What Are Piles? Symptoms Every Patient Should Know

What Are Piles?

Piles, also known as haemorrhoids, are swollen and inflamed veins in the rectum and anus. They are one of the most common conditions affecting adults worldwide. Despite being very common, many people feel embarrassed to talk about them and delay seeking treatment.

Types of Piles

Internal piles form inside the rectum. They are usually painless but can cause bleeding. They are graded 1 to 4 based on severity:

• Grade 1 — bleed but don't prolapse
• Grade 2 — prolapse during bowel movement but return on their own
• Grade 3 — prolapse and need to be pushed back manually
• Grade 4 — permanently prolapsed, cannot be pushed back

External piles form under the skin around the anus. They can be painful and may cause discomfort when sitting.

Common Symptoms

• Bright red bleeding during or after bowel movements
• A lump around the anus that may be sensitive or painful
• Itching or irritation around the anal area
• Pain or discomfort, especially when sitting
• Feeling of incomplete emptying after a bowel movement
• Mucus discharge after passing stool

What Causes Piles?

• Chronic constipation or diarrhoea
• Straining during bowel movements
• Low-fibre diet
• Pregnancy — increased pressure on pelvic veins
• Prolonged sitting or standing
• Family history of piles
• Obesity

Diagnosis

A doctor can usually diagnose piles with a simple physical examination. Sometimes a proctoscopy (examination with a small camera) is needed to confirm the diagnosis and grade the severity.

Treatment Options

Lifestyle and dietary changes — high-fibre diet, plenty of water, avoiding straining — are effective for mild piles.

Medications — topical creams and suppositories can relieve symptoms temporarily.

Minimally invasive procedures:

• Rubber band ligation
• Sclerotherapy (injection therapy)
• Infrared coagulation
• Laser treatment — minimal pain, faster recovery, day-care procedure

Surgery — haemorrhoidectomy for Grade 3 and 4 piles that don't respond to other treatments.