Prolapsed piles are inflamed tissue that protrudes outside the anus. Piles are also known as hemorrhoids. The swollen tissue may retract automatically into the rectal cavity after a bowel movement, or may only be able to be physically pushed back inside the rectal cavity. Changes in diet may relieve the symptoms of piles, but some prolapsed piles require surgery.
Symptoms of prolapsed piles usually begin with itching around the anal area. There may be swelling of the anal tissue that is noticeable when cleaning the anus after having a bowel movement. The swollen area can become painful to sit on and can disrupt daily activities. Blood may be visible on undergarments or on toilet paper after a bowel movement as well.
The soft tissue that forms prolapsed piles is called the anal cushions. People who eat a low fiber diet and frequently strain to pass bowel movements are more likely to develop piles. Pregnant women can develop piles from the extra pressure the fetus places on the pelvic area. Older people develop piles as they age because the muscle tone of the rectal cavity weakens and requires more effort to pass bowel movements.
Prolapsed piles may be prevented by eating a high fiber diet and drinking lots of water. The fiber promotes healthy peristaltic action in the intestines, and water will help the stool stay soft for easier passage through the anus. A mild exercise program also can encourage the movement of fecal matter through the intestinal passage.
Treatment for piles depends on the severity of the symptoms. The pain and itching of mild piles can be relieved by warm sitz baths and keeping the area clean from fecal matter. There also are many creams and ointments available that can soothe the inflamed tissue, and some contain a local anesthetic to numb the area.
Surgical treatment of prolapsed piles may become necessary if the condition interferes with daily activities. A physician may perform a procedure called banding, which is an elastic band placed above the prolapsed tissue in the rectal cavity. The band cuts off the blood supply to the piles, causing the tissue to suffocate and fall off a few days after the procedure.
Another procedure called sclerotherapy is helpful for some patients with prolapsed piles. The inflamed tissue is injected with an oily substance that causes the piles to shrink away. For patients who are not able to obtain any relief with either banding or sclerotherapy, a physician may recommend cryosurgery. During this method, the piles are frozen until the tissue dies and falls off.
Infrared laser or coagulation therapy is used for some patients to seal off the enlarged veins above the piles. The treated piles will shrink and eventually fall off. A different process called direct current electrotherapy is used to burn the pile, causing the tissue to shrivel and die.
The conventional surgical removal of piles is an invasive procedure. The operation is done under anesthesia, and usually is an outpatient procedure. A surgeon will cut away the pile from the rectal muscle and the incision is sewn together. Some doctors prefer a staple process, which is thought to shorten healing time and promote a less painful recovery.