Minimally Invasive Surgery for Piles (MIPH)
Hemorrhoids, also called piles, are enlarged veins around the rectum or in the anus. They are extremely common – about 50% of people over the age of fifty have had hemorrhoids at some point in their life. They are most common in people over the age of thirty. They may extend outside as prolapse in advanced stages.
Although they can be irritating, uncomfortable, and painful, hemorrhoids rarely cause more serious problems
Here are some FAQs answered!
What are causes of piles?
Hemorrhoids are caused by excessive pressure on the veins in the pelvic and rectal area. The pressure causes the veins to swell and become distended. Straining during bowel movements is the most common cause of excessive pressure on the veins and prolapsed of the rectal mucosa. Hemorrhoids can be caused by chronic constipation or diarrhea, a tendency to rush to complete a bowel movement, or unhealthy bowel functions caused by overuse of laxatives or enemas.
Hemorrhoids are also more common among overweight people, those who must sit or stand for prolonged periods, those who regularly lift heavy objects, and those who consume diets low in fiber and water.
Another common cause of hemorrhoids is pregnancy and childbirth. Many pregnant women develop hemorrhoids during the last six months of pregnancy because of increased pressure on the veins in the pelvic area. Straining to push the child out during birth is another common cause of hemorrhoids.
What are symptoms of piles?
- Bleeding while passing motion.
- Reducible swellings while passing motion or in later stages irreducible swelling in later stages. Can present with anemia and weakness.
How do you diagnose piles?
If you are experiencing rectal bleeding, it is extremely important to visit a doctor. Although it may be a symptom of hemorrhoids, rectal bleeding can also be a symptom of a number of far more serious conditions, including colorectal cancer. Hemorrhoids are generally diagnosed via a physical exam.
How do you treat piles?
Treatment of hemorrhoids depends on their severity and the degree of discomfort the cause. Many cases of hemorrhoids, particularly those resulting from pregnancy and/or childbirth, resolve themselves on their own with a minimum of treatment others may become chronic.
Home treatment is effective for many cases of external hemorrhoids. Sitting in a warm bath several times daily can sooth itching and relieve symptoms. Gradually increasing the amount of fiber and fluids (non-alcoholic) in your diet can also help relieve symptoms. Fiber and water soften stools and increase their softness, bulk, and regularity, decreasing pressure on the veins and causing less straining. Studies have shown that drinking six to eight glasses of water a day and consuming a diet high in whole grains, fresh fruit (preferably with the skin), dried or stewed fruit, and fresh vegetables leads to a lower chance of developing hemorrhoids and some relief of symptoms for those already suffering from them.
Dietary supplements can also assist with increasing the amount of fiber in your diet. Regular exercise can also increase the regularity and softness of your stools. For pregnant women, a special treatment is to lie on your left side for about 20 minutes every 4 to 6 hours. This decreases pressure on the main vein draining the lower half of the body.
Most internal hemorrhoids can be treated with the same home treatment measures as external hemorrhoids. Severe cases may be treated with a variety of methods intended to shrink, destroy, or remove the hemorrhoidal tissue. These include non-surgical procedures such as:
- Scarring the tissue around them (coagulation therapy)
- Injecting a solution into pile mass
- Banding tiny rubber bands around pile mass and cutting off blood supply
- IRC (Infra Red Coagulation)
What are the surgical treatments available for piles?
Anemia with grade I and Grade II or symptomatic Grade III and Grade IV surgery is the only option
- Conventional surgery: Pile masses are cut and there is wound which needs to be take care for two to three weeks. May require stay in the hospital.
- Minimal invasive surgery for piles(stapled haemorrhoidectomy): Pile mass is lifted and fixed to the place where it belongs. Circumferential mucosectomy is done in painless area. Blood supply to piles is taken off. No open wound after surgery and no pain leading to faster recovery. This procedure can be done as day care where individual is discharged on same day.
Image of internal hemorrhoids in anal canal
Image of a hollow tube inserted into the anal canal and pushing up the hemorrhoids
Image of suturing the anal canal through the hollow tube
Image of bringing expanded hemorrhoidal supporting tissue into the hollow tube by pulling on suture
Image of hemorrhoids pulled back above anal canal after stapling and removal of hemorrhoidal supporting Tissu
How do you prevent piles?
- Eat more vegetables and fruits (fibre)
- Drink a lot of water
- Avoid constipation
- Avoid straining while passing motion
- Medication for constipation
- Stool softeners
Dr. Nanda Rajaneesh has over 18 years of experience in surgical oncology and laparoscopic surgery. She is currently a visiting consultant in both Apollo Spectra Hospitals and Sakra World Hospital. She has operated many film stars & VIPS, both at regional and national level.