Hemorrhoids are one of the most commonly occurring ailments, affecting both men and women. One reason people do not talk about haemorrhoid problems with their doctors is because they anticipate a painful, traditional haemorrhoid surgery. But the fact is that better understanding of the disease process along with new technological improvements; have enabled more procedures to be performed as day care procedure.

Piles or Hemorrhoids can occur at any age. Many experts believe that they are caused by continuous high pressure in the veins of the body, which occurs because humans stand upright. The causes of haemorrhoids include constipation and excessive straining during bowel movements. Persistent diarrhoea and loose stool movements are also causes of haemorrhoids, and some people inherit a family tendency to develop piles. Women are more susceptible to haemorrhoids during pregnancy, as pressure from the growing uterus restricts blood flow in the pelvic area. Lifestyle factors can also contribute to hemorrhoid development.

Type	Symptoms
Internal hemorrhoid symptoms	May protrude Mucous discharge Rectal bleeding Rectal itching Feeling of incompletely emptying bowels.
External hemorrhoid symptoms	Rectal itching uncommon May protrude Rectal bleeding Interferes with anal hygiene.
Thrombosed hemorrhoid symptoms	Protrudes Rectal itching Rectal pain Rectal bleeding Tenderness Swelling.
Ulcerated hemorrhoid symptoms	Rectal itching Rectal bleeding Swelling Severe rectal pain.

Bulge of Internal Piles

Bleeding of Internal Piles

This technique uses a stapling device and takes advantage of the fact that pain-sensing nerve fibres are absent higher in the anal canal. In this procedure, the mucosa above the dentate line, which contains part of the pile mass, is excised and stapled with the stapler gun, thus taking care of bleeding and prolapse - the two major components of piles. The pile masses are compressed into a cup like cavity inside the stapler. When fired, the titanium staples cut and seal simultaneously, thus causing minimal bleeding and as the cut line is above the nerves, there is reduction in post operative pain. Additionally there is no incision on the perianal skin or lower part of anal canal and the wound in the anal mucosa is also primarily closed with a stapler, thus, there is no need to do any post operative dressing. It can be done as an outpatient, using local anesthesia with intravenous (IV) sedation. Routine preoperative workup for these techniques is required. Simple distal rectal evacuation is required for a clean operative field. Distal rectal evacuation is best achieved by small-volume saline enemas. But it should be done by a surgeon who is especially trained in doing stapler surgery. This is because there are few risks associated with the unskilled hands. The risks include: damage to the rectal wall, overstretching of sphincter muscles. etc.