What are Piles

Piles is another term for hemorrhoids. Hemorrhoids are collections of inflamed tissue in the anal canal. They contain blood vessels, support tissue, muscle, and elastic fibers.

Many people have piles, but the symptoms are not always obvious. Hemorrhoids cause noticeable symptoms for at least 50 percent of people in Nigeria and United States (U.S.) before the age of 50 years.

Fast facts on piles:

Piles are collections of tissue and vein that become inflamed and swollen.The size of piles can vary, and they are found inside or outside the anus.Piles occur due to chronic constipation, chronic diarrhea, lifting heavy weights, pregnancy, or straining when passing a stool. A doctor can usually diagnose piles on examination. Hemorrhoids are graded on a scale from I to IV. At grades III or IV, surgery may be necessary.

Piles are inflamed and swollen collections of tissue in the anal area.

They can have a range of sizes, and they may be internal or external.

Internal piles are normally located between 2 and 4 centimeters (cm) above the opening of the anus, and they are the more common type. External piles occur on the outside edge of the anus.

Symptoms

In most cases, the symptoms of piles are not serious. They normally resolve on their own after a few days.

An individual with piles may experience the following symptoms:

A hard, possibly painful lump may be felt around the anus. It may contain coagulated blood. Piles that contain blood are called thrombosed external hemorrhoids.After passing a stool, a person with piles may experience the feeling that the bowels are still full. Bright red blood is visible after a bowel movement. The area around the anus is itchy, red, and sore. Pain occurs during the passing of a stool.

Piles can escalate into a more severe condition. This can include:

excessive anal bleeding, also possibly leading to anemiainfectionfecal incontinence, or an inability to control bowel movementsanal fistula, in which a new channel is created between the surface of the skin near the anus and the inside of the anusa strangulated hemorrhoid, in which the blood supply to the hemorrhoid is cut off, causing complications including infection or a blood clot

Piles is classified into four grades:

Grade I: There are small inflammations, usually inside the lining of the anus. They are not visible.Grade II: Grade II piles are larger than grade I piles, but also remain inside the anus. They may get pushed out during the passing of stool, but they will return unaided.Grade III: These are also known as prolapsed hemorrhoids, and appear outside the anus. The individual may feel them hanging from the rectum, but they can be easily re-inserted.Grade IV: These cannot be pushed back in and need treatment. They are large and remain outside of the anus.

External piles form small lumps on the outside edge of the anus. They are very itchy and can become painful if a blood clot develops, as the blood clot can block the flow of blood. Thrombosed external piles, or hemorrhoids that have clotted, require immediate medical treatment.

Causes

Piles are caused by increased pressure in the lower rectum.

The blood vessels around the anus and in the rectum will stretch under pressure and may swell or bulge, forming piles. This may be due to:

chronic constipationchronic diarrhealifting heavy weightspregnancystraining when passing a stool

The tendency to develop piless may also be inherited and increases with age.

Diagnosis

A doctor can usually diagnose piles after carrying out a physical examination. They will examine the anus of the person with suspected piles.

The doctor may ask the following questions:

Do any close relatives have piles? Has there been any blood or mucus in the stools? Has there been any recent weight loss? Have bowel movements changed recently? What color are the stools?

For internal piles, the doctor may perform a digital rectal examination (DRE) or use a proctoscope. A proctoscope is a hollow tube fitted with a light. It allows the doctor to see the anal canal up close. They can take a small tissue sample from inside the rectum. This can then be sent to the lab for analysis.

The physician may recommend a colonoscopy if the person with piles presents signs and symptoms that suggest another digestive system diseases, or they are demonstrating any risk factors for colorectal cancer.

Over-the-counter (OTC) medications:These are available over-the counter or online. Medications include painkillers, ointments, creams, and pads, and can help soothe redness and swelling around the anus.

OTC remedies do not cure piles but can help the symptoms. Do not use them for more than 7 days in a row, as they can cause further irritation of the area and thinning of the skin. Do not use two or more medications at the same time unless advised to by a medical professional.

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