They become pathological or piles when swollen. They usually develop in three main sectors. They can present as painless small nodules or masses but can also produce a wide range of symptoms, such as
It can be a bigger bleed during passing stool, dripping into the toilet bowl, or can be a minor bleed causing a stripe of blood on the stool or on the toilet paper. Piles sometime trouble by fouling the underwear with small amounts of blood, irrespectively of a bowel movement.
Piles if not accompanied by inflammation are not necessarily painful. Patients usually describe anal dyscomfort rather then pain. If in turn inflammation develops around haemorrhoids, patients experience smaller or bigger pain, depending on their pain treashold/tolerance. Sharp, pinching, twinging, stabbing pain with burning sensation isn’t tipical for piles but are symptoms of anal fissures. We mention this kind of pain here as anal fissures frequently associate with inflammed emerods. Also, there is a condition when a small clot forms in an external haemorrhoid (thrombosed external haemorrhoid), this can also be painful.
Anal itching, mucous discharge
Most cases of itching in connection with haemorrhoids are caused by increased mucous discharge due to the inflammation of the piles. The discharged phlegm irritates the skin around the anus. The worse the inflammation the bigger is the irritation which together with consecutive scratching can cause wounds and injuries of the sensible skin around the anus.
Haemorrhoid disease starts with the swelling of the vasculature above the level of the anus. At this point the resulting nodule(s) can only be found up there (internal haemorrhoids). When the condition worsens these nodules slide and extend downwards, becoming visible and palpable on straining. This appearing mass can initially retract back up spontaneously. In later stages the masses can only be reduced manually and in the most serious condition they stay out prolapsed continously (grade I.-IV. of haemorroid disease).
Also, a small anal mass the size of a pea or bean can appear quite suddenly in the anus. This is caused by a blood clot (thrombus) forming in the external haemorroid region (thrombosed external haemorrhoid). A quick and definite ambulatory operation is applied by the Proctologist to cure this troublesome condition under local anaesthesia using a numbing cream or injection.
How can we treat haemorrhoids?
Rubber band ligation treatment
This is a painless ambulatory procedure to treat the internal haemorrhoids. Using a special suction ligator the Proctologist places a tight rubber band of about 3mm in diameter onto the stem of the hemorrhoid.
Laser treatment of haemorrhoids
It is well known that laser is the most modern surgical technique. Since the use of the newest generation laser equipment and proper surgical technique this is also true in Proctology.
In case of haemorrhoids the Proctologist uses the laser beam for the removal of external haemorrhoids (piles with or without blood clot). The procedure is performed with the help of a 'numbing cream', or after an injection of local anaesthetic. The laser technique minimises bleeding and provides quick, painless, complicationfree wound healing. During the procedure the Proctologist also removes the outstreched skin raised by the blood clot providing a smooth postoperative skin area which is important estetically and from the point of view of proper cleaning as well. The laser removal procedure is performed in one, two, exceptionally in three sectors in one go. With massive development in both the laser equipment and the surgical technique, reports of scars and strictures connected to the use of laser in the anal region represent only the past.