Piles (haemorrhoids) are lumps inside and around your bottom (anus). They often get better on their own after a few days. There are things you can do to treat and prevent piles.
Piles are swollen veins in the lower anus and rectum. This swelling can cause localized inflammation of other tissues. Piles is another term for hemorrhoids.
Many people have piles, but the symptoms are not always obvious. Hemorrhoids cause noticeable symptoms for at least 50%Trusted Source of people in the United States over 50 years of age.
This article will explore piles, their causes, how to diagnose, grade, and treat them, and what effects they might have on the body.
What are piles?
Piles are the result of swollen veins in the lower anus and rectum. They can cause tissue growths in and around the anus and can lead to significant discomfort. These growths can vary in size and location.
Internal vs. external pile
Internal piles occur within the rectum and are usually not visible during an external examination. However, in some cases, an external pile may grow to protrude outside of the anus. The medical term for this is prolapsed hemorrhoid.
Medical professionals’ grade internal piles on a four-point scale.
- Grade I: The growth does not cause symptoms and does not protrude out of the anus.
- Grade II: The piles may prolapse from the anus but return inside independently.
- Grade III: The piles prolapse and only recede within the anus with manual intervention.
- Grade IV: The piles prolapse outside of the anus and a person cannot push them back in.
External piles form small lumps on the outside edge of the anus. They are very itchy and can become painful if a blood clot develops because the clot can block blood flow. Thrombosed external piles, or hemorrhoids that have clotted, require immediate medical treatment.
Common Symptoms and Causes of piles (Hemorrhoids).
What are the symptoms of piles (hemorrhoids)?
In many cases, the symptoms of piles are not serious and resolve on their own.
An individual with piles may experience the following:
- painful lumps in and around the anus
- itching and discomfort around the anus
- discomfort during and after passing stools
- bloody stools
Piles can escalate into a more severe condition. These may include the following:
- excessive anal bleeding, possibly leading to anaemia.
- infection
- fecal incontinence
- anal fistula
- strangulated hemorrhoid, in which anal muscles cut off blood supply to the hemorrhoid..
When should I seek a doctor’s help?
You should seek a doctor’s help if you
- have bleeding from your rectum
- still have symptoms after 1 week of at-home treatment
Causes
Piles result from increased pressure in the lower rectum.
The blood vessels around the anus and the rectum will stretch under pressure and may swell or bulge, forming piles. This may be due to:
- chronic constipation
- chronic diarrhea
- lifting heavy weights
- straining when passing a stool
Risk factors
Certain factors may increase a person’s risk of developing piles, these include:
- Pregnancy: Up to 50%Trusted Source of people experience hemorrhoids during pregnancy. This is due to increased pressure on the pelvis, a person having a higher blood volume, and a higher incidence of constipation.
- Age: Piles are more common in older adults. Around half Trusted Source of people over the age of 50 develop piles.
- Weight: Research suggests that someone with a higher weight may increase Trusted Source a person’s chance of developing piles.
- Diet: Eating a diet low in fiber may increase the likelihood Trusted Source of a person having piles.
Diagnosis
A doctor can usually diagnose piles after carrying out a physical examination. They will examine the anus of the person with suspected piles.
The doctor may ask the following questions:
- Do any close relatives have piles?
- Has there been any blood or mucus in the stools?
- Has there been any recent weight loss?
- Have bowel movements changed recently?
- What color are the stools?
For internal piles, the doctor may perform a digital rectal examination (DRE) or use a proctoscope. A proctoscope is a hollow tube fitted with a light. It allows the doctor to see the anal canal up close. They can take a small tissue sample from inside the rectum for analysis.
The physician may recommend a colonoscopy if the person with piles presents signs and symptoms that suggest another digestive system disease, or they are demonstrating any risk factors for colorectal cancer.
Treatments
It’s important to consult with a healthcare professional for advice tailored to your specific situation. Here are some general suggestions for the treatment of piles:
- Dietary Changes:
- Increase fiber intake: Consuming more fiber helps soften the stool and reduces the strain on the rectum during bowel movements. Good sources of fiber include fruits, vegetables, whole grains, and legumes.
- Stay hydrated: Drinking plenty of water helps prevent constipation, which can aggravate hemorrhoids.
- Good Toilet Habits:
- Avoid straining: Straining during bowel movements can exacerbate hemorrhoids. Take your time and avoid excessive pushing.
- Use moist wipes: Consider using moist toilet wipes instead of dry toilet paper to clean the anal area gently.
- Warm Baths:
- Take warm baths: Soaking in a warm bath (sitz bath) for about 15 minutes several times a day can help relieve symptoms.
- Over-the-Counter Medications:
- Use creams and ointments: Over-the-counter creams or ointments containing hydrocortisone can help reduce itching and inflammation.
- Pain relievers: Non-prescription pain relievers such as acetaminophen or ibuprofen may help alleviate discomfort.
- Prescription Medications:
- In some cases, a doctor may prescribe medications to help reduce swelling or to relieve symptoms.
- Medical Procedures:
- Rubber band ligation: In this procedure, a rubber band is placed around the base of the hemorrhoid to cut off blood supply, causing it to shrink and fall off.
- Sclerotherapy: A solution is injected into the hemorrhoid, causing it to shrink.
- Infrared coagulation: Infrared light is used to coagulate the blood vessels feeding the hemorrhoid.
- Surgical Options:
- Hemorrhoidectomy: In severe cases, surgical removal of hemorrhoids may be recommended.
Medications
The choice of medications for piles (hemorrhoids) will depend on the severity of symptoms and individual health conditions. Here are some common over-the-counter and prescription medications that healthcare providers may recommend:
- Over-the-Counter (OTC) Medications:
- Topical Creams and Ointments: Many over-the-counter creams and ointments contain ingredients such as hydrocortisone, witch hazel, or lidocaine. These can help reduce itching, inflammation, and discomfort.
- Wipes and Pads: Medicated wipes or pads with witch hazel or aloe vera can be used for cleaning the anal area after bowel movements.
- Oral Pain Relievers: Non-prescription pain relievers like acetaminophen or ibuprofen may help alleviate pain and discomfort.
- Stool Softeners and Fiber Supplements: Over-the-counter stool softeners or fiber supplements can help prevent constipation and make bowel movements more comfortable.
- Prescription Medications:
- Prescription-Strength Creams: If over-the-counter options are not effective, a healthcare provider may prescribe stronger creams or ointments.
- Suppositories: Prescription-strength suppositories containing corticosteroids or other anti-inflammatory medications may be recommended.
- Pain Medications: In some cases, prescription pain medications may be prescribed for more severe pain.
- Procedures and In-office Treatments:
- Sclerotherapy: A solution is injected into the blood vessels around the hemorrhoid to shrink it.
- Rubber Band Ligation: This involves placing a rubber band around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off.
- Infrared Coagulation: Infrared light is used to coagulate the blood vessels, causing the hemorrhoid to shrink.
- Surgery:
- Hemorrhoidectomy: In severe cases, surgical removal of hemorrhoids may be recommended.
Prevention
Preventing hemorrhoids (piles) involves adopting healthy lifestyle habits and making choices that reduce the risk of developing these swollen blood vessels in the rectum or anus. Here are some preventive measures:
Dietary Changes:
Fiber-rich diet: Eat a high-fiber diet with plenty of fruits, vegetables, whole grains, and legumes. Fiber adds bulk to stool, making it easier to pass without straining.
Hydration:
Adequate water intake: Stay well-hydrated by drinking plenty of water throughout the day. Sufficient hydration helps prevent constipation.
Good Toilet Habits:
Avoid straining: Straining during bowel movements can contribute to the development of hemorrhoids. Take your time and avoid pushing excessively.
Use moist wipes: Instead of dry toilet paper, consider using moist wipes or baby wipes to clean the anal area gently.
Regular Exercise:
Physical activity: Engage in regular exercise to promote healthy bowel movements and prevent constipation. Activities such as walking, swimming, and yoga can be beneficial.
Weight Management:
Maintain a healthy weight: Having a higher weight can increase the risk of developing hemorrhoids. Maintain a healthy weight through a balanced diet and regular exercise.
Avoid Prolonged Sitting:
Take breaks: If your work involves prolonged sitting, take breaks to stand and stretch. Prolonged sitting can contribute to increased pressure in the rectal area.
Avoid Straining:
Proper lifting technique: When lifting heavy objects, use your legs rather than straining with your back to avoid unnecessary pressure on the rectal area.
Fiber Supplements:
Supplements: If it’s challenging to get enough fiber from your diet, consider fiber supplements. However, it’s always better to get fiber from natural food sources.
Regular Health Check-ups:
Regular medical check-ups: If you have a family history of hemorrhoids or are prone to developing them, discuss preventive measures with your healthcare provider.
Prompt Treatment of Symptoms:
Address symptoms early: If you experience symptoms like itching, discomfort, or bleeding, seek medical attention promptly. Early intervention can prevent the worsening of hemorrhoids.
Avoid Long Hours on the Toilet:
Limit time on the toilet: Avoid spending extended periods on the toilet, as this can increase pressure on the rectal veins.
Elevate Feet During Bowel Movements:
Use a stool or footstool: Elevating your feet while on the toilet can help achieve a more natural position for bowel movements.