Piles, or hemorrhoid’s, are a globally relevant problem. These are swollen veins located inside your rectum, just outside the anus that is accompanied by pain, itching and in most cases bleeding. These can be managed with at-home treatments but sometimes requires medical intervention. With this blog, we will try and understand the problem better to be able to deal with it better.

What is Piles?

Piles are enlarged veins inside the rectum around the anal area. They are often swollen, painful, and uncomfortable and cause bleeding in the rectum. They are also called hemorrhoid’s. These are present in our body since birth, and only pose a problem when they become swollen and start irritating the rectal area.

• Who can have piles? 
• While it can happen to people at any age, these are more common in old age, especially post-50 years. They can also happen in teenagers, but not in children as the hemorrhoid’s is not yet developed in them. 
• How many types of piles exist?

Since it occurs due to a swollen vein, the type of hemorrhoid’s will depend upon the location. Broadly it is of 2 types: 

• External: These are the veins under the skin of the anal area which swell up, and cause itching and pain. Sometimes it bleeds which can stay clotted in the area.
• Internal: These are located inside the rectum. They are not painful but cause bleeding nonetheless.

Both these types can extend or bulge outside the rectal cavity, these are called prolapse hemorrhoid’s. However, it is different from an anal fissure, although they have similar symptoms. Anal fissures occur due to tissue rupture whereas this happens from swelling of veins.

What are the symptoms of Piles?

Symptoms of piles depend upon the type of piles. In the case of internal piles, one hardly has any symptoms, since there is hardly any pain in this case. One might find some blood during excretion, which is a sign of rectal bleeding.

The external or prolapsed piles will have clear symptoms. These include:

• Itching in the anal cavity
• Hard lumps that feel tender or sore around the anus
• Rectal bleeding
• Pain or aching every time you sit down
• Bulging growths outside the anus that are painful

At this point, it is important to note that other conditions cause hemorrhoid’s-like symptoms, such as gastrointestinal disorders, bowel diseases, and in extreme cases colon cancer, Crohn’s disease, colitis, ulcer, etc.

When to see a doctor for Piles?

It is advisable to be observant of any of the above symptoms. Be wary of abdominal pain or chronic constipation with rectal bleeding. If you notice any of these, reach out to a doctor for advice. The doctor will perform one or more of the following procedures to determine the root cause.

• Digital rectal exam: Here the physician will insert a properly lubricated gloved finger inside the rectum to feel the veins for swelling.
• Anoscopy: A lighted tube or anoscope is used to observe the anal lining and rectum for swelling or protrusion.
• Sigmoidoscopy: A sigmoidoscopy is a lighted tube with a camera that is inserted into the lower sigmoid part of the colon and the rectum.

Based on the outcomes of these investigations, the next step will be a colonoscopy which will help detect any signs of colon cancer. These are all OPD procedures without anesthetic use. Therefore, there is nothing to be scared about.

What are the causes and risk factors of Piles?

Understanding a problem requires assessing the triggers that lead to the problem. Some of the relevant causes of piles or hemorrhoid’s are: 

• Strain in the rectum or anus. Just think of piles as varicose veins in the rectum. 
• Any sort of strain or pressure from the stomach or pelvic area will cause the rectal veins to swell and be inflamed. This pelvic pressure can be due to:
  • weight gain during pregnancy
  • constipation, leading to pushing bowels hard
  • Strain from lifting heavy objects and weights

From these causes, we can understand the primary risk factors that may lead to piles over time. These are:

• Being overweight due to obesity or pregnancy
• Eating fibre deficient diet that leads to constipation
• Presence of chronic constipation/diarrhoea
• Regularly lifting heavy weights or objects
• Strain during bowel movements

What are the treatment options available for Piles?

There are various ways in which piles can be handled. But broadly they can be categorized under home treatments and medical assistance from healthcare providers. Often in minor cases, piles heal without any treatment. If the symptoms surface, they usually last for a week.

At home, you can use over-the-counter medications over the affected area. Apart from this, you can:

• Stay hydrated and have a fibre-rich diet to ensure you don’t add constipation to make the healing slow. 
• Soak in a warm bath for about 15 minutes every day.
• Opt for laxatives to help clean out your system.
• Take steroid-free anti-inflammatory drugs to help with the condition.

If the above fails in relieving the pain, don’t lose sleep, reach out to a trusted healthcare provider and explain your situation clearly. Upon clear investigation and review of outcomes one of the following will be suggested:

• Rubber band ligation: With this technique, the blood supply to the vein is stopped and the pile is removed.
• Electrocoagulation: Another technique to administer restriction of blood flow to the piles.
• Infrared coagulation: Here a small probe is inserted around the vein, the heat from it helps remove the piles.
• Sclerotherapy: Here a chemical is injected into the swollen vein, destroying the tissue.
• Hemorrhoidectomy: Surgical process to remove large or prolapsed hemorrhoid’s.

Reach out to us in case you feel any of the symptoms above and seek medical attention from some of the best physicians in the field.

How to prevent Piles?

Piles are more common as we age. It can be prevented by maintaining a healthy lifestyle to avoid hard stools and constipation, which is the primary cause of piles. 

• Don’t push too hard while pooping. 
• Visit the toilet only when the urge hits, but don’t delay bowel movements.
• Hydrate and drink lots of water throughout the day.
• Use high-fibre foods in your diet. (For women at least 25 gms & men 35 gms)
• Use laxatives to keep bowel movements regular.
• Stay physically active. 

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FAQ’s

Q1. How do Piles go away? Can Piles be cured permanently?

A. Sometimes piles can be cured by themselves without the person knowing they have piles. This happens in the case of internal piles where there is hardly any pain. For an external incident, over-the-counter ointments or the help of a medical practitioner will help treat the concern faster. With at-home remedies, piles can be managed but not cured completely. For that one needs to have surgical intervention. 

Q2. How long do Piles take to heal?

A. The symptoms of piles last mostly for a week. If it goes away after seven days with over-the-counter medicine, then it has healed. If not, the help of a medical practitioner is required. Depending on the severity of the case and the stage of the piles the healing timeline will differ. 

Q3. Can stress cause Piles?

A. By stress, if we mean putting pressure on the pelvic muscles, then yes. Apart from this, when we are mentally stressed out, our blood pressure is increased. In such a case also the existing condition of piles will worsen. Also, more stress leads to more consumption of alcohol, which in turn dehydrates the body, therefore worsening the piles. 

Q4. What is the main cause of Piles?

A. The main cause of piles is constipation and improper bowel movements. If our stools are not soft and we spend hours in the washroom trying to pass them then it is a warning sign. The more pelvic pressure is applied the greater the chances of rectal bleeding. All of these are eventually the symptoms that show up in piles. So working at the root will help make things better, start by having a healthy diet rich in fibre that will assist in the process of passing stools.  

Q5. What are the stages of Piles?

A. Medically internal piles have four grades: 

• Grade I: There are no symptoms and no protrusions from the anus.
• Grade II: The piles may prolapse but also recede inside, independently.
• Grade III: The prolapsed piles only recede with manual intervention.
• Grade IV: The piles prolapse outside of the anus and can’t be pushed in.