what is Piles / Fissure ?

Hemorrhoids / Piles or Bawasir are different name of same problem. Piles are engorged blood vessels in Anal area. Approximately 75% of people may have Hemorrhoids / Piles at some point of time in their life. Hemorrhoids are very common in middle aged person & females also, particularly pregnant women.

Types of Piles:

  • EXTERNAL HEMORRHOIDS:- These visible around Anus. You can see swelling around Anus with naked eyes.
  • INTERNAL HEMORRHOIDS:- Such type of hemorrhoids are present in Anal Canal only. It can not be seen without proctoscopy.

Symptoms of Piles

  • Bleeding:- Patient complaint of having bleeding at the time of deifications (while passing the stool). Usually bleeding is painless but sometime patient may be have severe pain also with or without bleeding.
  • Swelling around Anus:- Initially swelling go back immediately after passing the stool but as disease progress swelling may persist for few minutes to hours. You have to push back with your finger or swelling reduces when sit on bed or hard surface for some time.
  • Mucus discharge
  • Itching around Anus
  • Pain during deification


  • Chronic constipation
  • Obesity
  • Hereditary
  • Heavy weight lifting
  • Pregnancy
  • Excessive straining during deification

Stages of Piles / Hemotages of Piles / Hemorrhoids

  • First degree Piles:- No Hemorrhoids around Anus from outside. Patient complaints of only bleeding while passing stool, only for 1-2 days, few drops only once/twice a year. Patient blames himself that he consume excessive quantity of Ginger/Egg/Garlic etc. He even don't realise that he is suffering from Piles. Sometime he goes to some medical store and buy some local medicine & he feel happy that his bleeding has stopped & he get rid of Piles but this not fact. Actually bleeding stop automatically whether you take medicine or not. As time passes bleeding quantity as well as frequency will increase. Previously blood comes once in an year of after 5-6 months now it become very frequent even regularly for many days. Initially blood comes only few drops but now it may come like a jet.
  • Second degree Piles: In 2nd degree hemorrhoids quantity & frequency of bleeding at the time of defication increases. Hemorrhoids or Piles comes out while passing stool but it go back immediately after completion of act.
  • Third degree Piles: Swelling increases as disease progress it don't go back automatically but you have to push back the piles mass back with the finger.
  • Fourth degree Piles:- There is a complete prolapse of piles. Too much swelling around Anus it is very painful condition. Patient not able to tolerate it. Patient have go for surgery as early as possible.


For Diagnosis of Piles, the doctor may perform a digital rectal examination (DRE) or use a proctoscope. A proctoscope is a hollow tube fitted with a light. It allows the doctor to see the anal canal up close. By proctoscopy doctor will be able to make diagnose weather you are suffering from piles or not. Sometimes other disease like Ulcer, Polyps or even in Cancer Rectum, petient have bleeding while passing stool. proctoscopy should be performed with upmost case to confirm the diagnosis.

Treatment of Piles / Hemorrhoids

  • A doctor will initially recommend some lifestyle changes to manage piles.

    Diet: Piles can occur due to straining during bowel movements. Excessive straining is the result of constipation. A change in diet can help keep the stools regular and soft. This involves eating more fiber, such as fruit and vegetables, or primarily eating bran-based breakfast cereals.

    A doctor may also advise the person with piles to increase their water consumption. It is best to avoid caffeine.

    Body weight:Losing weight may help reduce the incidence and severity of piles.

    To prevent piles, doctors also advise exercising and avoiding straining to pass stools. Exercising is one of the main therapies for piles.

  • INJECTION THERAPY (SCLEROTHERAPY): This kind of therapy is required very experience hands. Sometimes many quacks sitting in J.J Colony etc. give injection at the site of Hemorrhoids without proper knowledge. Patient have tremendous pain during injection & lie down on bed for 15-20 days.

  • BARREL & BAND LIGATION:- Doctor places a elastic band over the root of hemorrhoids but usually they slip or break. So this technique is less in use.

  • INFRA RED COAGULATION:- Infra Red Coagulation (IRC) is most advance technology for non surgical treatment of Piles. It is an OPD procedure no hospitalization is required even for a single minute. Patient can drive his car & can join duty immediately. No Anesthesia is required for this procedure.


    Laser Treatment: Patient has to be admitted in the hospital for at least 1-2 days, Anesthesia is required for laser treatment. It does not much difference whether you go for open surgery or Laser surgery. In both case you will face same problem.

    Hemorrhoidectomy:- It is good often for the patient having 4th degree of piles. Two methods are available:
    (a) Open Surgery
    (b) Stapler hemorrhoidectomy


Several medicinal options are available to make symptoms more manageable for an individual with piles.

Over-the-counter (OTC) medications:These are available over-the counter or online. Medications include painkillers, ointments, creams, and pads, and can help soothe redness and swelling around the anus.

OTC remedies do not cure piles they provide only symptomate relief for sometime. Do not use them for more than 7 days in a row, as they can cause further irritation of the area and thinning of the skin. Do not use two or more medications at the same time unless advised to by a medical professional.

Corticosteroids:These can reduce inflammation and pain.