Piles: Causes,Treatment and Surgery

Introduction to Piles

Piles, also known as haemorrhoids, are a gradually progressive disease. They are swollen veins in the anal canal. They can be painful and itchy. If you have symptoms like bleeding while passing stool, it’s essential to see a doctor so they can rule out other conditions, such as anal fissures or colorectal cancer. There are several types of piles, each with different symptoms and treatment options. Broadly, piles can be classified into:

Internal Piles

Internal piles are located inside the rectum and are usually not painful. Prolapsed piles are internal piles that have fallen out of the rectum. Internal piles can be graded into four types depending on the progression of disease:

Grade I: Only bleeding is present

Grade II: when piles mass come out while passing stools but goes inside on its own

Grade III: when piles mass has to be put back manually

Grade IV: when piles mass prolapse permanently

External Piles

External piles are located under the skin around the anus and can be very painful. Thrombosed pilesare a type of external piles that have a blood clot.


Causes of Piles:

• Straining when you go to the toilet – this could be due to constipation or diarrhoea

• Sitting on the toilet for long periods

• Pregnancy – this is because of the increased pressure on the veins in your pelvis

• Being overweight or obese.

• Family history – if your family members have had piles, you’re more likely to get them, too.

Best Treatment for Piles:

Medical Management

Our team at Habilite Clinics always ensures that piles are treated without surgery. We have a team of

dedicated nutritionists to offer you customized dietary plans and lifestyle modifications.

We also provide certain types of medications to relieve constipation and bleeding.

These conservative measures, if started at an early stage of piles, can help in the complete cure of piles without surgery.

Outpatient Procedures

Rubber Band Ligation:

  • This is a simple outpatient in which a band is placed around the piles mass, and the patient goes home
  • after 30 minutes.
  • The haemorrhoid then shrinks and falls off within a week.
  • Usually indicated for small Grade 3 haemorrhoids.



  • It is a minimally invasive treatment for haemorrhoids that involves injecting a solution into the blood
  • vessels around the anus to shrink the haemorrhoids.
  • It is a safe and effective procedure that can be done in your doctor’s office. Sclerotherapy is usually
  • done as an outpatient procedure.
  • It usually takes about 30 minutes to complete, and you can go home the same day.

Latest and Advanced Painless Procedures:

Laser Surgery:

  • Laser surgery is one option that is becoming increasingly popular. This minimally invasive procedure
  • uses a laser beam to target and destroy the pile’s mass.
  • In addition, it also blocks the blood supply to the pile’s mass, and hence, bleeding while passing stools
  • stops. It also causes shrinking of the haemorrhoid and relief from symptoms.
  • Laser surgery has its own indication. It should not be used for large, complicated or infected piles.
  • Laser machines come in different qualities and different wavelengths.
  • The use of high-quality laser machines, genuine laser fibre, highly experienced surgeons, and the proper
  • selection of patients are some of the necessities for obtaining the best and most permanent results.

Stapler Surgery for Piles

This is yet another surgery which has gained popularity in the past few years as a painless and effective procedure for haemorrhoids.

This procedure is a completely painless procedure, and the patient can get back to work within 3 days of surgery.

The stapler hemorrhoidopexy surgery is done in patients with grade 2 and grade 3 haemorrhoids who have a history of excessive bleeding while passing stools.

This procedure is not indicated in patients with large grade 1V haemorrhoids.

As in laser surgery, this surgery also requires proper patient selection and good expertise to cure piles permanently and avoid any complications.

DGHAL procedure:

  • DGHAL is one of the relatively new and excellent procedure for the management of bleeding piles which are usually grade II and early grade III haemorrhoids.
  • This is a very safe procedure and has an almost zero complication rate.
  • This procedure is very effective in grade II and grade III haemorrhoids.
  • The patients are discharged on the same day and can resume their activities on the next day of surgery.
  • In this procedure, with the help of an advanced doppler machine, the bleeding vessels are permanently sealed off.


  • Haemorrhoidectomy is the most conventional and oldest surgical option that removes the haemorrhoid completely.
  • The patient is usually discharged in 24 hours but might experience some discomfort and pain after the discharge.
  • We usually advise the surgery in patients who have complete, infected prolapsed piles, which means piles are in a very advanced stage.
  • This option is more invasive than laser surgery or stapler haemorrhoidectomy and has a longer recovery time.
  • It is, therefore, advisable to undergo piles surgery.


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