Best Piles (Haemorrhoids) Specialists in Dehradun

Piles, clinically known as haemorrhoids, are swollen and inflamed blood vessels in and around the rectum and anus. They develop when increased pressure on the veins in the lower rectum causes them to stretch, swell and sometimes bleed. While piles are extremely common - affecting people across all age groups - they vary significantly in severity, location and the level of discomfort they cause. At Graphic Era Hospital, our specialists assess piles across all grades and types to determine the most appropriate course of treatment. 

Piles are classified as:

• Internal Haemorrhoids: Develop inside the rectum and are typically painless, though they may bleed during bowel movements. Graded from I to IV based on the degree of prolapse.
• External Haemorrhoids: Form under the skin around the anus and are often more painful, particularly when a blood clot develops - a condition known as thrombosed haemorrhoid.
• Prolapsed Haemorrhoids: Internal haemorrhoids that protrude outside the anus during straining, ranging from those that retract spontaneously to those requiring manual reduction or surgical intervention.
• Thrombosed Haemorrhoids: External haemorrhoids in which a  blood clot forms, causing sudden, severe pain and swelling that often requires prompt medical attention.
• Bleeding Piles: Haemorrhoids - internal or external - that bleed during or after bowel movements, ranging from minor spotting on tissue to more significant blood loss requiring investigation.

Piles develop when increased pressure on the veins in the lower rectum causes them to swell and stretch over time. This pressure can build up due to a combination of lifestyle factors and underlying health conditions. Identifying the cause is important, as it helps guide both effective treatment and long-term prevention. Common causes and risk factors include:

• Chronic Constipation and Straining: Repeated straining during bowel movements is one of the most direct causes of haemorrhoids, placing sustained pressure on rectal veins with each episode.
• Low-Fibre Diet: A diet lacking in fibre produces hard, difficult-to-pass stools — increasing straining and the likelihood of haemorrhoid development over time.
• Pregnancy: Hormonal changes and the growing uterus place significant pressure on the pelvic veins during pregnancy, making haemorrhoids particularly common in the second and third trimesters.
• Obesity: Excess body weight increases intra-abdominal pressure and places sustained strain on the veins of the lower rectum, making obesity a significant risk factor for piles.
• Prolonged Sitting: Spending extended periods seated, particularly on the toilet, increases pressure on the anal and rectal veins and contributes to haemorrhoid formation.
• Chronic Diarrhoea: Frequent loose stools cause repeated irritation and inflammation of the rectal lining, increasing the risk of haemorrhoid development over time.
• Ageing: The supporting tissues around the rectum and anus weaken naturally with age, making haemorrhoids more likely in adults over 45.
• Heavy Lifting: Regular heavy lifting, particularly without proper technique, raises intra-abdominal pressure in a manner similar to straining and contributes to haemorrhoid development.
• Family History: A genetic predisposition to weak rectal vein walls increases the likelihood of developing piles, particularly when combined with other risk factors.

Diagnostic Approach

Accurate diagnosis determines both the grade of haemorrhoids and the most appropriate treatment. Our proctologists use a structured evaluation pathway:

• Clinical History and Symptom Assessment: A detailed review of symptom duration, bleeding pattern, bowel habits, diet and lifestyle factors to establish the likely cause and severity of piles.
• Digital Rectal Examination (DRE): A physical examination to assess the anorectal region, detect external haemorrhoids, prolapse or other anorectal pathology requiring further investigation.
• Proctoscopy: Direct visualisation of the anal canal and lower rectum using a short, lighted scope - the standard tool for grading internal haemorrhoids and detecting associated conditions such as fissures or polyps.
• Sigmoidoscopy or Colonoscopy: Recommended when rectal bleeding is significant, recurrent or associated with other symptoms, to rule out colorectal pathology beyond the anorectal region.
• Blood Tests: Ordered where chronic bleeding has caused anaemia or where systemic assessment is needed to guide treatment planning.

Non-Surgical Treatments

For Grade I and Grade II haemorrhoids - and selected Grade III cases - non-surgical options offer effective relief with minimal recovery time:

• Rubber Band Ligation: A small rubber band is placed around the base of an internal haemorrhoid, cutting off its blood supply and causing it to shrink and fall away within days. It is one of the most effective non-surgical treatments for internal piles.
• Sclerotherapy: A chemical solution is injected into the haemorrhoid tissue to shrink it, suitable for small internal haemorrhoids and patients where banding is not appropriate.
• Infrared Coagulation (IRC): Infrared energy is applied to the haemorrhoid to coagulate the blood vessels and reduce the tissue - a quick, well-tolerated outpatient procedure.
• Dietary and Lifestyle Management: High-fibre dietary guidance, adequate hydration and bowel habit modification form an essential part of both treatment and long-term prevention of recurrence.

Surgical Treatments

For Grade III and Grade IV haemorrhoids, thrombosed haemorrhoids or cases that have not responded to non-surgical management, surgical intervention provides definitive relief:

• Laser Haemorrhoidectomy: Uses a precisely focused laser beam to ablate haemorrhoid tissue with minimal bleeding, reduced post-operative pain and faster recovery compared to conventional surgery, available at Graphic Era Hospital for eligible patients.
• Stapled Haemorrhoidopexy (PPH): A circular stapling device repositions and reduces prolapsed haemorrhoidal tissue without excision, offering less post-operative pain and quicker return to activity than open surgery.
• Conventional Haemorrhoidectomy: Surgical excision of haemorrhoid tissue under anaesthesia - the gold standard for large, symptomatic Grade III and IV haemorrhoids - providing definitive, long-term resolution.
• Thrombosed Haemorrhoid Evacuation: Prompt surgical removal of a blood clot from a thrombosed external haemorrhoid, providing immediate pain relief when performed within 72 hours of onset.

Post-Treatment Care

Recovery and recurrence prevention are as important as the procedure itself. Our team provides:

• Pain Management: Tailored analgesia plans for the post-operative period, with guidance on sitz baths, topical applications and activity modification to support comfort during healing.
• Dietary Guidance: A structured high-fibre dietary plan and hydration advice to ensure soft, regular bowel movements during recovery and reduce the risk of recurrence.
• Wound Care and Follow-Up: Clear instructions on wound hygiene after surgical procedures, with scheduled outpatient follow-up to monitor healing and address any concerns.
• Long-Term Recurrence Prevention: Lifestyle counselling addressing the root causes of piles, including diet, hydration, weight management and bowel habits, to minimise the likelihood of recurrence after treatment.