External and Internal Hemorrhoids/piles , what’s the difference?

एंटीबायोटिक्स : अंधाधुंध प्रयोग के दुष्परिणाम
Piles during pregnancy and after delivery : Ayurveda treatment

External and Internal Hemorrhoids/piles , what’s the difference?


Author: Dr. Rahul Chauhan

Consulting Procto-surgeon, Shri Dhanwantari Clinic, Ghaziabad

Hemorrhoids , also called piles are swollen veins in your rectum and anus. The walls of these blood vessels ,sometimes stretch so thin that the veins bulge and get irritated, especially at the time of passing out stool.

Hemorrhoids/piles are classified in two types based on their location; External Hemorrhoids and Internal Hemorrhoids


External hemorrhoids :

These are  present outside the dentate line, under the skin around anus. They have sensory nerve endings, so they are often associated with pain, if inflamed or infected or thrombosed. Usually there is no bleeding in case of external hemorrhoids. In inflamed condition they are usually present at 3, 7 and 11 o’clock position, if observed under lithotomy position.

Internal hemorrhoids :

– These are situated above the dentate line / inside the anal canal. Therefore they are usually not visible unless inflammed or prolapsed .

– These are covered by mucous membrane and have no or minimum sensory nerves, therefore these are generally painless.

– The bleeding occurs when the person strains during passing of stool, in the form of drops or as stream in large amounts, but bleeding is usually painless.

– In advanced conditions the internal pile mass prolapses and comes out of the anal sphincter and appears as soft , more pinkish inflamed skin fold.

Ayurveda treatment of Piles/Hemorrhoids :

Initial stages of bleeding and inflammation can be controlled by using medicines, both orally and by local application. But in advanced stages, medicine alone is not enough to deal with the condition. Here surgery/kshar sutra play an important role in bringing the patient out of pain and bleeding.

Kshar sutra treatment in Piles :-

Kshar sutra ligation procedure is a minimally invasive, safe and way less painful and economical option, if we talk about surgical removal of both internal and external hemorrhoids. In this procedure the pile masses are ligated with a medicated alkaline thread called as kshar sutra, under anesthesia and the inflammed pile masses get necrosed and shed off within 10-15 days of procedure.

Also , the patient can regain his normal lifestyle and working schedule after 2-4 weeks of procedure.

Thanks for patiently reading this article. I hope Hemorrhoids/Piles and constipation patients will be benefitted by these tips. If however, you still have any query/doubt regarding your disease, you can e-mail me at consult@ayurvedapilescure.com

You must contact us if you are looking for Piles treatment by Ayurvedic ways.

You may call our helpline number +91-9818069989 for having appointment with our expert doctors.

एंटीबायोटिक्स : अंधाधुंध प्रयोग के दुष्परिणाम
Piles during pregnancy and after delivery : Ayurveda treatment

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