Piles (Symptoms, Causes, Treatments)

Piles are swellings in lining of anus and back passage (lower rectum), which can protrude outwards from the anus.

Piles which form on the lining of the anus are commonly known as internal piles. Piles which protrude out from the anus are commonly referred to as external piles (perianal haematoma).

The size of the piles is generally graded, from 1 to 4. With grade 1, being smaller swellings inside the anus, with grade 2 being larger and protruding only when trying to pass stools.

The next grade of piles, grade 3 hangs down from the anus and can be pushed back into the anus. Finally, grade 4 is given to larger piles which cannot be pushed back into the anus.

What are haemorrhoids?

Haemorrhoids are the medical term used to describe piles.


Generally smaller piles do not cause serious discomfort and may at worst probably only induce a minor itching sensation.

Larger piles may actually protrude from the anus and cause more discomfort. Bleeding (bright red blood color) or a mucus discharge may also be commonplace. In chronic cases, the likelihood of a blood clot developing in the protusion could be markedly increased.


With mild sufferers, the piles can settle down and no major treatment is required.

Piles treatments which try to reduce the discomfort and pain, include creams, that aim to reduce the itching by soothing the area around the anus.

Suppositories may be used particularly effectively with internal piles, where the suppository dissolves when it enters the anus and soothes the internal area.

Other types of suppositories involve softening the stools, allowing for their easier passage out of the rectum and thus avoiding straining.

Many treatments for piles look at prevention, where lifestyle changes can reduce the formation of piles. Such as reducing the straining needed to pass stools when going to the toilet.

This can be achieved in many ways including undergoing a high fiber diet, where more cereals, fruits and vegetables are introduced into the diet.

Hydration is also important, as some of the water drunk, does enter the digestive tract and helps in softening the stools.

Many people also put off going to the toilet when there is an urge and this delaying tactic can cause the stools to harden, from the pressure of more stools being pushed into the rectum.

Bulking agents can also be used to improve the stool flow through the rectum and stool softeners available from pharmacies, can also aid the softening of stools.

Serious cases of piles can involve surgery, with banding a common way of removing piles. This form of surgery involves the blood supply being cut off to the piles by putting a band around base of pile. Without a blood supply, the piles dry out and fall off.


The lining of the anus and lower rectum is delicate, containing many blood vessels (veins). When more blood passes through these blood vessels, they become dilated, this can cause the lining tissue to swell and form into multiple obstrusions known commonly as piles.

It is not known for sure what can cause more blood to pass through the blood vessels resulting in their dilation. However, increases in pressure around the area may be a cause. This increased pressure may be caused by straining and possibly by large stools (faeces) being passed when going to the toilet.

Constipation sufferers can incur a higher chance of developing piles, as the straining involved in passing stools on a regular basis increases the pressure in the anal area.

Piles are common during pregnancy and this may be due to the pressure from the baby lying in the womb against the lower areas.

Ageing can also cause an increase in piles, as the lining area, may become weaker, increasing the required straining and reducing regular movements.


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