Piles
What are haemorrhoids?
Haemorrhoids, commonly known as piles, are swollen blood vessels in or around the anus and rectum. The haemorrhoidal veins are located in the lowest part of the rectum and the anus. Sometimes they swell so that the vein walls become stretched, thin, and irritated by passing bowel movements. Haemorrhoids are classified into two general categories - internal and external.
Internal haemorrhoids lie far enough inside the rectum that you can't see or feel them. They don't usually hurt because there are few pain-sensing nerves in the rectum. Bleeding may be the only sign that they are there. Sometimes internal haemorrhoids prolapse, or enlarge and protrude outside the anal sphincter. If so, you may be able to see or feel them as moist, pink pads of skin that are pinker than the surrounding area. Prolapsed haemorrhoids may hurt because they become irritated by rubbing from clothing and sitting. They usually recede into the rectum on their own; if they don't, they can be gently pushed back into place.
External haemorrhoids lie within the anus and are often uncomfortable. If an external haemorrhoid prolapses to the outside (usually in the course of passing a stool), you can see and feel it. Blood clots sometimes form within prolapsed external haemorrhoids, causing an extremely painful condition called a thrombosis. If an external haemorrhoid becomes thrombosed, it can look rather frightening, turning purple or blue, and could possibly bleed. Despite their appearance, thrombosed haemorrhoids are usually not serious and will resolve themselves in about a week. If the pain is unbearable, the thrombosed haemorrhoid can be removed with surgery, which stops the pain.
Anal bleeding and pain of any sort is alarming and should be evaluated - it can indicate a life-threatening condition, such as bowel cancer. Haemorrhoids are the main cause of anal bleeding and are rarely dangerous, but a definite diagnosis from your doctor is essential.
What causes hemorrhoids?
Hemorrhoid swelling occurs when there is an increase in the pressure in the small vessels that make up the hemorrhoid causing them to swell and engorge with blood. This causes them to increase in size leading to symptoms. Increased pressure may be caused by a variety of factors:
- Low fiber diet and smaller caliber stool causes a person to strain when having a bowel movement, increasing the pressure within the blood vessels.
- Pregnancy is associated with hemorrhoid swelling and is likely due to increased pressure of the enlarged uterus on the rectum and anus. In addition, hormonal changes with pregnancy may weaken the muscles that support the rectum and anus.
- Prolonged sitting on the toilet may increase pressure within the hemorrhoid blood vessels
- Obesity
- Diarrhea, both acute and chronic
- Colon cancer
- Previous rectal surgery
- Spinal cord injury and lack of erect posture
Piles Painless Stapler Surgery
Out of the various types of medical and surgical interventions available to treat Piles, Minimally Invasive Procedure for Hemorrhoids (MIPH) 0r painless stapler surgery is known to be very popular since it acts an alternative approach to surgical interventions made for piles.MIPH is defined as a minimally invasive surgical technique in which a band of loose or prolapsed mucosa and sub mucosa in the rectum is excised , proximal to the piles and disrupted mucosa is fixed by ‘stapled end to end mucosal anastomosis’.
This will ultimately occlude the blood supply to the superior hemorrhoidal artery above the hemorrhoidal tissue, resulting in the retraction of prolapsed mucosa back to its original anatomical position. A special circular stapler known as PPHO3 is used in the anastomosis and the whole maneuver will take around 30–45 minutes.
