The controversies that exist about its nature and the best method of its treatment only indicates that we are still not sure as to what are haemorrhoids, why do they occur, and what is the best method to treat them. Common impression is that no treatment is totally satisfactory and most methods have some unacceptable morbidity and annoying failures. It seems that the last word has not been spoken yet. After examining over 25,000 patients and operating on about 12,000 patients I feel that almost everybody is right. The modalities of treating haemorrhoids, over last 3000 years have remained more or less same with scientific refinements which appear to be 'changes'.
All present methods have roots deep down in the past.
Ointments made from herbs and oils, cauterising piles with red hot irons, tying ligatures of threads, ice packs, leeches, hot baths, applying caustics and rectal bouginage were all used by our ancestors during last 3000 years. During the 19th century, ligature and sclerosants remained standard methods. Ligature was extended to ligature and excision during evolution of surgical methods, in early 20th century. Besides destroying piles, attention was focussed to sphincter, towards middle of 20th century and various types of sphincterotomies were evolved. Haemorrhoidectomy remained a more acceptable method over last century.