How piles can be treated?

Non-prolapsing piles which bleed can be managed by high-fibre diet. Itching and discomfort, usually associated with prolapsing piles, can be managed by emollient creams such Anusol. If bleeding does not settle with a high-fibre diet, piles can be injected with phenol, causing them to scar and shrink. Otherwise they can be treated with "rubber band ligation"; the rubber band snags the pile, cutting off its blood supply and causing it to drop off painlessly. A new technique has been developed in which the blood vessels which feed the piles are individually identified using an ultrasound probe and tied off ("ligated"). It is not clear whether this is superior to rubber band ligation.

Piles which prolapse can also be treated by rubber band ligation but may need a surgical operation. While a degree of post-operative pain is an inevitable with a conventional haemorrhoid operation, surgery does works well and provides good relief from haemorrhoidal symptoms. Conventional haemorrhoidectomy is considered to be the standard method against which other techniques are assessed. A new anal stapling technique is, however, available in some centres; this is particularly useful for mutliple prolapsing haemorrhoids, and despite being a radical treatment is associated with less pain post-operatively. Complications with this stapling technique have, however, been reported.