Management

Management

The treatment is mainly aimed at relieving symptoms. If you have been already diagnosed for piles (hemorrhoids) and suffering from a flare up of itching or pain you can try the following (with your doctor’s advice)

  • Try sitz baths. Sit in a tub filled with warm water for 10 to 15 minutes several times a day.
  • Apply cold compresses around the anal region, even ice can be helpful.
  • Application of cream or suppositories (bullet-shaped tablets to be inserted into the anus), soothes itching and pain, and diminishes the swelling and bleeding.
  • Keep the anal area clean using a very soft or moist toilet paper after motion.
  • Use stool softeners, which may help in softening the stools.
  • Simple dietary changes such as increasing the amount of fiber (such as raw vegetables, whole grain breads and cereals, prunes, raisins, popcorn) and fluid (6-8 glasses of water daily) in the diet can be enough to prevent constipation and ease the symptoms.
  • Exercise regularly as this will help in keeping the body weight within normal limits.
  • Modify your daily activities :
  • Avoid standing for long durations.
  • Lie down for sometime to ease pressure in the anal area.
  • Avoid straining at stool and sitting in the toilet for long periods.

If you are suffering from severe piles (hemorrhoids) (i.e. bulged out or thrombosed) your doctor may recommend you following treatment options

  • Rubber band ligation: This treatment is more effective for second degree hemorrhoids. A rubber band is passed around the base of the piles (hemorrhoids); this obstructs its blood supply causing it to shrink and fall off.
  • Sclerotherapy: This treatment is more effective for first degree hemorrhoids. A chemical solution is injected into the piles (hemorrhoids) or in the skin around the piles (hemorrhoids). This interferes with its blood supply causing it to shrink.
  • Coagulation therapy: In this treatment the piles (hemorrhoids) are destroyed by burning them with electricity, laser or infrared light.
  • Hemorrhoidectomy: This involves surgical removal of piles (hemorrhoids). Although this treatment is very effective at removing piles (hemorrhoids) permanently but it can cause scar formation which may interfere with bowel movement.
  • Another latest technique called Transanal Doppler Hemorrhoidal dearterialization has been proposed as an alternative to operative Hemorrhoidectomy. In this technique a special instrument, “Doppler modified proctoscope” is inserted into the anorectum to identify the hemorrhoidal arteries. The arteries are identified (by the pulsating Doppler sounds) and then ligated (tied up). This reduces the blood supply to the hemorrhoidal tissue and results in shrinking of the piles (hemorrhoids).