Dilated plexus of superior haemorrhoidal veins in relation to anal canal is called as haemorrhoids / piles. There are so many factors responsible for this engorgement of the anal veins. The most common cause is chronic constipation. In such condition patients have to strain for defecation which puts pressure on the veins leading to congestion & engorgement. When these veins get ruptured by passing hard stools or due to straining it initiates characteristic painless bleeding. Bleeding may be in the form of fresh blood drops or spurts of fresh blood. At this stage bleeding is the only symptom that patients complain of, this is known as 1st degree piles. When these congested rectal veins increase in size, the pile mass may protrude out during defecation. After passing stool, the pile mass reduces by itself and sometimes patients have to reduce the pile mass manually. This stage is labelled as 2nd degree piles. When these pile masses further increase in size they may protrude out during walking or sitting etc this is known as 3rd degree piles. When piles mass permanently protrude outside the anus and unable to digitally insert inside the anus that is known as 4th degree piles. Characteristic feature of 1st stage piles is painless bleeding from anus whereas 2nd and 3rd stages results in some pain with bleeding and pile mass protruding out from anus during defecation and also while walking or sitting.
1. In the first stage of Piles, Pratisaraniya kshara is applied which leads to arrest of the bleeding & regression of the pile mass. No surgery is required.
2. In the second, third & fourth stage of piles, the pile mass is ligated by the Ksharasutra as an OPD procedure in minor OT. After ligation, pile mass fall down in few days. Usually no hospitalization or bed rest is required & patients can go home after the treatment. Attendent can manage the patient in home only.
Stages of Piles treatment by Ksharasutra / Pratisaraniya Kshara:
Symptoms of Piles/Hemorrhoids