The anal canal is lined with tissues and veins. When the veins get swollen and inflamed they are called hemorrhoids. The common name for them is “piles”.

There are two types of hemorrhoids. Internal hemorrhoids develop inside the anal canal and are mostly painless. External hemorrhoids develop around the anus opening and can be quite painful. Both internal and external hemorrhoids can exist at the same time together.

Symptoms
A person can have hemorrhoids for a long time and be unaware. Some common symptoms include:

• Bleeding and painful sensation while passing stool
• Itching and irritation around the anus
• Pain around the anus
• Painful sensitive lumps and swelling around the anus
• Stool leakage into underwear

Causes
Hemorrhoids generally develop from excess pressure in the anal canal between the rectum and anus. There are many reasons for their formation:

• Irregular bowel movements caused by either diarrhoea or constipation.
• Obesity and excess body weight
• Pregnancy
• Less fibre in diet.
• Anal sexual intercourse

Treatment
There isn’t a permanent cure for hemorrhoids. There is no guarantee that they will not reappear after treatment.

Home Treatment
The initial steps at treating hemorrhoids can be done at the home very easily.

• Over-the-counter (OTC) creams, ointments and painkillers to relieve itchiness and pain.
• Moist wipes for anal hygiene.
• Warm water wash.
• Ice pack or cold compress to reduce swelling.

Medical Treatment
When home treatment do not help, medical / surgical intervention is required.

• Out-patient non-surgical procedures –
  • Incision – A cut made on the blood clot around an external hemorrhoid.
  • Rubberband ligation – A special elastic band tied round the base of the hemorrhoid resulting in it falling off within a week.
  • Sclerotherapy – A chemical injection into the vein wall causing it to collapse and shriveling up the hemorrhoids.
  • Infrared coagulation – Infra red rays directed to the hemorrhoid burning up the tissues.
• In-patient surgical procedures –
  • Hemorrhoidectomy – The surgical removal of hemorrhoids.
  • Stapled hemorrhoidectomy – Cutting a strip of the vein-filled wall resulting in the hemorrhoids being pulled back to their normal anatomical position.
  • Doppler guided transanal hemorrhoidal dearteriailzation – Ultrasound Doppler that ties up blood arteries and stitches the prolapsed hemorrhoid to its original position.
  • Cryosurgery – Freezing hemorrhoid tissues.

Prevention
The way to prevent hemorrhoids is to have soft stool. Simple lifestyle habits can be adopted:

• Keeping body weight and obesity in check
• Eating fibre-rich food
• Drinking plenty fluids
• Not straining or forcing bowel movement
• Not controlling the sensation of bowel movement.
• Being physically active
• Maintaining body hygiene

Conclusion
Hemorrhoids are mostly benign and not life-threatening. However they can be very painful and cause a lot of discomfort. Simple lifestyle and diet habits will go a long way in keeping them away.