Hemorrhoids, also called piles, are swollen veins which are located in your anus or in the lower rectum. Hemorrhoids can be caused due to a number of factors, however, the exact reason may not be entirely known. They can be caused as a result of straining heavy during bowel movements or due to increased pressure on the veins in the anus or the lower rectum during pregnancy. Hemorrhoids are mainly categorized into two types, internal and external. Internal hemorrhoids develop within the anus or rectum whereas External hemorrhoids develop under the skin around the anus. Hemorrhoids are quite common among people. About 50% of the people worldwide are known to experience symptoms related to Hemorrhoids by the age of 50. External hemorrhoids are more common than internal hemorrhoids and also have more troublesome symptoms than the latter. Hemorrhoids cause pain, severe itching, and difficulty sitting. But due to so many medical advancements in different fields of medicine, fortunately, there are a number of options of Hemorrhoid treatment. Most people are believed to get relief from hemorrhoids symptoms only home treatments and lifestyle changes.
As already mentioned, the presence of swollen veins causes hemorrhoids. These swollen veins can develop in the anus due to increased pressure in the anus and the lower rectum due to the following factors.
• Straining during bowel movements
• Sitting for long periods of time on the toilet
• Chronic diarrhoea or constipation
• Obesity
• Pregnancy
• Anal intercourse
• Low-fibre diet
Hemorrhoids are more likely to develop in patients as they age because the veins present in the anus and the lower rectum become weaken over time, making them susceptible to swelling due to increased pressure.
Signs and symptoms of hemorrhoids can range from mild to severe depending on the location of the swelling in the veins, i.e. external or internal. However, the most common symptoms of hemorrhoids are:
• Painless bleeding during bowel movements, small amounts of bright red blood on your toilet tissue or in the toilet
• Itching or irritation in your anal region
• Pain or discomfort
• faecal leakage
• painful bowel movements
• Swelling around your anus
• A lump near your anus, which may be sensitive or painful (maybe a thrombosed hemorrhoid)
Internal hemorrhoids: These hemorrhoids can't be seen or felt these hemorrhoids, but have symptoms like straining or irritation when passing stool, which may further cause bleeding.
Sometimes, straining hard enough pushes the internal hemorrhoid through the anal opening. This may result in known a prolapsed hemorrhoid which can cause symptoms like pain and irritation.
External hemorrhoids: Particular symptoms include irritation, itching and bleeding.
Thrombosed hemorrhoids: Sometimes, there may be blood aggregation in an external hemorrhoid which can lead to clot formation (also called thrombus) which can have symptoms like severe pain, swelling, inflammation and a hard lump near your anus.
Although hemorrhoid symptoms are not life-threatening, but they can be painful. Therefore, Hemorrhoid treatment is necessary and must be opted to curb the symptoms.
There are very rare complications of hemorrhoids but can conclude the following:
• Anemia: In very rare cases, bleeding from hemorrhoids may cause anemia, which can result in deficiency of red blood cells in the body responsible for carrying the oxygen.
• Strangulated hemorrhoid: If the blood circulation to the swollen veins, more specifically to an internal hemorrhoid is cut off, hemorrhoid may be "strangulated," which can cause extreme pain and formation of blood clots. Therefore, Hemorrhoid treatment may become life-saving
Here are some of the hemorrhoid treatment options done without an anaesthetic.
• Banding: Banding, also called rubber band ligation is done to treat internal hemorrhoids. The doctor ties a tight band around the base of the hemorrhoid to cut off its blood supply. This type of hemorrhoid treatment may require multiple procedures that are done every two months. Banding is not painful, but may put pressure, causing mild discomfort.
• Injection sclerotherapy for hemorrhoids: The Injection sclerotherapy for hemorrhoids involves injecting a chemical into the hemorrhoid. The chemical is responsible for shrinking the hemorrhoids to stop it from bleeding. This is an almost painless procedure. Injection sclerotherapy for hemorrhoids is known to have remarkable success rate for hemorrhoids which are small and internal.
• Coagulation therapy for Hemorrhoid Treatment: Coagulation therapy, alternatively called infrared photocoagulation is a type of hemorrhoid treatment which uses infrared light, heat, or extreme cold in order to shrink the hemorrhoid.
• Hemorrhoidal artery ligation for Hemorrhoid Treatment: Hemorrhoidal artery ligation (HAL), locates the swollen blood veins that cause hemorrhoid using ultrasound, and then finally closes off those blood vessels.
• Hemorrhoidectomy: A hemorrhoidectomy is a type of hemorrhoid surgery which is carried out to treat for large external hemorrhoids and internal hemorrhoids have been resistant to non surgical methods of hemorrhoid treatment. The surgeon injects general anesthesia to ensure a painless procedure. After the anesthesia puts you to sleep, your surgeon make incision near the anus or rectum area for hemorrhoid removal. After the hemorrhoid surgery, you will be made to stay in the hospital for a day or two before your doctor would discharge you. Pain and infection are the most common risks associated with this type of surgery.
• Hemorrhoidopexy: Hemorrhoidopexy which is also called stapling, is a piles surgery is done to treat prolapsed (a slipping forward or down) hemorrhoids. A surgical staple is used to put in place the prolapsed hemorrhoid back into the your rectum and also shrinks the hemorrhoid, thereby cutting its blood supply. Stapling recovery takes relatively lesser time and is less painful than recovery than hemorrhoidectomy.
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Gleneagles Global Hospital, Bangalore 
