To know why piles surgery should not be delayed, a good understanding of the condition that indicates the need for surgery is necessary. There is a lot of time, patience and determination involved in going through conservative management of piles. Though the popular choice is to treat piles with medicines and home remedies, advanced and complicated piles are better removed through piles surgery from the best piles hospitals. The fear of pain that accompanies a piles surgery can be overcome by knowing that the wait can be dangerous and regretful.
Why is piles surgery done?
Healthy eating and bowel habits can only prevent the worsening of the disease without achieving a cure. It has been established that nonsurgical treatments like medication and topical application are only as far as to relieve irritation and pain but do not provide long-term benefits. Gastroenterology surgeons explore options for piles treatment and decide on the most suitable for the condition depending on its size, position, grade and severity.
When is piles surgery done?
Piles treated conservatively, use many methods such as lifestyle modification, fibre supplements, anti-inflammatory drugs delivered as suppositories and administration of vagotonic drugs. Popular non-operative approaches include sclerotherapy and rubber band ligation. An operation is indicated when non-operative approaches have failed or complications have occurred. Piles surgery, medically termed as haemorrhoidectomy is considered appropriate when:
- Haemorrhoids are internal and very large
- Internal haemorrhoids that fail to heal after nonsurgical treatment.
- Large haemorrhoids that are external and causing significant discomfort
- Haemorrhoids that make toilet hygiene difficult to keep the anal area clean.
- There are both internal and external haemorrhoids.
- Other existing conditions can worsen haemorrhoids.
Reasons why piles surgery should not be delayed
The main reason is that piles can escalate into more severe conditions. Various such complications may include:
- Delaying piles surgery can develop prolapsed haemorrhoids
Internal haemorrhoids can prolapse where the tissues fall outside of the anal opening during a bowel movement. Though haemorrhoids may be retractable on their own or with a little help, over sometime, prolapsed haemorrhoids worsen and become severe.
When the prolapsed haemorrhoid is left untreated, there are chances that it gets trapped outside the anus and cause significant irritation, itching, bleeding and pain. This may raise a situation requiring immediate surgical excision of the haemorrhoid. Such situations can be avoided if prompt, planned piles surgery is accepted.
- Delaying piles surgery can form thrombosed haemorrhoids
A thrombosed haemorrhoid is when a blood clot forms inside a haemorrhoid. This happens when sacs in the anal passage get pushed onto the outside of the anus and fill with blood clots. There is no specific reason why blood clots form in some external haemorrhoids.
Thrombosed haemorrhoids are tender and extremely painful to the extent that everyday activities such as walking, sitting or going to the toilet become difficult and uncomfortable. Thrombosed haemorrhoids can also become infected, causing an abscess and anal fistulas.
An abscess can cause additional symptoms like fever and fatigue. Timely treatment and surgery can prevent the formation of thrombosed haemorrhoids.
- Delaying piles surgery can strangulate haemorrhoids
One of the more complications is a strangulated haemorrhoid, where the blood flow to an internal haemorrhoid is restricted. Absence of blood supply causes extreme pain. Strangulated haemorrhoids also present a high risk of infection, hence it is important to surgically remove the haemorrhoid to prevent this outcome.
- Delaying piles surgery can possibly lead to anaemia
Iron deficiency anaemia can be caused by chronic bleeding from internal haemorrhoids and this not so common but happens. The description of hemorrhoidal bleeding includes blood squirting or clots passing in the stools. Rectal bleeding from piles can lead to severe blood loss from the body.
This bleeding can be from inside or even outside the rectum. According to a study, while the mean haemoglobin concentration before piles surgery was 9.4 g/dl, it was found that recovery from anaemia after definitive treatment with haemorrhoidectomy was rapid, with a mean haemoglobin concentration of 12.3 g/dl after two months and by six months, the mean haemoglobin concentration was 14.1 g/dl.
- Delaying piles surgery can cause infection
In most piles conditions, there is enough circulation to the rectal and anal areas to keep immune system cells active and reduce the risk of infections. Serious systemic infections are possible if proper medical care is not taken for external or prolapsed haemorrhoids leading to the spread of infection.
In prolapsed internal haemorrhoids, it is more likely to become infected due to blood flow issues. In strangulated internal haemorrhoid, where blood flow to the vein can be cut off, lack of nutrients, oxygen and immune-system cells carried in the bloodstream can quickly form an infection.
In case of an infection paired with concomitant diseases such as blood pressure, heart diseases or diabetes, the condition can get complicated and pose a risk that can be challenging to control. Bacteria from the faeces can get into haemorrhoids that are bleeding and infect the surrounding tissues.
Untreated infections can sometimes cause serious complications, such as tissue death, abscesses and recurrent fever. An infection at the anorectal region that is ignored can lead to serious complications, such as peritonitis. This is an infection of the abdominal wall and internal organs that can potentially be life-threatening.
- Delaying piles surgery can cause faecal incontinence
Faecal incontinence is the inability to control bowel movements, causing faeces to leak unexpectedly from the rectum. Prolonged piles can lead to bowel incontinence if the sphincter muscles get affected and do not work as they should.
The haemorrhoid can keep the muscles around the anus from closing completely, which lets small amounts of stool or mucus to leak out. This can keep the garments soiled and causing soreness in the surrounding skin area. Thus, such bowel incontinence can be disturbing and embarrassing, affecting the quality of life. Piles surgery is recommended permanent relief from such discomforts.
Management options for piles have advanced to diverse methods ranging from clinical to operating-room procedures. Newer techniques of piles surgery are designed to minimize tissue dissection with the aim of reducing postoperative pain and bleeding. Piles surgery done earlier have a better chance of healing without causing any further complications.