Different Treatment of Piles:

Dietary changes

If constipation is the cause of your haemorrhoids, you need to keep your stools soft and regular. This will help you avoid straining to pass stools.
Increase the fibre in your diet and aim to eat 25-30g of insoluble fibre a day, such as wholegrain bread, cereal, and fruit and vegetables.
The body is unable to digest insoluble fibre, so it passes through the bowels and helps other food and waste move through more easily.
Also drink plenty of water. Aim to drink at least six to eight glasses of fluid a day and avoid too much caffeine (found in tea, coffee and cola).

Self care

Follow the advice below when going to the toilet:

• avoid straining to pass stools because it may make your haemorrhoids worse
• after passing a stool, use moist toilet paper rather than dry toilet paper to clean your bottom 
• using baby wipes can help ease any discomfort that you have after passing a stool
• pat the area around your bottom rather than rubbing it

Creams, ointments and suppositories

Creams, ointments and suppositories, available over-the-counter from pharmacies, can be used to relieve any swelling and inflammation that you have around your back passage. However, they will only treat your symptoms and will not cure the haemorrhoids themselves.
These types of medicines should only be used for five to seven days at a time. If you use them for longer than this, they may irritate the sensitive skin around your anus. Any medication you use should be combined with the diet and self care advice above.
There is no evidence to show that one preparation is more effective than another. Ask your pharmacist for advice about which product is most suitable for you. Also, always read the patient information leaflet that comes with your medicine before using it.
Do not use more than one product at the same time because they may contain similar ingredients.

Corticosteroid cream

If you have severe inflammation in and around your back passage, your GP may prescribe corticosteroid cream. This cream contains powerful hormones called steroids.
You should not use corticosteroid cream for more than a week at a time because it can make the skin around your anus thinner.

Painkillers

Painkilling medication, such as paracetamol, can relieve pain caused by haemorrhoids.
Products that contain local anaesthetic (painkilling medication) may also be prescribed to treat painful haemorrhoids. They should only be used for a few days because they can make the skin around your back passage more sensitive.

Laxatives

If you are constipated, your GP may prescribe a laxative. This is a type of medicine that can help you empty your bowels. Laxatives can be:

• bulk-forming – which contain fibre to make your stools heavier and softer
• osmotic – which increases the amount of water in your bowels to make your stools softer

Read more about laxatives.

Banding

Banding is a procedure that is sometimes used to treat second and third degree haemorrhoids.
Banding involves a very tight elastic band being placed around the base of your haemorrhoids to cut off their blood supply. The haemorrhoids should fall off within seven days of having the treatment.
Banding is usually carried out as a day procedure and you should be able to return to work the following day. However, you may feel some pain or discomfort for a day or so. Normal painkillers are usually effective but, if necessary, your GP may prescribe something stronger.
You may not realise the haemorrhoids have fallen off because they should pass out of your body when you go to the toilet. If you notice some mucus discharge within a week of the procedure, it usually means that the haemorrhoid has fallen off.
Directly after the procedure, you may notice some blood on the toilet paper after going to the toilet. This is normal, but there should not be a lot of bleeding. If you pass a lot of bright red blood or blood clots (solid lumps of blood), go to your nearest accident and emergency (A&E) department immediately.
Infections or ulcers (open sores) can occur at the site of the banding. However, these complications are rare and can be easily treated.

Injections (sclerotherapy)

Sclerotherapy is another common treatment for internal haemorrhoids. It can be used as an alternative to banding.
A chemical solution is injected into the blood vessels in your back passage. This relieves pain by numbing the sensory nerve endings at the site of the injection. It also hardens the tissue of the haemorrhoid so that a scar is formed. After about four to six weeks, the haemorrhoid should decrease in size or shrivel up.
After the injection, avoid strenuous exercise for the rest of the day. You may experience minor pain for a while and may bleed a little. You should be able to resume normal activities, including work, the day after the procedure.

Infrared coagulation

Infrared coagulation, also know as infrared light, can also be used to treat haemorrhoids.
A special device is used to burn the haemorrhoid tissue. One or two bursts of infrared light can cut off the circulation to small internal haemorrhoids, such as grade one or two haemorrhoids.

Surgery

Surgery is sometimes recommended to treat large internal haemorrhoids, or those graded as three or four.

Procedures to treat hemorrhoids

Some hemorrhoids can’t be managed with conservative treatments alone, either because symptoms persist or because an internal hemorrhoid has prolapsed. Fortunately, a number of minimally invasive treatments are available that are less painful than traditional hemorrhoid removal (hemorrhoidectomy) and allow a quicker recovery. These procedures are generally performed in a surgeon’s office or as outpatient surgery in a hospital.

Band it. The most commonly used hemorrhoid procedure in the United States is rubber band ligation, in which a small elastic band is placed around the base of a hemorrhoid (see bow above). The band causes the hemorrhoid to shrink and the surrounding tissue to scar as it heals, holding the hemorrhoid in place. It takes two to four procedures, done six to eight weeks apart, to completely eliminate the hemorrhoid. Complications, which are rare, include mild pain or tightness (usually relieved with a sitz bath), bleeding, and infection. Other office procedures include laser or infrared coagulation, sclerotherapy, and cryosurgery. They all work on the same principle as rubber band ligation but are not quite as effective in preventing recurrence. Side effects and recurrence vary with the procedure, so consult your physician about what’s best for your situation.

Hemorrhoidectomy. You may need surgery if you have large protruding hemorrhoids, persistently symptomatic external hemorrhoids, or internal hemorrhoids that return despite rubber band ligation. In a traditional hemorrhoidectomy, a narrow incision is made around both external and internal hemorrhoid tissue and the offending blood vessels are removed. This procedure cures 95% of cases and has a low complication rate — plus a well-deserved reputation for being painful. The procedure doesn’t involve an overnight hospital stay, but it does require general anesthesia, and most patients need narcotic analgesics afterward. Patients can usually return to work after 7–10 days. Despite the drawbacks, many people are pleased to have a definitive solution to their hemorrhoids.

Staples. A newer alternative to traditional hemorrhoidectomy is called stapled hemorrhoidopexy. This procedure treats bleeding or prolapsed internal hemorrhoids. The surgeon uses a stapling device to anchor the hemorrhoids in their normal position. Like traditional hemorrhoid removal, stapled hemorrhoidopexy is performed under general anesthesia as day surgery, but it’s less painful and recovery is quicker. It’s more painful than rubber band ligation and has more minor side effects, but it only needs to be done once; the hemorrhoids are also much less likely to return. Research is now under way comparing stapled hemorrhoidopexy with rubber band ligation and hemorrhoidectomy as a first-line treatment for internal hemorrhoids.

Diagnosing hemorrhoids

Hemorrhoids can usually be diagnosed from a simple medical history and physical exam. External hemorrhoids are generally apparent, especially if a blood clot has formed. Your clinician may perform a digital rectal exam to check for blood in the stool. She or he may also examine the anal canal with an anoscope, a short plastic tube inserted into the rectum with illumination. If there’s evidence of rectal bleeding or microscopic blood in the stool, flexible sigmoidoscopy or colonoscopy may be performed to rule out other causes of bleeding, such as colorectal polyps or cancer, especially in women over age 50.

Home treatment

Most hemorrhoid symptoms improve dramatically with simple, at-home measures. To avoid occasional flare-ups, try the following.

Get more fiber. Add more fiber to your diet from food, a fiber supplement (such as Metamucil, Citrucel, or Fiber Con), or both. Along with adequate fluid, fiber softens stools and makes them easier to pass, reducing pressure on hemorrhoids. High-fiber foods include broccoli, beans, wheat and oat bran, whole-grain foods, and fresh fruit. Fiber supplements help decrease hemorrhoidal bleeding, inflammation, and enlargement. They may also reduce irritation from small bits of stool that are trapped around the blood vessels. Some women find that boosting fiber causes bloating or gas. Start slowly, and gradually increase your intake to 25–30 grams of fiber per day. Also, increase your fluid intake.

Exercise. Moderate aerobic exercise, such as brisk walking 20–30 minutes a day, can help stimulate bowel function.

Take time. When you feel the urge to defecate, go to the bathroom immediately; don’t wait until a more convenient time. Stool can back up, leading to increased pressure and straining. Also, schedule a set time each day, such as after a meal, to sit on the toilet for a few minutes. This can help you establish a regular bowel habit.

Sitz. A sitz bath is a warm water bath for the buttocks and hips (the name comes from the German “sitzen,” meaning “to sit”). It can relieve itching, irritation, and spasms of the sphincter muscle. Pharmacies sell small plastic tubs that fit over a toilet seat, or you can sit in a regular bathtub with a few inches of warm water. Most experts recommend a 20-minute sitz bath after each bowel movement and two or three times a day in addition. Take care to gently pat the anal area dry afterward; do not rub or wipe hard. You can also use a hair dryer to dry the area.

Seek topical relief. Over-the-counter hemorrhoid creams containing a local anesthetic can temporarily soothe pain. Creams and suppositories containing hydrocortisone are also effective, but don’t use them for more than a week at a time, because they can cause the skin to atrophy. Witch hazel wipes (Tucks) are soothing and have no harmfu l effects. A small ice pack placed against the anal area for a few minutes can also help reduce pain and swelling. Finally, sitting on a cushion rather than a hard surface helps reduce the swelling of existing hemorrhoids and prevents the formation of new ones.

Treat the clot. When an external hemorrhoid forms a blood clot, the pain can be excruciating. If the clot has been present for longer than two days, apply home treatments for the symptoms while waiting for it to go away on its own. If the clot is more recent, the hemorrhoid can be surgically removed or the clot withdrawn from the vein in a minor office procedure performed by a surgeon.

Initial Treatment

The initial treatment for hemorrhoids involves dietary and lifestyle modifications to help treat the symptoms. Increasing the amount of fiber in the diet helps with the passage of soft stools that do not cause inflammation or bleeding of hemorrhoids. Natural sources of fiber include whole brains and vegetables. Artificial over-the-counter fiber supplements can also help maintain regular bowel habits, decreasing the symptoms of hemorrhoids. Other strategies include increasing the intake of water to about six to eight 8-ounce glasses a day; sitting in the bath tub with warm water for a few minutes at a time; regular exercise to promote regular bowel health; and decreasing the amount of time sitting on the toilet and not straining during bowel movements. Anti-hemorrhoid cream, ointments and suppositories can temporarily relieve symptoms of itching and pain, and steroid suppositories can decrease the inflammation and swelling associated with hemorrhoids.

Correct toilet sitting helps to cure, control and prevent hemorrhoids:

One of the most important treatments / preventatives, relates to how you sit on the toilet when doing your number 2's.

In the good old days, people squatted on the ground - we are designed to do our number 2's squatting. Toilets are designed to be sat on, not squatted on - they were not designed to allow the easy elimination of waste from our body. The more modern toilets, sometimes called squat toilets, are an endeavor to correct this historical mistake in toilet making.

However, the vast majority of us have not even seen a squat toilet. So, when using a normal toilet, the professional medical staff at my local hospital suggest that to prevent, or lessen / cure the effects of hemorrhoids, one should use a different sitting position on the toilet.

These professionals suggest:

First, when you sit on the toilet, have the toes and ball of the foot on the floor, but the heels raised up in the air.

Second, lean forward and rest your arms on your knees.

Third, let nature takes it's course, don't force.

Provided you have kept to a fiber rich diet and or used supplements to keep your bowel motions soft - be careful as certain herbal remedies can damage the bowel - the bowel should evacuate quickly, easily and fully. Remember to drink more water if adding fibre supplements to your diet - the fiber absorbs the moisture to create the soft bulky stool.

This simple strategy helps to avoid straining, which is good, as straining causes hemorrhoids. Straining puts undue pressure on the rectum area, which means the blood vessels are being pumped up with blood. This isn't good, as sooner or later the blood vessels will weaken and some will balloon out under pressure, at which point they are called hemorrhoids.

If you already have them, this approach can help to reduce their aggravation, soreness and swelling and may help prevent them from showing themselves, depending on just how bad they are.

A Little Trick to stop the Pain and Discomfort :

Doctors grade them on the basis of just how often and how much they show themselves, but a little trick to reduce the pain and discomfort is to just push the hemorrhoids gently back inside, where they belong. Most hemorrhoids become painful because they are being cramped and hurt while outside - they have the muscles clamping down on them to try and stop it from coming through, which is what the muscles there are for and then they have cheeks rubbing against them and so on.

Seeing Your Doctor About Your Hemorrhoids and Dealing with the Embarrassment:

They are also known as piles, but some use the term prolapse. Prolapse may sound something dreadful, but it's not your intestines falling out. When we are talking hemorrhoids, the doctor is simply saying the hemorrhoid is showing itself outside your bottom.

Doctors see hemorrhoid cases every day, so although it may be embarrassing for you, it's nothing new to your doctor. If you need to, just write all your symptoms down and let the doctor read them. A sensitive doctor will ease you through the embarrassment and provide you with a proper diagnosis. Until then you are just guessing - all sorts of things have to be ruled out.