PILESPiles mean a lump or swelling around anal canal. We, the doctors call it hemorrhoids. Inside anus there are three vascular cushions in every human being present since birth. Which makes the passage of stool easier. Exact cause of this disease is still unknown. We call it a disease when it causes symptom like bleeding, swelling, pain, discharge, itching etc.
People having piles usually has three swelling or lump around anus.

Age: Incidence is common in the age group of 30-60. It is uncommon below 20. In the USA 50% of people above the age of 50 is affected by hemorrhoids.

Cause: Exact cause of piles is unknown. Few problem like excessive straining during defecation, constipation, diarrhea, irregular bowel habit aggravates piles. Other factors which causes piles are genetics, prolonged standing, heavy weight lifting, pregnancy, tight dress, influence of hormone, lack of fiber containing food. There are two kind of piles, external piles & internal piles.

Symptom: Bleeding in toilet after passing stool, Itching swelling in anus, something coming out during defecation, pain ,discharge etc.

Investigation: Colonoscopy is mandatory for all patients having problem in the anal canal. Because symptom of piles, anal fissure and cancer in rectum are similar and confusing. It is very hard to distinguish between piles and anal fissure and cancer by listening to patients complains. In last 20 years I have seen nearly 1,50,000 patients, of them 20% have piles, 35% anal fissure, 15% fistula, 3%rectal cancer, 6%rectal polyp etc. 

Prevention: To avoid constipation and diarrhea, and treat them without delay. Don’t read newspaper in toilet, eat lots of vegetables, fruits, salad, and drink 6-8 glass of water daily. Do not lift heavy weight.

Treatment: If conservative treatment fails and the piles is small size i.e. 1st & 2nd degree then we do rubber band ligation. Piles of bigger sizes we do Longo (Stapled Hemorrhoidectomy) operation or conventional hemorrhoid operation. I have done Longo Operation for the first time in the history of Bangladesh on 8 June 2003. Since then we have done 9000 Longo operations. Result of Longo operation is very good if the patient comes timely. Patients need hospitalization for 2-3 days.He can go to work in a week. Conventional operation needs excision of hemorrhoids, which causes open wound that needs long time to heal. Patient need to be off from work for 2-6 weeks.

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