Piles (Hemorrhoids): Causes, Symptoms, and Treatment

Causes of Piles

Piles develop when the veins in the rectum or anus are subjected to increased pressure. Common causes include:

1. Straining During Bowel Movements: Often due to constipation or hard stools.
2. Chronic Diarrhea or Constipation: Both conditions irritate and stress the rectal veins.
3. Pregnancy: The increased pressure in the pelvic area and hormonal changes can lead to piles.
4. Obesity: Extra weight increases pressure on rectal veins.
5. Prolonged Sitting: Sitting for long periods, especially on the toilet, can aggravate hemorrhoids.
6. Low-Fiber Diet: Insufficient dietary fiber leads to harder stools, requiring more straining.

Symptoms of Piles

The symptoms of piles vary depending on their type and severity:

• Bleeding During Bowel Movements: Bright red blood on the stool or toilet paper.
• Itching or Irritation: Around the anal area.
• Pain or Discomfort: Especially during bowel movements.
• Swelling Around the Anus: May feel like a lump or bump near the anus.
• Mucus Discharge: From the anus.
• Protrusion of Hemorrhoids: Internal piles may protrude outside the anus during bowel movements.

Severe cases may involve persistent pain, larger protrusions, or complications like thrombosis.

Types of Piles

Piles are graded based on their severity:

1. Grade I: Small internal hemorrhoids that do not protrude.
2. Grade II: Prolapse during bowel movements but retract on their own.
3. Grade III: Prolapse and require manual repositioning.
4. Grade IV: Permanently prolapsed and may require surgical intervention.

Complications of Piles

If left untreated, piles can lead to complications such as:

1. Anemia: Chronic blood loss can cause iron deficiency.
2. Strangulated Hemorrhoid: Occurs when the blood supply to a prolapsed hemorrhoid is cut off, leading to severe pain and tissue death.
3. Thrombosis: Blood clots in external hemorrhoids can cause significant swelling and discomfort.

Diagnosis of Piles

Doctors diagnose piles through:

1. Physical Examination: External piles or protrusions can be visually inspected.
2. Digital Rectal Examination: A gloved finger checks for internal hemorrhoids.
3. Anoscopy: A small, lighted tube examines the anal canal for internal piles.
4. Colonoscopy or Sigmoidoscopy: Recommended if rectal bleeding is unexplained or to rule out other conditions like colorectal cancer.

Treatment Options for Piles

Treatment depends on the severity and type of piles. Options include:

Home Remedies and Lifestyle Changes

1. High-Fiber Diet:
   • Include fruits, vegetables, whole grains, and legumes to soften stools.
2. Stay Hydrated:
   • Drink 8–10 glasses of water daily to prevent constipation.
3. Avoid Straining:
   • Respond promptly to the urge to defecate.
4. Warm Sitz Baths:
   • Soak the anal area in warm water for 10–15 minutes several times a day to relieve discomfort.
5. Topical Treatments:
   • Over-the-counter creams or ointments containing hydrocortisone or witch hazel.

Medications

1. Laxatives: For managing constipation and reducing strain during bowel movements.
2. Pain Relievers: Such as ibuprofen to alleviate discomfort.

Minimally Invasive Procedures

For more severe cases:

1. Rubber Band Ligation:
   • A band is placed around the base of internal piles to cut off blood flow, causing them to shrink.
2. Sclerotherapy:
   • A chemical solution is injected into the hemorrhoid, causing it to shrink.
3. Infrared Coagulation:
   • Heat is used to cut off blood supply to internal piles.

Surgical Treatments

For Grade III or IV piles, surgery may be necessary:

1. Hemorrhoidectomy:
   • Complete removal of piles; effective for severe cases.
2. Stapled Hemorrhoidopexy:
   • Prolapsed hemorrhoids are stapled back into place.

Preventing Piles

Simple measures can help prevent piles or reduce the risk of recurrence:

1. Increase Fiber Intake: Add more fruits, vegetables, and whole grains to your diet.
2. Stay Active: Regular exercise improves bowel function.
3. Hydrate: Drink plenty of water to keep stools soft.
4. Avoid Prolonged Sitting: Limit time spent on the toilet.
5. Maintain a Healthy Weight: Reduces pressure on the pelvic area.

FAQs about Piles

1. What causes piles?

Piles are caused by increased pressure on rectal veins due to factors like straining, chronic constipation, pregnancy, or obesity.

2. How can I relieve piles at home?

Home remedies include eating a high-fiber diet, taking sitz baths, staying hydrated, and using over-the-counter creams.

3. When should I see a doctor for piles?

Seek medical advice if you experience persistent bleeding, severe pain, or prolapsed hemorrhoids that cannot be manually repositioned.

4. Can piles be cured without surgery?

Yes, mild cases of piles can often be managed with lifestyle changes, medications, or minimally invasive procedures.

5. Are piles permanent?

While piles can resolve with treatment, chronic constipation or strain may cause them to recur.

Conclusion

Piles are a common yet manageable condition affecting people of all ages. With a combination of lifestyle changes, home remedies, and medical treatments, most individuals can find relief from symptoms and prevent recurrence. If symptoms persist or worsen, consult a healthcare professional to explore advanced treatment options and improve your quality of life.