From the Editor's Desk
Dr. Saravana Bharathy. S. P
Consultant
Internal Medicine
Internal Medicine
HEMORRHOIDS (PILES): EARLY DETECTION PREVENTS MAJOR SURGERY
Discomfort ignored today can evolve into disease tomorrow.
Rectal bleeding is never normal. It is a symptom.
Why Piles Deserve Medical Attention
- Hemorrhoids are among the most common anorectal disorders in India, they remain underreported due to social stigma and delayed healthcare seeking behaviour.
Indian Data Snapshot
- According to community-based epidemiological studies published in Indian surgical and gastroenterology journals, the estimated prevalence of hemorrhoids in India ranges between 11 percent and 18 percent of adults.
- Clinical observations reported in colorectal literature suggest that up to 50 percent of individuals above 45 years of age experience hemorrhoidal symptoms at least once in their lifetime.
- As per urban health surveys and gastroenterology data from Indian metropolitan populations, chronic constipation affects approximately 22 percent to 30 percent of urban Indians, which is recognized as a major risk factor for hemorrhoidal disease.
- Public health analyses on lifestyle disorders in India indicate that sedentary behaviour and low dietary fibre intake significantly increase the incidence of anorectal conditions.
How Many People Suffer but Do Not Seek Care?
- Nearly one in six adults in India is estimated to experience hemorrhoidal symptoms, based on regional prevalence studies.
- More than half of individuals above 45 years develop symptoms at some point in their lives, according to colorectal practice data.
- Urbanization and lifestyle transitions have been associated with a documented rise in anorectal disorders over the last decade, as highlighted in Indian urban health trend reports.
- Multiple hospital-based studies note that patients often delay medical consultation for periods ranging from six months to three years.
- By the time medical advice is sought, the disease has often progressed in grade and severity.
“Embarrassment delays treatment. Delay increases suffering.”
What Exactly Are Piles?
- Hemorrhoids are enlarged and engorged vascular cushions within the anal canal. These vascular structures are part of normal anatomy but become symptomatic when swollen, inflamed, or prolapsed. They are classified as follows:
Internal Hemorrhoids (Graded I to IV)
Grade I
Bleeding without prolapse
Grade II
Prolapse that reduces spontaneously
Grade III
Prolapse requiring manual reduction
Grade IV
Irreducible prolapse, often requiring surgical intervention.
External Hemorrhoids
Often associated with pain.
May develop thrombosis, leading to acute severe discomfort.
- Are You Experiencing These Symptoms?
- Pain while passing stool
- Bright red bleeding
- Burning or itching
- Swelling or a small lump
- Feeling of incomplete bowel emptying
- When to Seek Immediate Medical Advice
- Consult a specialist urgently if you notice:
- Persistent rectal bleeding lasting more than one week
- Sudden onset severe anal pain, which may indicate thrombosis
- Prolapse that does not reduce
- Unintentional weight loss or altered bowel habits
- Symptoms of anemia such as fatigue or breathlessness
- It is important to note that not all rectal bleeding is caused by hemorrhoids. Conditions such as anal fissure, colorectal polyps, inflammatory bowel disease, and colorectal cancer must be appropriately ruled out through clinical assessment.
If there is blood in stool, it requires evaluation, not assumptions.
Risk Factors Common in Urban Populations
- Chronic constipation
- Low dietary fibre intake
- Pregnancy
- Obesity
- Chronic cough
- Frequent heavy lifting
- Prolonged sitting including desk-based occupations and long-distance driving
- Proctoscopy
- Allows direct visualization of internal hemorrhoids
- Helps determine grade and bleeding source
- Assists in ruling out other anorectal conditions
- Physical Examination
- Helps identify external hemorrhoids, fissures, fistulae, and other anorectal pathology.
- Hemoglobin Testing
- Detects anemia secondary to chronic blood loss
- Role of Clinical Examination and Proctoscopy
- Diagnosis is primarily clinical and supported by focused examination.
| Conservative Management | Office-Based Minimally Invasive Procedures | Advanced Surgical Options |
|---|---|---|
|
High fibre diet with 25 to 35 grams per day as recommended in gastroenterology nutrition guidelines |
Rubber band ligation |
Stapled hemorrhoidopexy |
|
Adequate hydration |
Infrared coagulation |
Laser hemorrhoidoplasty |
|
Stool softeners |
Sclerotherapy |
Conventional hemorrhoidectomy |
|
Topical medications |
These are typically recommended for Grade I and Grade II hemorrhoids. |
These procedures are indicated for Grade III and Grade IV disease or recurrent cases. |
|
Sitz baths |
|
|
Modern surgical techniques emphasize reduced postoperative pain, faster recovery, and lower recurrence rates.
What Makes This Package Different?
This initiative is structured to provide accurate diagnosis and clinical clarity rather than symptomatic relief alone.
- Package Includes:
- Specialist physical examination
- Proctoscopy with direct visualization
- Hemoglobin testing
- Expert consultation
- All for ₹249 only.
- No presumptions. No self-diagnosis. Evidence-based evaluation.
- Who Should Attend
- Office professionals with prolonged sitting hours
- Drivers and field workers
- Individuals with chronic constipation
- Women after pregnancy
- Individuals above 40 years of age
- Anyone who has experienced rectal bleeding even once
