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Hemorrhoids (Piles)
What are hemorrhoids?

Abnormally engorged blood vessels in the anus. These are common problems that affect about 50% of the general population. While most remain small and have no symptoms, others may cause bleeding and pain, leading to discomfort and inconvenience.

Symptoms of Hemorrhoids
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The most common symptom for piles is fresh, painless bleeding, ranging from simple streaks on the toilet paper to large amounts dripping into the toilet bowl. As the condition progresses, it may lead to a prolapse, a condition where the hemorrhoid protrudes outside the anal sphincter. When this happens, the patient will experience pain. In advanced stages the patient will have to push them back every time they come out. In some instances the hemorrhoids can become hardened, irreducible and acutely painful. This is an emergency and requires immediate medical attention.

Causes of Hemorrhoids

When pressure around the anus increases, it can stretch the veins, causing the anal canal blood vessels to engorge and then become hemorrhoids. Weakening of the supportive tissues and ligaments around the anus can also cause the hemorrhoids to prolapse. Pressure in the anus increases for different reasons, including:

Straining during defecation
Chronic constipation
Chronic diarrhea
Pregnancy and childbirth
Following a low-fiber diet
Sitting for extended periods

Although there is no scientific explanation,  hemorrhoids are known to run in certain families.

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What can I do to prevent hemorrhoids?

It is accepted that a well balanced diet containing adequate fibers will prevent constipation and therefore hemorrhoids. Fresh fruits, vegetables and cereals are excellent sources of fibers. Adequate fluid intake will also prevent hard stools and constipation. The association of spicy food intake and hemorrhoids is weak and largely unproven.

Can hemorrhoids turn cancerous?

No. Hemorrhoids are benign and will not progress to colorectal cancer if left untreated.

How are hemorrhoids diagnosed?

While large prolapsed hemorrhoids are easily seen and diagnosed, smaller ones are more difficult to detect. Hemorrhoids that do not prolapsed cannot be felt. The doctor will have to use a short proctoscope in the colorectal clinic to see the hemorrhoids.

What are the types of operations available for hemorrhoids?

For decades, operation for hemorrhoids (hemorrhoidectomy) has been done through the surrounding anal skin. The hemorrhoidal tissues are then dissected and excised. This results in raw skin wounds after surgery. Eventually the wounds will heal over but this can take some time.

condi-piles-2Recently a new technique has been developed to operate on hemorrhoids. This is known as stapled hemorrhoidectomy. Hemorrhoidectomy using laser is no longer practised as the results are not any more superior and the cost does not justify its use.

MORE INFO ON PILES SURGERY
Will hemorrhoids recur after surgery?

That depends entirely on the patient. After the piles surgery, as long as the patient takes measures to prevent constipation and straining, and to observe good bowel habits, the likelihood of recurrence should be minimal.