Hemorrhoid, also called as “Piles,” is the sagging of the vein pads in and on the anus in the last part of the large intestine, their displacement, growth, and enlargement.

Hemorrhoid Formation

Hemorrhoid may occur with prolonged constipation, excessive diarrhea, excessive straining, prolonged stay in the toilet, and excessive strain during this period. The main cause is formed due to constipation lasting for more than 6 months.

Complaints in Individuals with Hemorrhoid

The doctor is consulted with the complaint of painless bleeding after defecation. Seeing the blood on the toilet stone after defecation makes the person quite uneasy. Sometimes there is such intense bleeding, that the person who cannot stand seeing the blood may faint in the toilet.

People with simple hemorrhoid often do not have pain in the rectum. However, in the case of blood clotting in these enlarged vessels (called thrombosed hemorrhoid), a painful small rigid marble-like mass may come to the patient’s hands.

Pain may also occur in the case of crack in the anus (anal fissure) together with hemorrhoid.

Furthermore, a feeling of wetness and accordingly itching in the anus are also possible in patients. The hemorrhoid sagging outside creates a feeling of wetness in the anus, and as a result of skin tension with its drying over time, itching appears.

Apart from these, piles palpable in the advanced stages may cause a disturbance in the form of the presence of a foreign body or fullness in the person’s anus.

Hemorrhoid Grading

There are two types of hemorrhoid: internal and external hemorrhoid. The distinction between internal and external hemorrhoids is the dentate line in the anal canal.

External hemorrhoids are defined as hemorrhoids remaining outside the dentate line, while internal hemorrhoids are defined as hemorrhoids remaining inside.

There are four types of internal hemorrhoids:
• First degree: Only enlarged hemorrhoidal structures are palpable.
• Second degree: Hemorrhoidal structures exit from the anal canal with straining and while defecating and re-enter by themselves.
• Third degree: Hemorrhoidal structures exit the anal canal during straining and defecation and can be pushed back by hand.
• Fourth degree: The hemorrhoid is completely outside and cannot be pushed inside by hand.

What Are the Types of Hemorrhoid Treatment?

There are different treatment methods and principles. These principles differ according to the type and degree of hemorrhoids.

Medications are not recommended in external hemorrhoids. The treatment of external hemorrhoids is a surgical option.

Two types of treatment are applied in thrombosed hemorrhoids caused by blood clotting in the hemorrhoid pouch. If the hemorrhoid pouch is too large, hemorrhoidectomy is performed when this pouch is removed together with coagulated blood. When the hemorrhoid pouch is small but painful thrombosis is present, only the coagulum is cleaned under local anesthesia, which is called thrombectomy.

First and second-degree hemorrhoids are treated with vasodilators and drugs that regulate bowel movements. In second-degree hemorrhoids, laser, band ligation, and infrared treatment can be preferred.

Third and fourth-degree hemorrhoids are treated surgically. As well as the classical surgical procedure can be applied, very good results are also obtained with sagging surgery and hemorrhoidopexy with the Longo method.