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Piles: Symptoms, Images, Causes, and Types

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Dr. Hemant Kumar Khowal
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Medically Reviewed by Dr. Hemant Kumar Khowal Written by Sangeeta Sharma

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Piles or Haemorrhoids is a swelling containing enlarged blood vessels and tissues found inside the rectum or under the skin around the anus. Piles is also known as Bawaseer (बवासीर) in Hindi. This condition is common in people within the age group of 45-65 years.

Depending on the location, haemorrhoids can be internal, external, or prolapsed. Let’s read about Piles representation by real images, symptoms, causes, types, diagnosis, prevention, treatment, and more.

Disease Name Piles
Alternative Name Haemorrhoids,Bawaseer (बवासीर)
Symptoms Pain, Discomfort, Swelling, Itchiness, Redness, Lump formation
Causes Straining while passing stools, Constipation, Pregnancy, Chronic diarrhoea
Diagnosis Visual inspection, Digital examination, Proctoscopy
Treated by General Surgeon (Proctologist)
Treatment options Haemorrhoidal Artery Ligation, Sclerotherapy, Stapler surgery, Laser surgery

What is Piles?

Piles, also known as Haemorrhoids, are a common medical condition that affects many people. They are essentially swollen blood vessels located in the anus or lower rectum. It can cause discomfort, pain, itching, and bleeding, especially during bowel movements. 

While the exact cause of piles is unclear, factors such as constipation, pregnancy, obesity, and prolonged sitting or standing can contribute to their development.

Piles can be uncomfortable; they are not considered serious health concerns. They can often be managed effectively with simple lifestyle changes such as eating a high-fibre diet, drinking plenty of fluids, and exercising regularly.

Types of Piles Disease

This condition can be classified based on the location and severity.

Type of Piles Based on Location

Haemorrhoids are classified into four main types based on their location within the rectum and where the swollen vein develops. These include:

  1. External: These are small lumps that form underneath the skin around the anus. They are very itchy and painful. Usually, bleeding is present in this case.
  2. Internal: The lumps develop within the rectum and are usually not visible during an external examination. A small amount of bleeding can be seen during bowel movements. They rarely cause pain or discomfort.
  3. Prolapsed: Internal and external piles can prolapse, which means they can stretch and bulge outside the anus. These may bleed or cause severe pain.
  4. Thrombosed: It occurs when a blood clot forms in one or more veins in the anal area. They typically appear as a hard lump on the anus, which can be painful to touch or sit on.

Different types of piles image

Type of Haemorrhoids Based on Severity

Piles are graded based on their severity and the extent to which they have prolapsed or come out of the anus. The grading system for it is as follows:

  1. Grade I: In this stage, the piles are small. They may not be visible or felt as they are located inside the anus.
  2. Grade II: During bowel movements, the piles may prolapse or come out of the anus but return afterwards to their original position.
  3. Grade III: The piles prolapse during bowel movements and require manual pushing back afterwards.
  4. Grade IV: Here, the piles will always be prolapsed and cannot be pushed back in manually.

    different grades of piles

Signs and Symptoms of Piles

In most cases, the piles symptoms are not serious and resolve on their own. Haemorrhoids are characterised by one or more of the following symptoms:

  • Painful lumps around the anal region
  • Itching, redness, inflammation and discomfort 
  • Presence of slimy fluid near the anus
  • Bright red coloured blood after passing stools
  • Feeling of incomplete bowel emptying even after passing stool

piles disease symptoms

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Haemorrhoids Causes

The exact cause of piles is uncertain. They are associated with increased pressure in the blood vessels and tissues around the anal area, resulting in swelling and inflammation. These include:

  • Applying excessive pressure while passing stool can cause veins in the rectal area to swell
  • A diet that is low in fibre can cause constipation, leading to piles
  • Infections in the anal or rectal area can cause inflammation and swelling, increasing the likelihood of developing it
  • Infrequent bowel movements and difficulty in passing stool can lead to the development of this disease

piles is caused by

Piles Risk Factors

The following are the potential risk factors for piles that might put an individual at a higher chance of developing the disease:

  1. Pregnancy: Pregnant women are more likely to develop haemorrhoids due to the pressure exerted on the rectal veins by the growing uterus.
  2. Age Between 45-65 Years: Bawaseer can affect people of any age, but they are more common in individuals aged 45 to 65.
  3. Obesity: People who are overweight or obese have a higher risk of developing piles because of the extra pressure on the rectal veins.
  4. Chronic Constipation: If you suffer from chronic constipation, you may be more prone to developing haemorrhoids as you strain more often during bowel movements.
  5. Sitting for Long Hours: If you spend a lot of time sitting, especially on hard surfaces, it can increase pressure on the veins in the anus and rectum, leading to piles.
  6. Lifting Heavy Weights: Regularly lifting heavy objects can put undue pressure on the rectal veins and increase the risk of developing bawaseer.
  7. Family History of Haemorrhoids: Having a family history of piles increases the likelihood of this condition.

    Piles risk factors image

How to prevent Piles?

There might not be a definitive way to prevent piles. Still, there are measures to reduce the risk of developing bawaseer or worsening the condition. Below mentioned are some of the measures for the prevention:

  • Eating a fibre-rich diet
  • Maintaining a moderate weight
  • Limit the amount of sitting time on the toilet
  • Manage constipation and prevent straining during bowel movements
  • Avoiding heavy lifting
  • Staying physically active by doing regular exercise

    Piles prevention Image

Piles Diagnosis

The healthcare professional will generally be able to diagnose piles based on symptoms and a physical examination. The proctologist will do a complete physical examination to examine the anal area carefully. They may ask the following questions:

  1. Do any close relatives have piles?
  2. Has there been any blood or mucus in the stools?
  3. Did you recently lose any weight?
  4. Has your bowel movements changed recently?
  5. Have you seen piles real images?

However, in a few cases, the following additional tests may also be recommended to confirm the presence and severity of the piles.

  1. Digital Rectal Exam: The doctor will insert a gloved, lubricated finger into the rectum to feel for swollen blood vessels.
  2. Anoscopy: An anoscope (lighted tube) will be used to view the lining of the anus and rectum. 
  3. Sigmoidoscopy: A sigmoidoscope (lighted tube with a camera) is used to view the lower part of the colon and rectum. This technique includes two types: flexible sigmoidoscopy and rigid sigmoidoscopy
  4. Stool Guaiac Test: A stool sample is analysed to find any traces of blood in it.
  5. ColonoscopyThe doctor may advise it when they want to examine the entire colon by using a colonoscope (long, flexible, lighted tube) to check for any abnormal growths, a tissue that is red or swollen, sores (ulcers), or bleeding.

    Diagnostic Test of Piles

How to prepare for the doctor's consultation?

If you are planning to see a doctor for symptoms of piles, there are several steps you can take to prepare for your appointment. It's helpful to keep a record of all the symptoms that you have been facing. Some things that you should keep in mind include: 

  1. List down piles symptoms, including any that may seem unrelated to the condition.
  2. The patient must inform the doctor about key personal information, including dietary habits and regular bowel movements.
  3. The doctor must be informed about all the medications, vitamins or supplements that they take.
  4. The following questions should be asked the doctor:
    • What's the likely cause of the condition?
    • Is this condition likely to be temporary or permanent?
    • Will there be any complications related to this condition?
    • What treatment approach do you recommend?
    • Which treatment would work if the first line of treatments doesn't work?
    • Am I a candidate for surgery? Why or why not?
    • Are there additional self-care steps that might help?
    • I have other medical problems. How can I manage these along with haemorrhoids?
    • Can I see some piles real images?
    • Can you explain piles meaning to me?

Treatment for Haemorrhoids

In most cases, piles resolve on their own without needing any treatment. However, if an individual has haemorrhoids for an extended period, the lumps may grow in size, and the piles symptoms may also worsen, leading to significant pain, discomfort and reduced quality of life.

In that case, the following treatment for piles are suggested by the proctologist:

Home Remedies for Piles

While there are various medical piles problem treatment, there are also several home remedies that may help alleviate symptoms. Some common remedies for haemorrhoids include: 

  • Sitz Bath: Sitting in a warm bath for 10-15 minutes can help alleviate pain and itching caused by bawaseer. You can prepare for it using Epsom salt and add glycerin for additional benefits. This video will help you understand how to use it for a cure.
  • Fibre Intake: Eating a diet high in fibre helps prevent constipation and straining during bowel movements, which can aggravate piles. Good sources of fibre include fruits, vegetables, whole grains, and legumes.
  • Flavonoids: These are compounds found in fruits and vegetables such as blackberries, cherries, and red grapes, reduce inflammation and improve circulation, reducing the risk of developing piles.
  • Vitamin C Rich Foods: Foods that are high in vitamin C, such as oranges, strawberries, and bell peppers, strengthen blood vessels.
  • Cold Compress: Applying a cold compress to the anus reduces swelling and alleviates pain.
  • Aloe Vera Gel: This gel lessens pain, itching, and inflammation.
  • Witch Hazel: Applying witch hazel prevents pain and bleeding.

home treatment for piles

Ayurvedic Treatment for Piles

Ayurveda, an ancient system of medicine originating from India, offers a range of natural remedies and treatments for piles. Some common treatments are:

  1. Triphala Powder:
    • This powder can help alleviate symptoms of piles by improving digestion and reducing constipation.
    • Triphala is a blend of three fruits - amla, haritaki, and bibhitaki. It is often taken in powder form mixed with water or as a supplement in capsule form.
  2. Kshar Sutra:
    • Kshar Sutra is an Ayurvedic treatment for haemorrhoids that involves the use of a medicated thread. The thread is inserted into the rectum near the piles and is said to cause the piles to dry up and fall off over time.
    • The Kshar Sutra treatment is performed by a trained practitioner and is usually done on an outpatient basis. The procedure takes about 30 to 45 minutes, and most people are able to return to their normal activities within a few days.piles ayurvedic treatment

Lifestyle Changes for Haemorrhoids

Making certain lifestyle changes can help prevent and manage symptoms of piles. Some of the lifestyle modifications that can help with piles include:

  • Exercise: Regular exercise can help prevent constipation and improve overall bowel function.
  • Avoid Prolonged Sitting or Standing: Prolonged sitting or standing can increase pressure on the veins in the anus and rectum, which can aggravate piles.
  • Staying Hydrated: Drinking plenty of water can help prevent constipation and keep stools soft.
  • Avoid Straining During Bowel Movements: Straining while passing stool can pressure the anus and lower rectum veins. 
  • Avoid Heavy Lifting: Heavy weight lifting can increase the pressure in the anorectal region and lead to swelling of blood vessels, posing a risk for piles.
  • Using Indian Commode: A squatting toilet may help alleviate symptoms of piles (haemorrhoids) in some individuals. The squatting position improves bowel movements by relaxing the anal muscles, which helps prevent straining and constipation.

    piles be cured by lifestyle changes

Medications for Piles

There are several medications available to help relieve piles symptoms. Over-the-counter oral medications, creams and ointments are some of the treatments used for haemorrhoids.

Depending on the severity of the disease, the proctologist would prescribe the following:

  • Pain Reliever Medications such as Aspirin or Ibuprofen can temporarily help relieve the discomfort.
  • Stool Softeners help relieve constipation.
  • Over-the-counter Topical Haemorrhoid Creams or suppositories containing hydrocortisone, or use pads containing witch hazel or a numbing agent.

"In my experience treating patients with piles, I’ve observed that while the discomfort can be overwhelming, the real challenge lies in overcoming the embarrassment and stigma. Effective treatment requires not just medical expertise but also a compassionate approach to ease their worries and restore their quality of life."

Dr. Hemant Kumar Khowal

General Surgeon, Proctologist


Piles Treatment without Surgery

If the condition do not improve by home remedies and prescription medicines, then the following methods of removing piles without surgery
 can be considered:

  1. Rubber Band Ligation: The surgeon places a rubber band around the haemorrhoids. This causes haemorrhoid necrosis (tissue death), and they drop off.
  2. Sclerotherapy: The surgeon injects a liquid called a sclerosant into the haemorrhoids, which decreases the blood supply and causes the haemorrhoids to shrink. 
  3. Electrotherapy: An electrical current is applied to the piles, causing them to shrink and eventually fall off.
  4. Infrared Coagulation: This method works similarly to that of sclerotherapy. Instead of a liquid, infrared light is used to shrink the haemorrhoids.best treatment for piles without surgery

Haemorrhoids Treatment with Surgery

Surgical treatment of piles is recommended if any of the therapies mentioned above do not work.

The various surgical treatment methods for haemorrhoids include:

  1. Haemorrhoidectomy: In this surgery, doctors remove the swollen veins in the anus or rectum that cause piles. It is usually done for large or protruding piles and requires general anaesthesia. 
  2. Stapled Haemorrhoidectomy: This procedure involves using a stapling device to cut off the blood flow to the piles and reposition them back inside the anus. It is less painful than traditional surgery but may not be suitable for all types of piles. 
  3. Haemorrhoidal Artery Ligation: During this minimally invasive procedure, the surgeon uses ultrasound to locate the blood vessels supplying the piles and ties them off, which causes the piles to shrink and eventually fall off. It is generally used for grade-1 piles.
  4. Laser Surgery for Piles: In this surgery, a laser beam is used to cut off the blood supply to the piles. It causes piles to shrink and eventually disappear. It is a quick and relatively painless procedure. 

    Surgical treatment of piles  

Refer to the page recovery rates for piles to know more about the cure rate after a patient has undergone the above-mentioned piles treatment methods.

Piles Treatment Cost

The piles surgery cost can vary depending on several factors, including the type of surgery, the hospital or clinic where the procedure is performed, and the location.

Here is a table highlighting the cost of different types of procedures: 

Sclerotherapy Cost ₹25,000 to ₹80,000
Laser Piles Surgery Cost
₹35,000 to ₹1,10,000
Rubber Band Ligation Cost
₹25,000 to ₹60,000
Stapler Haemorrhoidectomy Cost ₹42,000 to ₹1,10,000
Open Haemorrhoidectomy Cost
₹32,000 to ₹1,00,000
Haemorrhoidal Artery Ligation Cost
₹38,000 to ₹90,000

Risks and Complications of Piles

Piles can be uncomfortable and painful if piles are not treated in time, but they don’t tend to cause serious problems.The risks and complications of piles include:

  1. Blood clots in the swollen vein
  2. Bleeding
  3. Iron deficiency anaemia is caused by blood loss
  4. Infection of an external haemorrhoid
  5. Skin tags, or excess skin when an external haemorrhoid goes away
  6. Development of strangulated haemorrhoids (muscles in the anus cut off blood flow to a prolapsed internal haemorrhoid)

When to see a proctologist?

In some cases, the symptoms of piles can be mistaken for those of other conditions, such as anal fissures or colorectal cancer.

A proctologist can perform a physical examination and possibly other tests to determine the cause of your symptoms and provide an accurate diagnosis and effective treatment plan.

You can contact the doctor if you have the following complications: 

  1. Haemorrhoids do not improve after a week
  2. Severe pain
  3. Bleeding during bowel movement
  4. Itching
  5. Inflammation and swelling

Searching for piles images online can provide visual aids for understanding the condition, but it is important to consult with a healthcare professional for a proper diagnosis and treatment plan.

Diet for Piles

The dietary habits of an individual play an important role in developing any disease condition. Staying hydrated and eating a diet rich in minerals and vitamins will help reduce the risk of developing any disease condition.

Below mentioned are some dietary measures for individuals with piles:

  • Consuming foods that are high in dietary fibre, such as wheat, brown rice, oatmeal, bran, etc., can help keep stools soft and make their passing easier
  • Including fresh fruits and vegetables in the diet
  • Drinking plenty of water prevents constipation, decreasing the need to strain while passing a bowel movement
  • Avoid caffeine (found in coffee and cola) and tea intake
  • Avoid alcohol consumption

    diet for piles treatment

Takeaway

Piles can cause discomfort and embarrassment but can be managed easily with proper knowledge and treatment. Maintaining a healthy diet with enough fibre, staying hydrated, and avoiding prolonged sitting or standing can help prevent its development.

In some cases, surgery may be necessary to treat piles. You can contact the experts at HexaHealth for the best surgical and non-surgical treatment options available for piles. 

Don't let piles hold you back! With the right knowledge and care, you can live a comfortable and confident life, free from the discomfort of haemorrhoids.

Suggested Reads

Patient Success Story - Piles Surgery

FAQs for Piles

Piles or haemorrhoids are swollen, enlarged blood vessels that form inside or outside the anus and rectum. They are the most common anorectal condition. They can be painful, uncomfortable and cause rectal bleeding.

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Piles affect people of all ages and genders. Piles in men are more common in people within the age group of 50-60 years.

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Piles can develop from increased pressure in the lower rectum due to:

  1. Straining during bowel movement
  2. Sitting for long periods on the toilet
  3. Chronic diarrhoea or constipation
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Piles can happen inside or outside the anal region. The type depends on where the swollen vein develops.

  1. External Piles: When the swollen blood vessels form underneath the skin around the anus
  2. Internal Piles: The swollen blood vessels form inside the rectum
  3. Prolapsed Piles: The internal and external piles stretch and bulge outside of the anus
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Piles symptoms can range in severity from mild to severe. The most common piles symptoms are:

  1. Pain and itching around anus
  2. Irritation in the anal region
  3. Discomfort while sitting
  4. Bleeding from the anal area
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Piles will usually go away on their own but, if they don't, you might need to have a procedure to deal with the problem. Contact HexaHealth for a free consultation with our experienced doctors.

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If piles are left untreated, they can cause the following:

  1. Bleeding
  2. Severe pain
  3. Irritation and discomfort
  4. Thrombosis (blood clotting)
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Yes, home remedies can manage and provide some relief from the symptoms of piles. Home remedies like topical ointments, sitz bath, cold compresses etc., temporarily relieve painful piles symptoms.

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You should call your doctor if you suspect haemorrhoids and experience the following:

  1. Abdominal pain
  2. Fever
  3. Chills 
  4. Nausea
  5. Vomiting
  6. Chronic constipation or diarrhoea
  7. Severe rectal bleeding and pain
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Laser treatment for piles is the most opted treatment as it is painless. It involves no stitches, minimal blood loss and other postoperative complications, and quick recovery with no chances of recurrence.

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Laser treatment for piles offers the following advantages over conventional surgery:

  1. Painless 
  2. No stitches
  3. Quick recovery
  4. Excellent success rate
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Yes, all health insurance plans cover the treatment for piles disease. Paperwork is facilitated by our team on your behalf ensuring smooth approval and a cashless facility. Contact HexaHealth for a simple cashless, and hassle-free experience.

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The piles surgery cost is variable, considering the type of hospital chosen, the grade and stage of piles, the technique recommended, the patient's medical condition based on age and other health factors, etc. Contact HexaHealth for price transparency.

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  1. Myth: All types of haemorrhoids are always painful.
    Fact: Piles don't need to be painful always. People can have both types of haemorrhoids i.e., internal haemorrhoids that develop inside the anus, which generally are not painful.
     
  2. Myth: Everyone is equally at risk of getting haemorrhoids.
    Fact: Generally, certain groups are more at risk of developing haemorrhoids. People with chronic constipation, obesity and pregnancy are often at risk of developing haemorrhoids.
    Men and women are both at increased risk of getting them if they:
    1. Strain during bowel movement
    2. Sit on the toilet for long periods
    3. Are older than age 50
       
  3. Myth: Changing the diet won’t help haemorrhoids.
    Fact: Modifying diet is one of the best ways to prevent diseases. Drinking more water, eating more fibre, and eating fresh fruits and vegetables all decrease your chance of constipation, eventually preventing the development of haemorrhoids.
     
  4. Myth: Piles treatment needs surgery.
    Fact: In most cases, piles don't need surgery to be treated. The doctor recommends surgery only when the condition is severe and if it causes discomfort and pain.
     
  5. Myth: Exercising must be avoided if you have piles.
    Fact: Exercise reduces the risk of getting piles. Generally, a person should ensure they do not lift heavy weights incorrectly by putting pressure on the pelvic muscle. 
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Piles or Hemorrhoids are a common medical condition, and there are many resources available for Piles meaning and piles images. You can also read Piles in Women to find out what piles pictures in females look like. 
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Homeopathy can help manage the symptoms. According to research by Kaushik Deb Das, six months of individualised homoeopathic treatment significantly improved hemorrhoidal symptoms like pain, bleeding, heaviness, and itching, though it didn't reduce discharge. While the results are promising, more rigorous studies are needed to draw definitive conclusions.

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Spicy food doesn't directly cause piles, but it can worsen symptoms like pain and irritation if you already have them. It's best to avoid spicy foods if you're prone to digestive issues or piles.

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Piles are swollen blood vessels in the rectum or anus, causing discomfort, bleeding, or itching. A fissure is a small tear in the lining of the anus, leading to sharp pain and sometimes bleeding during bowel movements.

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The initial approach to treating haemorrhoids is conservative therapy, which involves increasing dietary fibre, using stool softeners, and drinking more water. These changes reduce straining and the pressure exerted during bowel movements.

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Low-graded internal haemorrhoids can often be effectively treated with medications and non-surgical options, like rubber band ligation or injection sclerotherapy. In addition, a high-fiber diet, proper hydration, and stool softeners can ease symptoms and reduce the need for surgery.

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If you have piles, it's best to avoid spicy foods, caffeine, and alcohol, as they can irritate the digestive tract and worsen symptoms. Additionally, limit foods low in fibre, such as processed or refined foods, to prevent constipation and straining.

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. National Institute of Diabetes and Digestive and Kidney Diseases. Hemorrhoids. (2021).link
  2. Definition & facts of hemorrhoids. National Institute of Diabetes and Digestive and Kidney Diseaseslink
  3. Definition & facts of hemorrhoids. National Institute of Diabetes and Digestive and Kidney Diseases.link
  4. Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist’s view. World Journal of Gastroenterology. 2015;21(31):9245.link
  5. Lawrence A, McLaren ER. External Hemorrhoid [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020.link
  6. Gardner I. Benign anorectal disease: hemorrhoids, fissures, and fistulas. Annals of Gastroenterology [Internet]. 2019;link
  7. Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist’s view. World Journal of Gastroenterology. 2015;21(31):9245.link
  8. Das K, Ghosh S, Das A, Ghosh A, Mondal R, Banerjee T, et al. Treatment of haemorrhoids with individualized homoeopathy: an open observational pilot study. Journal of Intercultural Ethnopharmacology. 2016;5(4):335.link

Last Updated on: 28 August 2024

Disclaimer: The information provided here is for educational and learning purposes only. It doesn't cover every medical condition and might not be relevant to your personal situation. This information isn't medical advice, isn't meant for diagnosing any condition, and shouldn't replace talking to a certified medical or healthcare professional.

Reviewer

Dr. Hemant Kumar Khowal

Dr. Hemant Kumar Khowal

MBBS, MS General Surgery, Fellowship in Minimal Access Surgery

14 Years Experience

Dr Hemant Kumar Khowal is a well-known General Surgeon and a proctologist. He has 14 years of experience in general surgery and worked as an expert general surgeon in different cities in India. He has worked in many reputed hospital...View More

Author

Sangeeta Sharma

Sangeeta Sharma

BSc. Biochemistry I MSc. Biochemistry (Oxford College Bangalore)

6 Years Experience

She has extensive experience in content and regulatory writing with reputed organisations like Sun Pharmaceuticals and Innodata. Skilled in SEO and passionate about creating informative and engaging medical conten...View More

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