Piles, also known as hemorrhoids, are swollen veins located in and around the anus and rectum. They are very common, with about 50% of people experiencing them at some point in their lives. The most common symptoms of piles include bleeding, itching, swelling, irritation, and pain. While piles can sometimes go away on their own, they often come back. So do piles actually get bigger and smaller over time? Let’s take a closer look.
What causes piles?
Piles occur when the tissues and blood vessels around the anus become swollen and inflamed. There are two types of piles:
- Internal piles occur inside the rectum and are not visible from outside.
- External piles occur underneath the skin around the anus and are visible from the outside.
Piles can be caused by a number of factors, including:
- Chronic constipation and straining to pass stools
- Pregnancy – the extra weight and pressure from the baby can cause veins to swell
- Age – piles become more common as people get older
- Heredity – some people are just prone to developing piles
- Chronic diarrhea
- Obesity
- Lifting heavy objects
- Prolonged sitting or standing
When straining to pass stools, the pressure forces the veins in the anus and rectum to stretch and swell. Over time, they can form into lumps or piles. Pregnancy can also increase pressure in the veins due to the weight of the uterus.
Do piles start off small and get bigger?
Yes, piles often start off quite small, but they can grow larger over time if left untreated. Here’s a bit more about the progression:
- At first, piles may be tiny swellings that bulge out from the anus when straining to pass stools.
- As they grow, they can form into lumps or clusters of swollen tissue that hang down from the rectum.
- Larger piles may remain prolapsed outside of the anus and can become quite painful.
- Eventually, very large piles can swell to the size of grapes or golf balls.
Piles are classified into 4 grades based on their size:
| Grade | Size |
|---|---|
| Grade 1 | Small swellings inside the anus. |
| Grade 2 | Larger lumps that may partly protrude from the anus. |
| Grade 3 | Prolapsed piles that need to be pushed back in. |
| Grade 4 | Permanently prolapsed and cannot be pushed back inside. |
As you can see, the piles increase in size from grade 1 through grade 4. The smallest are tiny internal swellings, while the largest are big, protruding lumps.
What causes piles to shrink?
While piles often gradually get larger over time, they can also shrink and reduce in size. Here are some reasons piles may shrink or go away:
- Improved diet – Eating more fiber and staying hydrated can soften stools and reduce straining.
- OTC medications – Creams, ointments, and suppositories can reduce swelling and pain.
- Sitz baths – Warm water soaks can improve blood flow and relax the area.
- More exercise – This can prevent constipation which reduces pressure on the veins.
- Ice packs – Applying ice can constrict blood vessels and reduce swelling.
- Procedures – Rubber band ligation, sclerotherapy, infrared coagulation can get rid of piles.
- Surgery – Removal of larger piles that don’t respond to other treatments.
Making lifestyle changes like adding fiber, exercising more, and drinking water can help prevent and treat constipation. This reduces straining during bowel movements so the piles aren’t under constant pressure. Medications, sitz baths, and minimally invasive procedures can also shrink piles by improving circulation and reducing inflammation.
Are piles sometimes temporary?
Yes, in some cases piles can be a temporary condition. Piles that are caused by a specific trigger may go away once that trigger is no longer present. Here are some examples:
- Pregnancy piles – Up to 40% of pregnant women experience piles due to the pressure from the fetus. These piles often resolve after giving birth.
- Short-term constipation – Constipation from medications, dietary changes, or short illnesses can lead to temporary straining and piles.
- Long distance travel – Sitting for very long periods on planes or in cars can temporarily cause blood pooling in the rectal veins.
- Diarrhea or vomiting illnesses – Severe vomiting and diarrhea can irritate the anus and cause temporary piles.
However, piles caused by chronic underlying issues like chronic constipation, obesity, aging, and genetics tend to come back after initially improving or going away for a while. Managing these underlying causes is important for long-term relief.
Can you make piles go away completely?
Some early, grade 1 piles can go away completely with at-home treatments like over-the-counter creams, dietary changes, exercise, and sitz baths. However, larger, more severe piles are less likely to go away permanently without medical procedures.
Here are some pros and cons of methods to completely get rid of piles:
| Method | Pros | Cons |
|---|---|---|
| Diet & lifestyle changes | – Non-invasive – No side effects |
– Takes time – Doesn’t always work – Piles may come back |
| Medications & ointments | – Treat symptoms – Easily accessible |
– Temporary relief – Piles may come back |
| Minimally invasive procedures | – Effective – Minimal recovery time |
– May require multiple treatments – Small risk of complications |
| Surgery | – Highest success rate – Permanent removal |
– Risk of complications – Longer recovery time |
As you can see, while conservative at-home treatments are worth trying, invasive procedures or surgery offer the best chance for complete, permanent removal of large piles. But they also have a higher risk of complications like bleeding or infection.
Conclusion
In summary, piles often start off small but can grow larger and more severe over time. The exact progression varies between individuals though. Small piles caused by temporary triggers may go away completely without treatment. But chronic, long-standing piles are less likely to go away permanently without medical procedures. While piles can shrink down temporarily with various treatments,grade 3-4 piles in particular tend to return without definitive surgical removal. Maintaining a high fiber diet, exercising, not straining, and seeing a doctor if symptoms persist are key to managing piles over the long-term.