Piles, also known as hemorrhoids, are swollen veins located around the anus or in the lower rectum. They are common and affect nearly 50% of people at some point in their lifetime. There are many reasons why people get piles.
What are piles?
Piles are swollen veins that develop around the anus and lower rectum. There are two types:
– Internal piles occur inside the anus and often cannot be seen or felt. They are usually painless.
– External piles occur outside the anus and can be seen or felt as soft lumps. They are often painful.
Some key facts about piles:
| Affects | Nearly 50% of people |
| Types | Internal and external |
| Symptoms | Pain, itching, bleeding, swelling around anus |
| Causes | Constipation and straining, increased pressure in lower rectum |
Piles develop when the veins around the anus and lower rectum become stretched and swollen. The exact cause is often unknown, but they are associated with increased pressure in the lower rectum.
What causes piles?
There are several factors that can increase your risk of developing piles:
Constipation and straining: Straining during bowel movements puts extra pressure on the veins. Chronic constipation leads to straining.
Pregnancy: Hormonal changes and increased pressure from the baby on the veins. Piles are common during pregnancy.
Obesity: Excess weight increases pressure in the lower abdomen and rectum.
Aging: The tissues around the anus weaken over time. Piles are more common in older adults.
Persistent coughing or sneezing: This increases abdominal pressure.
Heavy lifting: This can also increase abdominal pressure.
Long periods of sitting or standing: Blood pools in the veins of the rectum and anus, leading to swelling.
Low fiber diet: A lack of fiber can lead to constipation and straining.
Spinal cord injury: Loss of sensation leads to excessive straining.
Anal intercourse: This can irritate and damage the lining of the anus and rectum.
Family history: Some people may inherit a weakness in the veins that makes them prone to piles.
How do you know if you have piles?
The most common symptom of piles is bleeding after going to the toilet. Other symptoms include:
– Pain, soreness, redness or swelling around the anus
– Itching or irritation around the anus
– A lump hanging down outside the anus, which may need to be pushed back in after passing a stool
– Mucus discharge after passing a stool
– Difficulty cleaning the anus after a bowel movement due to soreness
If piles are not visible externally, a doctor may perform a digital rectal exam. They can feel internal piles by gently inserting a lubricated, gloved finger into the anus.
Further tests like a sigmoidoscopy or colonoscopy can also be done to examine the rectum and colon. This allows internal piles to be identified.
What problems can piles cause?
In most cases piles are minor and do not cause any issues other than bleeding and discomfort. However, they can sometimes lead to:
Anemia: If bleeding is severe, piles can cause anemia (low red blood cells) due to loss of iron.
Strangulated piles: If the blood supply to a pile is cut off it can become strangulated. This causes extreme pain and may require surgery.
Anal fissures: Piles can irritate and stretch the anal skin, causing painful tears called fissures.
Abscesses: A collection of pus around a pile can lead to an abscess. This causes pain and swelling.
Who gets piles?
Piles can affect anyone, but are more common in certain groups:
– Pregnant women – Due to increased pressure from the baby and hormonal changes
– People aged 45-65 – Around half have piles by age 50 due to tissues weakening
– Overweight or obese people – Extra pressure on pelvic veins
– People with chronic constipation – Leads to straining
– Individuals with a family history – Weak veins may be inherited
Piles affect men and women equally and occur most often in middle aged to older adults. Some studies report a higher rate in men. People who sit for long periods daily for work may also have increased risk.
How are piles treated?
Most mild cases of piles can be treated at home with simple measures:
Over-the-counter topical treatments: Ointments, creams, suppositories and medicated wipes can relieve swelling, itching and pain. Common ingredients include hydrocortisone, witch hazel and lidocaine.
Sitz baths: Sitting in a few inches of warm water for 10-15 minutes can reduce swelling and soothe piles.
Ice packs: Applying an ice pack wrapped in cloth can reduce swelling.
Oral pain relievers: Non-steroidal anti-inflammatory drugs like ibuprofen can ease discomfort.
High fiber diet: Increasing fiber intake can reduce constipation and straining.
Stay hydrated: Drinking plenty of fluids prevents constipation.
If home treatments do not improve symptoms within 1-2 weeks, medical treatments may be recommended:
– Medications like vasoconstrictors to shrink piles
– Ligation – Rubber bands placed around piles to cut off blood supply
– Sclerotherapy – Injecting chemicals into piles to scar and shrink them
– Infrared coagulation – Using heat to scar and shrink piles
– Surgery – Full removal of piles that do not respond to other treatments
Most people are able to manage piles successfully and prevent recurrence with at-home remedies and lifestyle changes. But severe, persistent cases may require medical procedures for relief.
How can piles be prevented?
While the exact cause of piles is unknown, the following tips may help prevent them:
Avoid constipation and straining: Eat a high fiber diet, stay hydrated and avoid sitting on the toilet for long periods.
Lose excess weight: This reduces pressure on the veins.
Exercise regularly: Physical activity can prevent constipation.
Avoid prolonged sitting and standing: Take regular breaks, stretch and walk around.
Practice good bathroom habits: Do not delay bowel movements. Avoid reading on the toilet.
Improve posture: Slouching and sitting hunched over can increase strain.
Consider a squatting position: Elevating the feet with a stool while on the toilet mimics a squatting posture that relaxes the rectum.
Be gentle: Avoid aggressive wiping and clean the area gently after a bowel movement.
Avoid lifting heavy objects: Use proper technique and get help when needed.
Making lifestyle changes to have regular, soft bowel movements is key to preventing piles from developing or recurring. Seeking early treatment can also stop piles from worsening.
Conclusion
Piles are very common, but often easily managed with home treatments, prevention strategies, and early intervention when needed. They develop due to increased pressure around the veins of the anus and rectum. Chronic constipation and straining are major contributors for most people. Leading a healthy lifestyle with a high fiber diet, exercise, proper bathroom habits and maintaining a healthy weight can go a long way in preventing piles. While frustrating and sometimes painful, piles generally do not pose serious medical concerns if treated promptly. Being aware of the causes, symptoms and treatment options allows people with piles to find effective relief and stop them from interfering with daily life.
