Piles are lumps that can be found around your bottom (anus), another name for this is Haemorrhoids. Piles are caused by the blood vessels inside or around your anus becoming enlarged, once these vessels become enlarged you will likely start to notice the symptoms associated with Piles.
The blood vessels surrounding the anus are helping to supply the tissue lining within this area, these work to help your anus close. This is perfectly normal, although this is what you would find sometimes developing into piles. Piles can look like discoloured lumps, you might be able to feel them hanging from your anal canal.
Symptoms of Piles
Piles do not necessarily always cause pain and sometimes may not even cause any symptoms. However, if you are experiencing symptoms, here are signs of piles to look out for:
- Bright red blood when you poo
- Discoloured lumps in or around your anus
- Mucus in your underwear or slimy discharge
- Feeling like your bowels haven’t been fully emptied or still feeling discomfort afterwards
- Pain and discomfort around your anus
If left untreated they can become increasingly swollen and painful and could even become infected. Medically they can be classified into four grades:
Grade 1 No prolapse
Grade 2 The haemorrhoids recede by themselves.
Grade 3 The prolapse can be pushed back manually
Grade 4 The haemorrhoids are permanently external
Treatment in the past has involved having them cut out or stapled – procedures which can be painful and may involve protracted recuperation periods.
Different types Piles treatment available
Most often haemorrhoids are considered to be mild and changes in lifestyle and diet can be sufficient in alleviating the condition. One aim is to ensure that the stool should be soft and easily passed – a high fibre diet will help achieve this.
Keeping the anal area clean is also important for recovery. Sitz baths (sitting in warm water) can help bring relief and over the counter wipes containing witch hazel (a natural astringent) can also help.
Methods of Piles Treatment
The first step in treating piles is to go to your local pharmacy and speak to the pharmacist. A pharmacist will be able to offer you advice about which medicines you should try and will be able to answer any questions or concerns you may have. The pharmacist will be able to suggest treatments to help ease swelling and itching and medicine to reduce constipation. You should seek attention from a doctor if you see no improvement after 7 days of your treatment, or if you keep getting piles regularly.
Non-surgical Piles treatment
If your piles do not go away on their own, you may have to have a procedure to help with your problem. Non surgical treatments are available such as RBL-rubber band ligation-A small rubber band is placed around the haemorrhoid. This will starve it of blood and both the band and haemorrhoid will be discharged after a few days and the wound will heal. This minor procedure can be performed in an outpatient setting for small symptomatic haemorrhoids if appropriate rubber band ligation.
Piles treatment surgery
HALO technique
Haemorrhoid artery ligation operation (HALO) is a technique which uses an ultrasound probe within an instrument to access the anal canal (a protoscope) which locate blood flow into the pile. A stitch down the instrument is used to ligate these vessels which subsequently shrivel. As this does not involve damaging the skin and is all internal it is relatively painless, or any pain usually lasts no longer than a few days, is performed as a day case procedure and recovery is swift.
HALO RAR technique
The HALO procedure works well for smaller haemorrhoids where bleeding is the main problem. When haemorrhoids become larger (grades 3 & 4) both the bleeding and the prolapse need to be addressed. A relatively recent modification of the HALO procedure called the recto-anal repair (RAR) addresses the prolapse.
A modified hand piece allows a plication stich to pull the prolapsed haemorrhoids back into position inside the anal passage after the HALO has been performed. Approximately 20% of patients can experience pain and spasm post surgery. This may last a few days, but it is nearly always self limiting and in the vast majority resolves completely.
RAFAELO procedure
The Rafaelo Procedure is a new treatment that utilises safe and reliable radio frequency technology to reduce, and in most cases, eliminate, the common symptoms of internal (Grade 1-3) haemorrhoids. Similar technology has been used successfully for many years to treat varicose veins in the legs, and this has now been adapted and modified for the treatment of haemorrhoids by the insertion of a special needle probe into the haemorrhoidal cushion, through which radio frequency energy is applied which aims to shrink the haemorrhoids by heating the tissue.
A Rafaelo Procedure is a minimally-invasive, day case procedure, which typically takes no longer than 15-20 minutes to perform. It can be carried out using only local anaesthetic (although some patients may choose to have a mild sedative, or even a general anaesthetic). Most patients report very little pain or discomfort, and as a result the post-operative recovery time is very short.
Formal haemorrhoidectomy
Another treatment offered by Mr Andrew Clarke is a formal haemorrhoidectomy. This surger can be used to remove internal or external haemorrhoids that are particularly extensive or severe. A formal haemorrhoidectomy is the most effective piles treatment available, however, it is important to consider that this treatment is associated with higher rates of complications.
Risks of piles treatment
As with any surgical treatment, there are risks involved. During your consultation with Mr Andrew Clarke, any risks, contraindications and side effects of each haemorrhoids treatment will be discussed in detail.