Piles are the common term for hemorrhoids which are swollen, enlarged veins in or around the anus and lower rectum. They are very common and occur for various reasons.
What Are Piles?
- Definition:
Hemorrhoids (piles) are vascular structures that normally help with stool control but become problematic when they swell or become inflamed. - Types of piles:
- Internal Hemorrhoids: Located inside the rectum they often cause painless rectal bleeding unless they prolapse.
- External Hemorrhoids: Found under the skin around the anus and can cause pain, itching, or discomfort, especially if a blood clot forms.
Causes of Piles and Risk Factors
Piles generally develop due to increased pressure in the lower rectum and can be triggered by several factors:
- Straining during bowel movements: Often due to constipation or hard stools.
- Low-fibre diet: This can lead to constipation and increased straining.
- Pregnancy: Extra pressure from the uterus and hormonal changes can cause the veins to swell.
- Prolonged sitting: Particularly on the toilet may increase venous pressure.
- Heavy lifting: Which also increases intra-abdominal pressure.
Common Symptoms
- Rectal Bleeding: Bright red blood typically noticed on toilet paper or on the surface of stools.
- Itching or Irritation: Around the anus, especially with external piles.
- Pain or Discomfort: Particularly when sitting or during bowel movements.
- Prolapse: In some cases, internal hemorrhoids can protrude outside the anus, sometimes requiring manual reduction.
Treatment Options
- Conservative (Home) Treatments:
- Dietary Changes: Increase fibre (fruits, vegetables, whole grains) and fluids to soften stools and reduce straining.
- Sitz Baths: Soaking the affected area in warm water several times a day can ease discomfort.
- Topical Treatments: Over-the-counter creams, ointments, or suppositories (often containing hydrocortisone, witch hazel, or lidocaine) to relieve pain and inflammation.
- Pain Relief: Paracetamol for pain management.
- Office-Based Procedures:
- Rubber Band Ligation: A small rubber band is placed around the base of an internal hemorrhoid to cut off its blood supply, causing it to wither and fall off.
- Sclerotherapy: Injection of a chemical solution to shrink the hemorrhoid.
- Infrared Coagulation: Uses infrared light to shrink the hemorrhoid by cutting off its blood supply.
- Surgical Options:
Reserved for severe or persistent cases, including:- Hemorrhoidectomy: Surgical removal of hemorrhoids.
- Stapled Hemorrhoidopexy: A circular stapler is used to reposition the hemorrhoidal tissue and reduce blood flow.
- Hemorrhoidal Artery Embolization (HAE): A minimally invasive procedure that blocks the blood flow to the hemorrhoids using tiny coils or particles.
Prevention
To help reduce the risk of developing piles or prevent flare-ups:
- Diet and Hydration: Consume a high-fiber diet and drink plenty of water.
- Avoid Straining: Go to the toilet as soon as the urge arises rather than delaying, and try not to sit on the toilet for extended periods.
- Regular Exercise: Helps promote regular bowel movements and reduces constipation.
- Healthy Bowel Habits: Consider using a footstool during bowel movements to achieve a natural squatting position, which can help ease passage of stools.
Summary
Piles (hemorrhoids) are swollen veins that can cause symptoms like rectal bleeding, pain, and itching. They are commonly associated with straining during bowel movements, a low-fiber diet, and factors like pregnancy. Most cases can be managed with conservative measures such as dietary modifications, sitz baths, and over-the-counter treatments. More severe or persistent cases may require procedures like rubber band ligation, sclerotherapy, or even surgery. Preventative steps—especially a high-fiber diet, proper hydration, and avoiding prolonged sitting on the toilet—are key to reducing your risk.
