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Hemorrhoid’s are also known as Piles.  In their normal state, hemorrhoids are cushions that help with stool control. They become a disease when swollen or inflamed. Hemorrhoids are classified into two groups:

  • Internal Hemorrhoids

They present with painless, bright red rectal bleeding.

  • External Hemorrhoids

They are usually painful when thrombosed and look rather frightening, turning purple or blue, and could possibly bleed. Despite their appearance, thrombosed hemorrhoids are usually not serious but can be painful. They will resolve themselves in a couple of weeks.


  • Pain and discomfort around the anus
  • Bleeding, usually painless. The patient may notice red on the toilet paper or in the toilet bowl
  • Itching or irritation in the anal area
  • Bleeding from the anus
  • Internal hemorrhoids, which lie inside the rectum, usually have no symptoms; the patient is not aware of them as they do not generally cause any discomfort. However, straining when passing a stool may cause them to bleed.


  • Increased intra-abdominal pressure (prolonged straining, ascites, an intra-abdominal mass, or pregnancy)
  • Chronic Diarrhea and Constipation
  • Anal intercourse
  • Obesity
  • Sitting on the toilet for a long time
  • Genetic


·Conservative treatment consists of intake of foods rich in dietary fiber, high intake of water, sitz baths (sit in warm water for 15 minutes, several times a day, especially after a bowel movement) and rest.
Topical agents which include a combination of active ingredients can be used. These may include a barrier cream such as petroleum jelly or zinc oxide, an analgesic agent such as lidocaine, and a vasoconstrictor such as epinephrine. Analgesics like aspirin, ibuprofen and paracetamols may alleviate the pain and discomfort.

  • A number of procedures like Rubber band ligation, Sclerotherapy, electrocautery, infrared radiation, laser surgery etc can also be performed. Number of surgical techniques (like Excisional hemorrhoidectomy, Stapled hemorrhoidectomy) may be used if conservative management and simple procedures fail.