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  • Q&A with Australian Health Practitioners

    What is the treatment for type 2 piles ?

    Related Topics
    Digestive Health Haemorrhoids
    I have type 2 piles as per the description, as this comes while going to toilet and goes back automatically, no pain and no blood, basically no issue.

    Do I need to take any treatment to avoid any future problems?
    Can a good diet with fibre and a good lifestyle can prevent this?
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    Thanks

    Dr Kenneth Wong

    Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon

    Dr Ken Wong is a very experienced specialist surgeon focussing on keyhole surgery techniques for gallstones, bowel cancer, hernia and weight loss surgery. He graduated … View Profile

    With haemorrhoids or piles, the fundamental treatment is avoidance of strainig and keeping the stools soft and smooth.

    This is achieved by drinking lots of water, exercising and maintaining a high fiber diet.

    However, if despite doing these, the haemorrhoids or piles are still causing bleeding or irritation, then I would usually treat these by placing rubber bands on them. This is a day case procedure with some sedation. 

    The rubber bands constrict the piles, making them fall off. However, this is only a temporary solution and lifestyle and stool consistency changes are the best guard against recurrence.

    If the piles are too large for rubber bands, then I would proceed to formal removal of haemorrhoids in the operating theatre. Formal cutting out of haemorrhoids requires an overnight stay in hospital and there is often six weeks of pain afterwards.

    Ken Wong

    http://www.centralcoastsurgery.com.au

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    Thanks

    Dr Jason Wong

    Bariatric (Obesity) Surgeon, General Surgeon, Laparoscopic Surgeon, Upper GI Surgeon (Abdominal)

    Jason Wong is a skilled Laparoscopic and Bariatric Surgeon with expertise in sleeve and gastric bypass surgery, gallbladder, hernia, endoscopic pilonidal, antireflux and emergency general … View Profile

    First step is lifestyle modifications including increasing fibre in the diet, adding fibre supplement such as metamucil or benefibre, ensuring softer stools, drinking plenty of water.

    Second step is modify toileting habits. Avoid excessive straining, avoid sitting for prolonged periods on the toilet reading, playing on phone etc. etc. just do the business and get out.

    If these measures are not successful, then next treatment would be proctoscopy to look into the anal canal, usually done by a surgeon, and rubber band ligation can be performed. Small rubber bands are placed NOT ON THE HAEMORRHOIDS AND THE HAEMORRHOID DOES NOT DROP OFF as previously mentioned. Banding a haemorrhoid directly would be extremely painful. Bands should be placed on the rectal mucosa just above the haemorrhoidal tissue. This causes an ulcer to form which scars and contracts, pulling the prolapsing haemorrhoid tissue back in.

    I would usually try banding twice for Grade 2 haemorrhoids and if unsuccessful, would then offer surgery for the haemorrhoids.

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