Haemorrhoids generally present as a small lump or the nodule in the anal area. It may cause bleeding per rectum especially while straining for stools. Bleeding is either drop by drop or occasionally as a small jet. 
There is a large number of cases diagnosed in India and all over the world. 

Haemorrhoids start as a swollen tuft of veins in the anorectal region.  There are grossly three types of haemorrhoids, Internal, External and interno-external.  The Internal haemorrhoids make their presence felt by its primary symptom of bleeding per rectum. External haemorrhoids are noticed while washing the area. Most of the external haemorrhoids associated with the fissure in ano are painful. Haemorrhoid associated with acute fissure is called as a sentinel or a guarding pile. 

Otherwise, Painless bleeding is the hallmark of the internal and interno-external haemorrhoids. As a protective mechanism slimy mucus is excessively secreted when the soft mucus membrane comes in contact with the undergarments. This leads to constant wetness and irritation and itching.

The Prolapsed thrombosed piles are painful.

The most common cause for the development of piles is the habit of straining during the act of defection. Constipation is one strong reason for that.  Haemorrhoids are commonly seen in pregnant mothers.

​Some haemorrhoids develop in patients with liver cirrhosis and portal hypertension. 

Prolapsed thrombosed haemorrhoids need emergency attention to shrink its swelling and pain factor. Local application of specific medicated gauze help in regressing its turgid swelling. Once it becomes smaller in size, with the help of lubricant local anaesthetic jelly the rest of the piles can be reposed inside the anorectal region. This hastens the reduction in the size of the congested piles. Elective Surgery is recommended.  

The sentinel pile associated with an acute fissure in ano may need emergency surgical procedure anal dilatation or internal sphincterotomy under general anaesthesia is advised to reduce the anal spasm.  

The sentinel pile excision is NOT  advised. 

Bleeding internal haemorrhoids may need medication to avoid constipation and the straining at stools. Surgery may be advised to remove the piles.

Some oral medications may be advised to reduce the venous pressure and hence the bleeding severity. 
Sitz bath for about 10 to 15 minutes, is helpful in painful conditions. 

Treatment is advised as per the patient's condition. One kind of treatment is not best suited for every kind of problem. 

Proper clinical examination and discussion are useful in the best long-lasting outcome.

Surgical hemorrhoidectomy offers an excellent solution. 

Stapler hemorrhoidopexy surgery is useful in large interno-external haemorrhoids. 

Laser when used as a tool is another option available.

What To Ask,

when you meet your doctor

Do I need any treatment? 
What treatment modality will suit my disease condition? 
Could this be anything more serious than haemorrhoids?

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Dr. Shriniwas Deshpande MS Samarth Clinic
Herekar Park Building, Rajyog, B3, First Floor, Near Kamala Nehru Garden, off Bhandarkar road, ErandPune, Maharashtra411004INdocshri
Phone: 919822067607 Website: docshri.com