Piles, also known as hemorrhoids, are swollen veins in or around the anus and lower rectum. They are usually caused by pressure during bowel movements.
Piles may lead to pain, itching, or bleeding. They are common and often related to constipation or straining.
Types of Piles
Based on their location and severity, piles are classified into four main types.
1. Internal Piles
Internal piles develop inside the rectum and are usually not visible from outside.
Key Characteristics:
- Located inside the rectal lining
- Usually painless
- May cause bleeding during bowel movements
Common Symptoms:
- Bright red blood in stool or on toilet paper
- A feeling of incomplete bowel emptying
- In advanced stages, piles may protrude outside the anus
Grades of Internal Piles:
- Grade 1: Small swelling, no prolapse
- Grade 2: Prolapse during straining but retracts on its own
- Grade 3: Prolapse requires manual pushing back
- Grade 4: Permanently prolapsed and cannot be pushed back
Internal piles often go unnoticed until bleeding occurs.
2. External Piles
External piles form under the skin around the anus and are visible.
Key Characteristics:
- Located outside the anal opening
- Can be painful and itchy
Common Symptoms:
- Pain or discomfort while sitting
- Swelling around the anus
- Itching and irritation
- Occasional bleeding
External piles are more noticeable and can cause discomfort during daily activities.
3. Thrombosed Piles
Thrombosed piles occur when a blood clot forms inside an external pile.
Key Characteristics:
- Sudden and severe pain
- Hard lump near the anus
- Bluish or purplish swelling
Common Symptoms:
- Intense pain, especially while sitting or walking
- Inflammation and tenderness
- Difficulty passing stools
Although thrombosed piles can be very painful, they often improve on their own with proper care.
4. Prolapsed Piles
Prolapsed piles are internal piles that extend outside the anus due to severe swelling.
Key Characteristics:
- Visible bulge outside the anus
- Can be painful if strangulated
- May cause mucus discharge
Common Symptoms:
- Discomfort and pain
- Difficulty maintaining hygiene
- Risk of infection if untreated
Prolapsed piles usually indicate an advanced stage and may require medical intervention.
Common Causes of Piles
- Chronic constipation or diarrhea
- Straining during bowel movements
- Sitting for long periods, especially on the toilet
- Pregnancy and childbirth
- Low-fiber diet
- Obesity
- Aging
Treatment Options for Piles
The treatment of piles depends on their type, severity, and symptoms. Most mild cases can be managed with conservative methods, while advanced cases may require medical procedures.
1. Lifestyle and Home Remedies
- Increasing fiber intake through fruits, vegetables, and whole grains
- Drinking plenty of water
- Avoiding straining during bowel movements
- Exercising regularly
- Maintaining proper anal hygiene
2. Medications
- Over-the-counter creams and ointments to reduce pain and itching
- Suppositories for internal piles
- Pain relievers as prescribed by a doctor
3. Non-Surgical Procedures
- Rubber band ligation
- Sclerotherapy
- Infrared coagulation
These procedures are minimally invasive and commonly used for internal piles.
4. Surgical Treatment
- Hemorrhoidectomy
- Stapled hemorrhoidopexy
Surgery is usually recommended for severe, recurring, or prolapsed piles that do not respond to other treatments.
When to See a Doctor
You should consult a doctor if:
- Bleeding is persistent
- Pain becomes severe
- Piles do not improve with home remedies
- There is a lump that increases in size
Early diagnosis helps prevent complications and the need for surgery.
Conclusion
Piles are a common but manageable condition. Knowing the types of piles internal, external, thrombosed, and prolapsed can help you recognize symptoms early and seek timely treatment. Simple lifestyle changes such as eating a high-fiber diet, staying hydrated, and avoiding excessive straining can significantly reduce the risk of developing piles.
If symptoms persist, medical advice is essential to ensure proper treatment and long-term relief.