Proctological Surgery

Piles and Proctological Surgery

Piles, also known as hemorrhoids, are one of the anal conditions treated by the Department of Gastroenterological Surgery. This page explains symptoms, related conditions, prevention tips, and when surgical treatment may be needed.

The Department of Gastroenterological Surgery diagnoses and treats conditions commonly known as “hemorrhoids.” These include hemorrhoids, anal fissures, and anal fistulas. These conditions may cause pain, bleeding, swelling, or discomfort.

In many cases, daily habits are important for managing piles and related anal conditions. Regular meals, proper bowel habits, and daily bathing may help reduce symptoms. However, surgery may be needed if symptoms do not improve with medications such as ointments or suppositories.

Hemorrhoids (Piles)

Hemorrhoids formed inside the dentate line are called internal hemorrhoids. Those formed outside are called external hemorrhoids. Sometimes, hemorrhoids may protrude outside the anus. This is called prolapse.

Piles can occur when blood circulation around the anus becomes poor. Common causes include straining during bowel movements or staying in the same posture for a long time. Surgical treatment involves ligation and excision of the hemorrhoids under spinal anesthesia. A hospital stay of approximately 4 to 5 days is required.

	Classification		Symptoms
Internal Hemorrhoids	Grade I		No prolapse. Bleeding often occurs during bowel movements, but pain is usually not present.
	Grade II		Prolapse occurs during bowel movements. However, it returns spontaneously. Bleeding and pain may begin to develop.
	Grade III		Prolapse occurs and does not return unless pushed back in manually.
	Grade IV		Prolapse cannot be pushed back in. The hemorrhoids become hard. Pain and bleeding may subside, but mucus leakage may soil underwear.
Acute Phase	Thrombosed External Hemorrhoids		A thrombus, or blood clot, forms around the anus. The skin may rupture and bleed. Severe pain may also occur.
	Strangulated Hemorrhoids		Multiple thrombi form within the hemorrhoid. As a result, the hemorrhoid becomes prolapsed, swollen, and difficult to reduce. Severe pain may occur.

Perianal Abscess

A perianal abscess occurs when E. coli from stool spreads to the anal area and pus accumulates. It may cause pain, redness, swelling, and sometimes a high fever. Incision and drainage are necessary.

After drainage, an anal fistula may remain. This is a tunnel for pus. In that case, hospitalization and surgery for excision may be required.

Anal Fissure

An anal fissure occurs when the anus is torn due to straining during bowel movements. It is characterized by intense pain and bright red blood on the toilet paper after defecation.

For this reason, bowel habit management is important. Constipation should be avoided. Ointments are an effective treatment.

Seven Rules to Prevent Piles