Piles usually do not require treatment as they often disappear after a few days. However, discomfort and itching may be treated with various options.
1. Dietary and lifestyle modifications
If the main cause for the formation of piles is constipation, the first line of treatment usually involves softening and regularizing stools. The symptoms of piles can be relieved with dietary changes and lifestyle modifications. A high fibre diet, including fruits, vegetables, whole grain cereals and breads can help to soften stools and avoid straining. Your doctor will also advise you to increase your water consumption and exercise regularly to avoid constipation. Soaking yourself in warm water for 10 minutes several times a day may also provide relief.
Your doctor may suggest short-term remedies such as over-the-counter creams, ointments, or suppositories to relieve pain, swelling, inflammation and itching. Avoid using them for a longer time as they may damage the skin around your anus. Your doctor may prescribe pain killers to treat painful piles, and laxatives to soften stools and empty your bowels.
3. Minimally invasive procedures
When blood clots form in external hemorrhoids, your doctor will make a simple incision and remove the clot. Piles that are painful and bleed continuously may be treated with minimally invasive procedures. These include:
- Rubber band ligation: This procedure involves placing tight elastic rubber bands at the base of an internal pile. The bands cut off blood supply causing the piles to fall off within a week. You may experience slight bleeding after the procedure. Rubber band ligation of piles should be limited to grade 1 and grade 2 haemorrhoids which are well above the dentate line as below that line the area is very painful
- Transanal hemorrhoidal dearterialization or THD: This procedure does not deal directly with piles but instead is focused on identified the artery which is feeding the hemorrhoids and performed a precise ligation of it. The procedure is then completed with superficial continuous suturing of the lining above the hemorrhoidal tissue in order to lift the prolapsed hemorrhoidal tissue inside the anal canal. This procedure is completed under general anesthesia but is a fully day cases procedure and it does not required overnight stay. This type of procedure is also extremely well tolerated by the patient causing a minimal amount of pain that usually subsides in few days. The recovery and the time off work are also extremely limited usually within a week.