Hemorrhoids are vascular structures in the anal canal which help with stool control. They become pathological or piles when swollen or inflamed. In their normal state, they act as a cushion which helps in continence to the passage of stools and flatus. They are of Internal and External types.

1. Detailed Facts about Hemorrhoids – CMC Mohali Hospital
Hemorrhoids are vascular structures in the anal canal which help with stool control. They become
pathological or piles when swollen or inflamed. In their normal state, they act as a cushion which helps
incontinence to the passage of stools and flatus. They are of Internal and External types.
Internal hemorrhoids usually present with painless rectal bleeding while external hemorrhoids if
thrombosed can cause significant pain and swelling in the area of the anus. Many people incorrectly
refer to any symptom occurring around the anal-rectal area as "hemorrhoids" and serious causes of the
symptoms should be ruled out. While the exact cause of hemorrhoids remains unknown, a number of
factors which increase intra-abdominal pressure, in particular constipation, are believed to play a role in
their development.
Internal hemorrhoids are those that originate above the dentate line which is approximately 4 cms
above the anal verge. They lack pain receptors. They were classified into 4 grades.
• Grade I: No prolapse, just prominent blood vessels.
• Grade II: Prolapse upon bearing down, but spontaneous reduction.
• Grade III: Prolapse upon bearing down requiring manual reduction.
• Grade IV: Prolapse with an inability to be manually reduced.
Initial treatment for mild to moderate disease consists of increasing fiber intake, oral fluids to maintain
hydration, NSAIDs to help with the pain, and the rest. A number of minor procedures may be performed
if symptoms are severe or do not improve with conservative management. Surgery is reserved for those
who fail to improve following these measures. Up to half of people may experience problems with
hemorrhoids at some point in their life. The outcomes are usually good.
Author is a Laproscopic surgeon in Chandigarh at Cheema medical complex, pH. 4, Mohali.
For any further inquiries
Contact: Dr. Sukhtej Sahni
Email id; sukhtejsahni@yahoo.co.in
PH. No. 9646001675