Laparoscopic Surgeon in Bangalore

A guide to Piles

Piles as it is commonly termed means a swollen blood vessel or “Ball”. Piles medically is termed Haemorrhoids, meaning “Blood Flowing”.

What is Piles?

Piles are actually swollen blood vessels in the lower part of the rectum and anal canal. In the initial stages the blood vessel which is swollen are internal and bleed when hard stool rubs and tears them. As the disease progresses the swollen blood vessel prolapses out of the anal canal to cause much discomfort and more bleeding. At a later stage the pile may get strangulated at the anal sphincter muscle to cause thrombosed and strangulated piles. This is a very painful condition.

What causes Piles?

Piles tend to occur when patients are constipated for long periods of time, tend to strain to move their bowels and eat low fiber diets. Pregnancy can lead to piles due to the strain of the baby on the veins inside the mother’s abdomen. Standing too much, being overweight and lack of exercise may be contributing factors in the development of piles. Piles may run in some families and is known to have a genetic component. Patients run an increased risk of developing piles as they grow older. Very rarely piles many be a presenting feature of an underlying tumour in the lower end of the intestine. They must be checked up by a doctor who will feel the lower end of the anal canal and put a light (proctoscopy/sigmoidoscopy) to check for piles and rule out any tumour.


When piles are only internal and there is no swelling at the bottom, they are referred to as Grade I Haemorrhoids. They are called Grade II when they prolapse out during a bowel movement and spontaneously return in. When the patient has to manually push the pile mass into the anal canal they are Grade III. They become Grade IV when the pile mass protrudes out of the anal canal and remains so.

The problem with piles is that they tend to bleed on and off and cause discomfort to the patient, this causes the patient to become anaemic and constantly tired and weak. Sometimes bleeding may be so severe that it may exsanguinate the patient and cause a life threatening condition.


The first stage of piles are usually treated with medications such as stool softeners, laxatives, venotoner drugs and a high fibre diet. Sclerotherapy is a technique which has been employed, the procedure uses and injection into the pile mass with a sclerosant solution so that the pile mass shrinks. Infra red coagulation is an alternative for grade I piles where heat is used to obliterate the pile mass.

In the second stage the pile mass may be ligated with rubber band so the pile gets strangulated and ultimately falls off. It is painful and may require several visits to the doctor. In this stage and the third and fouth stages piles are operated upon to give a cure.

Conventionally piles were excised by surgery which involved ligating the root of the pile and excising the pile mass. The condition involved a lot of pain and discomfort for the patient. The procedure required the patient to stay in the hospital for several days and needed him/her to take analgesics for prolonged periods.

New technologies used in Piles treatment

Now relief is available in the form of a new technique using a new technology called “Stapled Haemorrhoidectomy”, also called MIPH – Minimally Invasive Procedure for Haemorrhoids and Prolapse. The technique involves excising a circumferential segment of mucosa of about 1-1.5 cms about 4-5 cms from the anal verge. In essence the root of the pile is removed. The cut raw edges are then approximated with 33 staples each measuring 3 mm. This seals off any blood vessels and the patient get an instant cure. There is less blood loss and since the surgery takes place at any area 3-4 cms from the anal verge pain is not a factor. Patients return home early and return early to work. There is less blood loss, less pain, early return to work due to faster recovery.

From many a wrong reason modern surgical treatment for piles has been surrounded by fear of pain and suffering and many a patient have sought alternative forms of medicine with partial or no relief. Here is a new tested technique offering good results and cure with little pain, shorter hospital stay, less blood loss and early recovery.