• ● Internal hemorrhoids : Internal hemorrhoids develop deep inside the rectum and may not be visible to the naked eye. They usually do not cause any pain, but you may notice slight bleeding through your anus.
• ● External hemorrhoids : External hemorrhoids develop on the outer edge of your anus. They may not be visible in some cases, but in other cases, they may look like lumps. External hemorrhoids cause severe pain and discomfort.
• ● Thrombosed hemorrhoids : Sometimes, blood clots develop within the hemorrhoid tissue. These are known as thrombosed hemorrhoids. They cut off the blood supply to the rectal tissue, causing extreme pain. If left untreated, thrombosed hemorrhoids can cause severe complications.
• ● Prolapsed hemorrhoids : Prolapsed hemorrhoids develop when the internal hemorrhoids swell and start to bulge outside the anus. They can cause itchiness, pain, discomfort, and a burning sensation.

• ● Pregnancy
• ● Straining during bowel movements
• ● Chronic diarrhea and constipation
• ● Lifting heavy objects and weights
• ● Obesity

The common signs and symptoms of piles include:

• ● An itchy, sore, and red anal region
• ● Pain during bowel movements
• ● Bright red blood after passing stool
• ● The feeling of a hard, painful lump around the anal region

In severe cases of piles, the following symptoms are:

• ● The inability to control bowel movements, known as fecal incontinence
• ● Excessive anal bleeding
• ● Strangulated hemorrhoid, which occurs when its blood supply is cut off
• ● Anal fistula, which is a bridge created between the inside and outside of the anal region

If you experience any of these symptoms, seek medical assistance immediately.

• ● Digital examination : Your doctor will insert a gloved and lubricated finger inside your rectum to feel for unusual growths and bulges.
• ● Visual inspectionIn some cases, internal hemorrhoids may be too soft to be felt during a digital examination. The doctor may use a sigmoidoscope, proctoscope, or anoscope to examine your rectal and anal region. Your doctor may recommend a colonoscopy if your signs and symptoms suggest another digestive system disease.

Home Remedies
Home remedies can help relieve mild symptoms such as inflammation, pain, or swelling from piles.

• ● Consume vegetables, fruits and high-fiber foods to help soften the stool and increase its bulk. This will slow down the symptoms from worsening.
• ● Use over-the-counter topical medications with hydrocortisone or heating pads that contain numbing agents or witch hazel.
• ● Soak your anal region in warm water for 10 to 15 minutes. Do this twice or thrice a day to relieve mild symptoms.

Medications
If your piles cause mild pain and discomfort, your doctor may recommend over-the-counter ointments, lotions, pads, or creams. These contain witch hazel, lidocaine, and hydrocortisone, which can help provide relief from mild pain, itching, and discomfort. However, do not use over-the-counter medications for more than a week unless prescribed by your doctor.

Surgical Options
In cases of painful piles, your doctor may recommend surgical options. These include:

• ● Rubber band ligation : The doctor will place small bands around the internal hemorrhoid to cut off its blood supply. It will cause hemorrhoids to shrink and fall off in a few days.
• ● SclerotherapyThe doctor will inject a chemical injection into your hemorrhoid to shrink it. This procedure may be less effective than rubber band ligation.
• ● CoagulationThis technique will use infrared light, laser or heat to harden and shrivel internal hemorrhoids.
• ● HemorrhoidectomyThe surgeon will remove any excess tissue that may be causing the bleeding. It is the most effective treatment for completely removing piles.
• ● Hemorrhoid staplingThis procedure involves blocking the blood flow to the hemorrhoid tissue. Although it is less painful than a hemorrhoidectomy, it has an increased risk of hemorrhoid recurrence or rectal prolapse, where a part of the rectum comes out of the anus.

Result Most cases of piles resolve on their own and do not require surgery. However, the few people that do undergo surgery show positive results.

• ● Urinary tract infection
• ● Fecal impaction
• ● Pain and discomfort
• ● Wound breakdown
• ● Infection
• ● Anal stricture

Description
According to the OWH (Office on Women’s Health), approximately 50% of pregnant women suffer from piles or haemorrhoids. Piles mainly occur during the third trimester of pregnancy. The third trimester is between 27 to 40 weeks. However, if not appropriately treated, piles can become consistent throughout one’s life.
The medical practitioners have divided piles into two categories- internal haemorrhoids and external haemorrhoids. Internal haemorrhoids can be treated with the help of medications and some nonoperative treatments. However, external haemorrhoids do not need attention until it causes pain or discomfort.

Other than constipation, the growing size of the uterus increased progesterone level, and the baby’s positioning can also play a significant role in piles development among the expected women. Also, giving birth while in the second stage of labour can develop the issue of piles.

If you suffer from piles during pregnancy, get your appointment at Smiles Hospitals, Bangalore, now for consultation and treatment.

1. Enlarging uterus
2. Pressure from the increased weight of the developing fetus
3. Positioning of the fetus in the uterus
4. While giving normal birth
5. Increased blood volume
6. Constipation
7. Hormonal levels and changes

Few other reasons include carrying heavyweights, a low fibre diet, chronic constipation, weakened supportive tissues around the anus and prolonged sitting or standing positions.

1. Rectal bleeding
2. Prolapsed haemorrhoids

1. Pain
2. Itchiness
3. Burning sensation
4. Painful bowel movements
5. Lumps formation
6. Bleeding
7. Blood clot
8. Swelling

• ● Maintain a high fibre and fruit diet
• ● Drink plenty of water and other fluids
• ● Do not delay the urge of urination
• ● Avoid sitting or standing position for an extended period
• ● Take gentle walks to maintain the flow of blood
• ● Regular kegel exercise
• ● Change your sleep positions

Medical treatments for piles include Rubber band ligation, laxatives, oral treatments like ruto-sides and hidrosmine, Sclerotherapy, Hemorrhoidectomy and Stapledhemorrhoidopexy. However, most of these treatments are not recommended by doctors for pregnant women.

There are several home remedies and lifestyle changes that can be helpful in the treatment of piles during pregnancy. However, none of it should be applied before consulting your healthcare provider. You should always consult with your doctor for diagnosis and treatment of piles, especially during pregnancy.

Few treatments for piles in pregnancy, as per doctors recommendations, includes:

• ● Taking sitz bath
• ● Taking mild laxative
• ● Cold compress
• ● Sleeping on left side
• ● Applying witch hazels
• ● Using doughnut cushions
• ● Appling stool softeners

Visit the Smiles Hospital, Bangalore, for treatment of piles during pregnancy.

You may visit the colorectal surgeon or a gastroenterologist for the issue of piles. Your gynaecologist may also suggest various treatment procedures involved in piles treatment.

• ● Bagels
• ● White bread
• ● Dairy products such as milk, cheese, and butter
• ● Processed foods such as frozen food
• ● Meat

• ● Urinary tract infection
• ● Fecal impaction
• ● Pain and discomfort
• ● Wound breakdown
• ● Infection
• ● Anal stricture

1. Rubber band ligation
2. Laxatives
3. Oral therapies
4. Sclerotherapy
5. Electrotherapy
6. Hemorrhoidectomy
7. Stapled hemorrhoidopexy.