Hemorrhoid is also known as piles are enlarged painful veins in rectum .Medically it is defined as cushion of tissue filled with blood vessels at the junction of the rectum and anus.

Symptoms:

1. Painless or painful bleeding during defecation
2. Pain or discomfort
3. Itching or irritation in your anal region
4. Felling of something coming from anus
5. swelling around the anus
6. Leakage of feces

Causes:

1. Chronic constipation
2. Sitting for long periods of time on the toilet
3. Straining during bowel movements
4. COPD or chronic cough, Liver failure
5. Portal hypertension
6. Benign prostate enlargement
7. Pregnancy
8. Pelvic tumor

Complications:

Anemia due to chronic blood loss and strangulated hemorrhoid are the main complications of hemorrhoid.

Classification:

1. 1^st degree: remain in the rectum
2. 2^nd degree :they prolapse through the anus on defecation but spontaneously reduced
3. 3^rd degree hemorrhoid : same as second degree but require digital reduction
4. 4^th degree hemorrhoid : These remain persistently prolapsed

Diagnosis:

Diagnosis relies on complete history, physical examination (digital rectal examination) and proctocopy. Complete blood test for anemia.

Treatment:

1. Life style change and diet:

• Eat fiber diet.
• Drink plenty of water.
• Regular exercise
• Use hemorrhoid cream.
• Keep anal area clean.
• Seitz bath with betadin solution.
• Take pain killer if pain is severing.Metronidazole for 5 to 7 days.

2 . Medical treatments:

• Band Ligation
• Injection (sclerotherapy) in hemorrhoid
• Coagulation of hemorrhoid
• Cryotherapy(freezing)
• Surgery procedures

Conclusion:

Hemorrhoids are swollen painful inflamed veins in the anus and rectum. Increased intraabdominal pressure is the main cause of piles. Many effective option are available to treat hemorrhoids.

References:

1. Bailey and love 25^th edition
2. Sabiston  textbook of surgery  18^th edition
3. medicinenet.com
4. quickcare.org
5. mayoclinic.com
6. en.wikipedia.org
7. Oxford handbook of clinical medicine, 7th edition.

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