis

Diagnosis is done by history and physical examination of rectum.

Treatment

In past, open surgery was the only option available. But today, with minimally invasive procedures, doctors approach for patient care has revolutionized. New procedure for haemorrhoids is called ‘Minimally Invasive Procedure for Piles’ (MIPS), also called ‘Stapler Haemorrhoidectomy’. It is less painful and ensures early recovery.

The technique uses a stapling device and takes advantage of the fact that pain-sensing nerve fibres are not present high up in the anal canal. In this procedure, the mucosa above the dentate line (containing part of pile mass) is excised and stapled with the stapler gun, thereby taking care of bleeding and prolapse. The pile masses are compressed into a cup like cavity inside the stapler. When fired, the titanium staples cut and seal simultaneously, causing minimal bleeding. As the cut line is above the nerves, there is less post-operative pain. Also, there is no incision on the perianal skin or lower part of anal canal and the wound in the anal mucosa is also primarily closed with a stapler, thus, there is no need to do any post-operative dressing