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Hemorrhoids or piles are swollen veins in the lower rectum or the anus. 

Types of Hemorrhoids

Hemorrhoids may be external or internal. If they develop inside the rectum, they are called internal hemorrhoids. External hemorrhoids develop around the anus just below the skin. Some of the external hemorrhoids develop blood clots and are quite painful. They are called thrombosed hemorrhoids. Another type of piles is so large that they often protrude during defaecation. They are called prolapsing piles.

What Causes Hemorrhoids?

The exact cause of hemorrhoids is unknown. Possible causes include:

  • Pregnancy and childbirth 
  • Prolonged straining to pass stools (If you suffer constipation)
  • Obesity
  • Diet low in fiber
  • Chronic diarrhea
  • Anal intercourse

Symptoms of Hemorrhoids

The symptoms of hemorrhoids include:

  • Pain and discomfort
  • Pain may increase during defecation
  • Bleeding, which is commonly observed during defecation
  • Itching or irritation to the anal area
  • Lumps outside the anus which may or may not be painful
  • Your anal area may be swollen

Diagnosis of Hemorrhoids

The presence of hemorrhoids is diagnosed by your doctor digitally with a gloved finger. Your doctor may use an anoscope, sigmoidoscopy or a proctoscope to check for internal piles.

Treatment of Hemorrhoids

Hemorrhoids are never life-threatening. The symptoms of bowel cancer may be like hemorrhoid symptoms. Therefore, it is important to be properly diagnosed. 

Most hemorrhoids are treated by non-surgical methods. Minimally-invasive procedures are found to be effective in many patients. Surgery may be needed in extreme cases.

Non-surgical Methods

  • Your doctor prescribes medications to reduce pain, itching, and inflammation. It may be in the form of tablets or ointments.
  • You must consume a high-fiber diet. Avoid straining during defecation.
  • Keep the anal area clean. Use cold packs to reduce inflammation. Take a sitz bath.
  • Your doctor may remove a painful clot by simple incision. 

Minimally-Invasive Methods

  • Sclerotherapy: Your doctor injects certain chemicals to cause shrinkage of the hemorrhoids.
  • Rubber band ligation: The base of the hemorrhoids is tied with small rubber bands. This cuts blood circulation and the hemorrhoids fall off. There may be certain complications associated with this technique. 
  • Coagulation technique: It involves the hardening of hemorrhoids with radiation or heat increases the chances of hemorrhoids falling off.


  • Hemorrhoidectomy: The hemorrhoids are surgically removed. It is performed under general anesthesia or with local anesthesia. Pain and difficulty in defaecation after surgery for a few days are some of the complications of the surgery.
  • Hemorrhoid Stapling: It is a surgical method to block blood flow to the hemorrhoids. This technique has various complications such as the recurrence of hemorrhoids.

Prevention of Hemorrhoids

Follow these simple lifestyle and diet habits to avoid the occurrence of hemorrhoids. 

  • Eat a high fiber diet. Do not consume foods such as chips, ice creams, fast food, frozen food, processed food, red meat, etc which may increase the chances of constipation and hemorrhoids.
  • Stay physically active. Exercise maintains gastrointestinal health.
  • If you are obese, plan a weight loss program. 
  • If you are suffering from inflammatory bowel disease, properly manage it. 


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Dr. Gyawali is exclusively available at

Mubadala Health – Jumeirah, Dubai

Sunset Mall - First Floor
Jumeirah Beach Rd Jumeirah 3
Dubai, UAE

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I was referred to Dr Gyawali for a manometry test. He carefully studied my medical history. and realised that my previous doctor had repeatedly missed a significant diagnosis. He immediately referred me on to the necessary specialists for urgent treatment. I cannot thank him enough..

Patient at Queen's Hospital

29th February 2020