Piles are swollen veins in the anal canal. Most cases settle with the right treatment, and only some need surgery — the grade decides which.
Also known as: Haemorrhoids · Hemorrhoids · Arsha (Ayurveda) · Mulavyadhi
Piles are cushions of blood vessels in the anal canal that everyone has. They become a problem when they enlarge, bleed or prolapse. They are extremely common, they are not cancer, and in most people they are manageable.
They are classified as internal (inside the anal canal, usually painless, typically present with bleeding) or external (under the skin at the anal opening, which can be painful, especially if a clot forms).
Internal piles are graded, and the grade drives the treatment:
Please do not self-diagnose rectal bleeding. See a doctor without delay if you have:
These features do not mean you have something serious, but they do mean piles should not be assumed.
Treatment is matched to the grade and to how much the symptoms affect you.
For most Grade 1 and many Grade 2 piles, this is enough:
A classical Ayurvedic para-surgical technique in which a prepared alkaline caustic (kshara) is applied directly to the pile mass under vision. The mass shrinks and separates over the following days.
It is a clinic procedure, generally done without general anaesthesia, and recovery is usually quicker than conventional excision. It suits selected Grade 2 and Grade 3 piles.
Where disease is advanced, complicated or has not responded, conventional surgical options are available in the same hospital, performed by our general surgical team. You are not sent elsewhere, and you are not pushed toward a procedure you do not need.
The pile mass is the symptom; the straining is usually the cause. Treatment that ignores this tends not to hold.
Often, yes. First- and second-degree piles usually respond to medication, dietary correction and local treatment, without any procedure. Third- and fourth-degree piles, and piles that keep bleeding despite treatment, are more likely to need a procedure. The grade is what decides this, which is why an examination matters before anyone promises an outcome.
Kshara Karma is an Ayurvedic para-surgical procedure in which a specially prepared alkaline caustic paste is applied to the pile mass, causing it to shrink and slough off. It is done under vision in the clinic, usually without general anaesthesia, and most people return to routine work quickly. It is not suitable for every case — large prolapsing piles and complicated disease may still need conventional surgery, which we also perform.
Cost depends on the grade, the procedure chosen and whether a day-care admission is needed, so we do not quote a figure before examining you. We give you a written estimate at consultation, before anything is scheduled.
Bleeding from piles is usually bright red, painless and small in volume. But rectal bleeding can also come from fissures, polyps, inflammatory bowel disease or cancer, and those are not distinguishable by symptoms alone. Any rectal bleeding should be examined, particularly if you are over 40, the pattern has changed, or there is weight loss or altered bowel habit.
After Kshara Karma most people are back to desk work within a few days, with follow-up visits over the next few weeks. Conventional haemorrhoidectomy takes longer, typically two to three weeks. Your recovery depends on the procedure and on how advanced the disease was.
They can, if the underlying cause is not addressed. Constipation, prolonged straining, long hours of sitting, low-fibre diet and inadequate water intake are the usual drivers. Treating the pile mass without changing these makes recurrence more likely, which is why diet and bowel habit are part of the treatment plan rather than an afterthought.
Proctology & General surgery - (Shalya Tantra)
BAMS, MS(Ayurveda), PhD
Dr. NEELAMBIKA G. B. is an Ayurvedic Surgeon with special emphasis on Management of Surgical conditions through Ayurvedic approach and makes the best use of conventional clinical and diagnostic evaluations for the diagnosis and outcomes assessment.
Reg. 88606/15180 KAUP Board
