Hemorrhoids (Piles)

Hemorrhoids are lips at the other end. Everyone has them, even infants. They are normal structures. Hemorrhoids are blamed for pretty much everything bad that can happen from the waist down. But, in reality, they are often innocent. So what can they do? Hemorrhoids can bleed, they can stick out (prolapse), and they can occasionally (and quite rarely) clot. If they do clot, they can be quite painful. But except in this rare circumstance, hemorrhoids are painless. So, attacks of pain, burning, itching etc are not due to hemorrhoids (despite what the television commercials say). It is amazing how many patients have undergone hemorrhoid surgery for these symptoms, only to continue to have the symptoms afterwards, not surprisingly. Patients with ‘hemorrhoids’ need to be carefully assessed in order to determine if this is the correct diagnosis.

For hemorrhoids that are bleeding or prolapsing (sticking out), treatment may include diet and hygiene changes, infrared photocoagulation treatments, elastic band ligation (hemorrhoid banding), or surgery.

By the way, no one uses the term ‘piles’ anymore except elderly patients from the old country.

Michael E Pezim, MD FRCSC FACS

Pezim Clinic, Vancouver, British Columbia, Canada