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Piles: Causes, Symptoms, Treatment, Prevention

Piles (Haemorrhoids) is a medical condition which is characterized by swelling of blood vessels in and around the anus and rectum.

Piles are also known as Hemorrhoids. Haemorrhoids are masses or cushions of tissue in the anal canal that is full of blood vessels, tissues, muscle and elastic fibres. Gradually, these swellings further descend with the passage of stools and finally protrude out of the anus becoming visible.

Piles vary in size and can affect people of any age though it is more common in elderly people and during pregnancy.


Types of Piles (Hemorrhoids)

Based on their location of appearance, piles are classified into two – Internal and External.

1 :: Internal. This type of piles is the most common type which is present in the upper part of the anal canal. They are not visible until they protrude outside the anus. Internal piles are usually painless as there are no pain nerve fibres present in the upper anal canal. Bleeding may be present in internal piles.

2 :: External. They lie in the lower part of the anal canal and are generally troublesome. As the lower part of the anal canal is rich with pain nerve fibres, external piles may be painful. External piles are also known as perianal haematoma.



Grade 1 – Small swellings are present on the inner lining of the anal canal which is not visible from outside the anus. Piles of this grade are common.

Grade 2 – Larger swellings are present which protrudes out while passing stools but recedes back on its own.

Grade 3 – Piles prolapsed during stools but fail to recede back on its own, they can be reduced manually with a finger.

Grade 4 – Swellings hang out from the anus and cannot be pushed back inside.



Piles (Hemorrhoids) are a resultant of stretching of blood vessels around the anus and in the rectum under pressure. There are numerous causes leading to increase in pressure, such as

1 :: Obesity;

2 :: Diarrhoea;

3 :: Pregnancy;

4 :: Cancer of colon;

5 :: Spinal cord injury;

6 :: Wrong food Habits

7 :: Lifting heavy weights;

8 :: Chronic constipation;

9 :: Imbalanced Lifestyle;

10 :: Hereditary factors; etc.

11 :: Previous rectal surgery;

12 :: Prolonged sitting in the toilet;

13 :: Consumption of low-fibre diet;

14 :: Straining during bowel movements;



Symptoms may range from mild and temporary to painful and persistent. In few cases, the symptoms are mild and may subside without the requirement of any treatment. Some of the symptoms experienced are

1 :: Burning;

2 :: Irritation;

3 :: Rectal pain;

4 :: Anal itching;

5 :: Mucus anal discharge;

6 :: Protrusion and swelling near the anal region;

7 :: Pain or tenderness during bowel movements;

8 :: Passing of bright red blood from anus. Stools may be blood streaked.


Diagnosis and Treatment

Piles can be diagnosed by performing physical examination of the anus and rectum. Proctoscopy is another procedure that is conducted to examine the anal canal and rectum for the clinical diagnosis of Haemorrhoids. Below mentioned are a few modes of treatment…

1 :: Painkillers are administered to alleviate pain.

2 :: Surgery is done when other modes fail to respond.

3 :: Injection sclerotherapy causes falling off of the piles.

4 :: Sitz bath – Sitting in warm water for 10 – 15 minutes.

5 :: Stool softeners are given to decrease straining and constipation.

6 :: Infrared Coagulation treatment leads to shrinking of the haemorrhoids.

7 :: Creams, ointments and suppositories prescribed to relieve swelling and inflammation.

8 :: Banding – In this procedure, a rubber band is placed at the base of the hemorrhoids, cutting off its blood supply which leads to the dropping off of the piles. This is usually indicated in grade 2 & 3 hemorrhoids.



Best way to prevent hemorrhoids is to prevent constipation. Below are mentioned a few tips which can help in keeping your stools soft…

1 :: Avoid straining at stools.

2 :: Consume fibre rich foods.

3 :: Encourage regular exercises.

4 :: Avoid prolonged sitting in the toilet.

5 :: Avoid medications that cause constipation.

6 :: Intake of plenty of fluids should be encouraged.

7 :: Avoid intake of alcohol and drinks containing caffeine.

8 :: Pass bowels as soon as the urge is felt, waiting can harden the stools.

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