Piles, also known as hemorrhoids, are swollen and inflamed veins in the rectum and anus. They can cause discomfort, pain, and bleeding, especially during bowel movements. Piles are a common condition and can be classified into two main types: internal and external. Here we will explore everything you need to know about piles, including their symptoms, causes, diagnosis, and treatment options.
What Are Piles?
Piles develop due to increased pressure in the lower rectum, which causes the veins to swell and become inflamed. The condition is often associated with straining during bowel movements, chronic constipation, or prolonged sitting. Hemorrhoids are generally harmless but can cause significant discomfort and affect quality of life.
Types of piles
- Internal Piles: These occur inside the rectum and are usually not visible. They may not cause pain but can lead to bleeding during bowel movements.
- External Piles: These are located under the skin around the anus. They can be painful, itchy, and may form hard lumps.
Symptoms of piles
The symptoms of piles depend on their type and severity. Common signs and symptoms include:
Internal piles:
- Painless bleeding during bowel movements.
- Blood-stained toilet paper or stool.
- A feeling of incomplete evacuation.
- Prolapsed hemorrhoids that protrude through the anus, which may cause discomfort.
External piles:
- Itching and irritation around the anus.
- Swelling and lumps near the anal opening.
- Pain or discomfort, especially when sitting or during bowel movements.
- Bleeding from the anal area.
Severe cases:
- Thrombosed hemorrhoids (blood clots within external piles) that cause intense pain and swelling.
- Permanent bleeding leads to anemia.
Causes and Risk Factors
Piles can result from various factors that increase pressure on the veins in the rectal and anal areas. Common causes and risk factors include:
- Chronic constipation or diarrhea: Strained during bowel movements puts excessive pressure on the rectal veins.
- Prolonged sitting: Sitting for long periods, especially on the toilet, can increase rectal pressure.
- Obesity: Excessive weight adds strain to the pelvic and rectal areas.
- Pregnancy: Increased blood volume and pressure from the growing uterus can lead to piles.
- Low-fiber diet: Insufficient dietary fiber results in hard stools and straining.
- Aging: Weakened rectal and anal tissues with age increase the risk of piles.
- Heavy lifting: Regular heavy lifting can raise abdominal pressure.
Diagnosis of piles
A healthcare provider can diagnose piles through a combination of a medical history, physical examination, and diagnostic tests.
Medical history:
- The doctor will ask about symptoms, bowel habits, and any family history of hemorrhoids or related conditions.
Physical examination:
- Visual Inspection: External piles can be easily observed around the anal area.
- Digital Rectal Exam: The doctor may insert a gloved, lubricated finger into the rectum to check for internal piles or other abnormalities.
Diagnostic tests:
- Anoscope: A small, lighted tube is inserted into the rectum to view internal piles.
- Sigmoidoscopy: This test examines the lower part of the colon and rectum using a flexible tube with a camera.
- Colonoscopy: Recommended if piles are accompanied by other symptoms like unexplained weight loss or changes in bowel habits, to rule out other conditions such as colorectal cancer.
Treatment of piles
The treatment for piles varies depending on the severity and type of hemorrhoids. Options range from home remedies and lifestyle changes to medical procedures.
1. Home remedies and Lifestyle Changes
Dietary modifications:
- Increase your fiber intake by consuming fruits, vegetables, whole grains, and legumes.
- Drink plenty of water to soften stools and prevent constipation.
- Avoid spicy foods and alcohol, which can irritate the digestive system.
Hygiene and comfort:
- Keep the anal area clean and dry.
- Use moist wipes or damp toilet paper instead of dry tissue.
- Take warm sitz baths for 15-20 minutes, 2-3 times a day, to relieve itching and discomfort.
Over-the-Counter Treatments:
- Use topical creams, ointments, or suppositories containing hydrocortisone or witch hazel to reduce inflammation and pain.
- Apply cold compresses or ice packs to reduce swelling.
2. Medical treatments.
Non-surgical Procedures:
- Rubber Band Ligation: A small rubber band is placed around the base of an internal hemorrhoid to cut off blood supply, causing it to shrink and fall off.
- Sclerotherapy: A chemical solution is injected into the hemorrhoids to shrink them.
- Infrared Coagulation: Heat is applied to cause the hemorrhoids to harden and shrink.
- Electrocoagulation: Electrical current is used to cut off the blood supply to the hemorrhoid.
Surgical Procedures:
- Hemorrhoidectomy: The surgical removal of large or severe hemorrhoids. This procedure is highly effective but may require a longer recovery.
- Stapled Hemorrhoidopexy: A circular stapling device repositions and secures the hemorrhoids, cutting off blood supply.
- Thrombectomy: For thrombosed hemorrhoids, the clot is surgically removed to relieve pain.
Prevention of Piles
Preventive measures can significantly reduce the risk of developing piles or prevent recurrence after treatment. These include:
- Maintain a high-fiber diet:
- Incorporate fiber-rich foods to promote healthy bowel movements and prevent straining.
- Stay hydrated:
- Drink at least 8-10 glasses of water daily to keep your stools soft.
- Exercise regularly:
- Engage in moderate physical activities like walking or yoga to improve bowel function and reduce pressure on the veins.
- Avoid straining:
- Don’t delay bowel movements, and avoid excessive straining or sitting on the toilet for prolonged periods.
- Practice good hygiene:
- Gently clean the anal area after bowel movements and avoid harsh or scented soaps.
- Manage body weight:
- Maintain a healthy weight to reduce pressure on the rectal veins.
Complications of untreated piles
If left untreated, piles can lead to complications, such as:
- Anemia: Chronic blood loss from bleeding hemorrhoids can result in low red blood cell levels.
- Strangulated Hemorrhoid: When the blood supply to a prolapsed hemorrhoid is cut off, it can cause severe pain and tissue death.
- Infections: Swollen tissue can become infected, leading to abscesses or fistulas.
Piles are a common yet manageable condition. With the right combination of lifestyle changes, home remedies, and medical treatments, most people can find relief and prevent recurrences. If symptoms persist or worsen, it is essential to seek medical advice for proper diagnosis and treatment. By taking proactive steps, you can effectively manage piles and improve your quality of life.
