Introduction to Piles
Piles, also called as Hemorrhoids are swollen, enlarged and painful veins around the anus or lower rectum. The rectum is the last part of the large intestine which leads to the anus, from where the bowel contents leave the body. Piles often arise due to pressure or straining during bowel movements.
Other common Causes of Piles are:-

  • Sedentary lifestyle, lack of exercise or obesity
  • Improper dietary habits such as low fiber diet or excess of meat products (One must have ample of green leafy vegetables, fresh fruits and whole grain cereals eg. wheat, barley, oats, corn, rice etc)
  • Lack of Water in the body (One must drink at least 8-10 glasses of water every day)
  • Extra spicy food, excess of alcohol and caffeine rich products like tea, coffee also aggravate piles
  • Pregnancy, due to increased pressure in the veins of the anus
  • Aging
  • Hereditary
  • Irregular bowel habits and Chronic constipation
  • Anal intercourse
  • Wearing very tight-fitting clothing and undergarments made from synthetic materials acts as an irritant

Piles should not be confused with fissures. Fissures’ is a small tear, crack or a temporary injury in the lining of the anal wall which may be caused by hard stools. However piles occur when the veins in the anal wall are swollen or inflamed. 

Types of Piles
Piles can be both internal and external.

  • Internal hemorrhoids occur just inside the anus, at the beginning of the rectum. They cannot be seen or felt unless they are severe.
  • External hemorrhoids occur at the anal opening and may hang outside the anus. They can be seen and felt on the outside of the anus. When visible they look like round pink swellings of the size of a pea or a grape.

Piles can also be classified according to their position.

  • First-degree piles remain inside the rectum or anal canal.
  • Second-degree piles protrude (or prolapse) from the anus when the bowels are opened, but return of their own accord afterwards.
  • Third-degree piles are similar, but only return inside when pushed back.
  • Fourth-degree piles hang permanently outside the anus.

Signs / Symptoms of Piles
Symptoms of hemorrhoids include:

  • Itching, swelling or irritation in or around the rectum or anus
  • Painful swelling or lump around the anus
  • Anal ache or pain, especially while sitting
  • Bright red blood covering the stool, on toilet paper, or in the toilet bowl. The blood is not mixed with stools.
  • Pain during bowel movements
  • Rectal fullness, mucus discharge, and prolapsed (falling out) of the pile mass

Related Tests to Piles

  • Fecal occult blood test (FOBT)
  • Physical rectal examination
  • Anoscopy
  • Colonoscopy
  • Sigmoidoscopy
  • Barium enema x ray

Synonyms : Hemorrhoids, Rectal lump