Hemorrhoids, commonly called Piles are swollen and inflamed veins inside the anus and rectum. Depending on where they arise, they are termed as internal and external hemorrhoids. Internal hemorrhoids are seen inside the rectum and typically not visible outside the anus. (There are cases when the internal hemorrhoids come out through the anus.) External hemorrhoids are seen outside and near the anus region. Piles cause a lot of discomfort, especially if external. They bleed and are often painful and itchy.
Thrombosed Hemorrhoids are the swollen veins that are caused due to blood clots formed inside the veins. Thrombosed veins cause severe pain and inflammation. Internal hemorrhoids bleed when passing hard stools. The hard stool can scrape or cut through the piles’ surface resulting in bleeding. Thrombosed hemorrhoids bleed when there is too much amount of blood pooled in a particular region of the vein that bursts out.
Treatment for bleeding hemorrhoids
As said, when the surface of hemorrhoids is damaged, either due to rupture with hard stools or due to any other reason, they start bleeding. Usually, piles (in some) resolve on their own but most of them will need treatment to get them removed and to stop recurrence of piles. In any case, seeing a doctor is very important if you notice any streaks on stools or bleeding near the anus. There could be several other reasons other than piles that can cause bleeding.
Treating piles (hemorrhoids) at home
- Using soft wet wipes to clean your bottom. After you pass stools, instead of wiping your bottom with dry tissue, you can use wet wipes to reduce irritation and pain. If you live in India, use warm water to wash your bottom. You may also use handmade (chemical free) soaps to keep the area clean.
- Sitz bath – It is like a small tub filled with warm water that can be placed on (western) commode to rest your bottom. Add some Epsom salt to help relieve pain and inflammation caused due to piles.
- Applying cold pack – Inflammation and pain can be reduced to an extent when you apply ice pack in the area. If you don’t have ice packs, just wrap a cotton towel or cloth with some ice cubes and apply in the area.
- Drink lots of water and add fiber to your diet. If you realize that you are passing hard stools, you will need to drink lot of water and add fiber to your diet to ease passage of stools. The odds of scraping the surface of piles by the poop can reduce to a great extent.
- Use stool softener to soften the stool if you feel constipated. This can reduce the chances of bleeding from internal piles.
- Workout regularly or be active – Staying active can help you in being less constipated.
Treatment for piles by a specialist
While home remedies can only give relief from the symptoms temporarily, the permanent solution for piles is to see a doctor and get them treated or removed. “Once the piles are treated in the best possible way, the quality of our patients’ lives has greatly improved and they are very happy” says Dr. Karthik Gunasekaran, leading gastroenterologist in Chennai from The Laser Gastroenterology Clinic. Most of the treatment procedures can be done as day-care of out-patient procedures and they are relatively pain free. They include:
- Rubber band ligation. A rubber band is tied at the base of the hemorrhoids. This effectively cuts off the blood supply to the rest of the hemorrhoids and they shrink and drop off. This procedure is usually employed for internal hemorrhoids.
- A medicated solution is injected into each pile which will again block the blood flow to it and results in it shrinking and dropping off.
- Coagulation (Infrared, laser or bipolar). This procedure may cause little discomfort compared to other methods. Laser or infrared energy is applied at the base of the hemorrhoids that cause scarring and eventually shrink.
Surgical procedures to treat piles
- Hemorrhoidectomy (Removal of hemorrhoids). Surgery is done usually under anesthesia. Severe and recurring hemorrhoids are removed using hemorrhoidectomy. The excess tissue that causes bleeding is removed during the procedure.
Antibiotics and pain relieving medicines will be prescribed during the healing process.
- Hemorrhoid stapling. Hemorrhoid stapling is also called ‘hemorrhoidopexy’ targets towards blocking blood flow to the tissues in hemorrhoids. This procedure is usually employed for internal piles. Though stapling of hemorrhoids is a less painful procedure, many people report recurrence of piles after the surgery. Also, the procedure puts the patient at risk of rectal prolapse.
When should see a good gastroenterologist near you?
If you see blood streaks on your poop or if you feel pain near the anus region and see blood, you should see a good lady gastroenterologist near you. There could be several reasons including colon cancer that can cause streaks on poop or cause anal bleeding, so it is important not to ignore any symptom and get yourself checked up by a good doctor.
Your doctor may perform certain tests such as colonoscopy to see what is happening inside the rectum and may also perform biopsy of tissues if he/she feels necessary. You will need to tell your doctor every symptom that you had (or having) that might include change in colour of stools, pain and redness near the anal region, dizziness etc.