Common symptoms:

• May have no symptoms if haemorrhoids are small. Even large haemorrhoids may be asymptomatic
• Bleeding: This can happen irrespective of haemorrhoids size! This is usually related to straining to pass stools but this can also happen even without straining at defecation.
• Prolapse:  This usually happens as the haemorrhoids enlarge in size. In most cases they can be manually pushed back in the anal canal.
• Perianal symptoms: usually present due to mucous leak, itching, soreness.

Common causes:

• No specific cause
• Chronic constipation
• Straining at defecation
• Increased intrabdominal pressure
• Pregnancy.

Treatment:

• Conservative:  This involves use of stool softeners, high fibre diet and most importantly no straining at defecation.
• Banding: This involves application of rubber bands be an instrument. This helps procedure helps in fibrosing the veins and reduce the size. This treatment may need to be repeated at times.
• Surgical: there are various procedures which are done at the hospital and the procedure is commonly called Haemorrhoidectomy and this is done in general or spinal anaesthesia. These radical procedures are usually done for Grade 3/ 4 size piles.

Process:

You will need to have an internal examination to confirm the diagnosis of haemorrhoids and to rule out any other cause

At first visit a detailed history is taken to make a provisional diagnosis. After that a date will be arranged for a rigid sigmoidoscopy and for banding if the haemorrhoids are visualised. A separate date is needed as bowel preparation is needed. Multiple haemorrhoids can be banded at the same sitting. It takes a few weeks after the first application to assess the benefits and need for more banding.

Conclusion:

Haemorrhoids are difficult to treat. No method guarantees a permanent solution. This is due to the fact that more haemorrhoids can form. The aim is symptomatic control and relief of symptoms.