Piles: Symptoms, Images, Causes, and Types

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Piles or Haemorrhoids are swellings containing enlarged blood vessels and tissues that are found inside the rectum or under the skin around the anus. Piles are also known as Bawaseer (बवासीर) in Hindi. 

Piles are a very common anorectal condition affecting millions worldwide and represent a major medical and socioeconomic problem. This condition is highly prevalent in people within the age group of 50-60 years. Based on the lump's location, haemorrhoids can be internal or external. Let’s read about Piles' representation by pictures, symptoms, causes, types, diagnosis, prevention, treatment, and more.

Disease Name Piles
Alternative Name Haemorrhoids, Bawaseer (बवासीर)
Symptoms Pain, Discomfort, Swelling, Itchiness, Redness, Lump formation
Causes

Strain bowel movement, Obesity, Pregnancy, Constipation, Chronic diarrhoea

Diagnosis Visual inspection, Digital examination, Proctoscopy
Treated by General surgeon (Proctologist)
Treatment options

Sclerotherapy for piles, Stapler surgery for piles, Laser surgery for piles, Haemorrhoidal artery ligation and Recto-anal repair

What is Piles?

Piles or Haemorrhoids are collection of blood vessels and tissues in the lower anus or rectum that become swollen and inflamed. This is the most common anorectal condition. Piles can develop inside the rectum or under the skin around the anus. Piles is also known as Bawaseer (बवासीर) in Hindi. 

Piles types

Piles can develop inside or outside the rectum. The types of piles depend on where the swollen vein develops. Types include:

  1. External Piles: Small lumps form underneath the skin around the anus. They are very itchy and painful. Usually, bleeding is present in this case. In some cases, they can fill with blood resulting in clot formation that can increase pain and swelling.
  2. Internal Piles: The lumps develop within the rectum and usually are not visible while doing an external examination. A small amount of bleeding can be seen during bowel movements. They rarely cause pain or discomfort.
  3. Prolapsed Piles: Both internal and external piles can prolapse, meaning they stretch and bulge outside of the anus. These may bleed or cause severe pain. 

Piles types image

Piles Symptoms

In most cases, the symptoms of piles are not serious and resolve on their own. However, piles are characterised by one or more of the following symptoms:

  1. Painful lumps around the anal region
  2. Itching, redness, inflammation and discomfort 
  3. Presence of slimy fluid near the anus
  4. Bright red coloured blood after passing stools
  5. Feeling of unclear bowel even after passing stoolPiles symptoms image

Piles Causes

The exact cause of piles is uncertain, but they are associated with increased pressure in the blood vessels and tissues around the anal area which results in swelling and inflammation. The condition can develop from increased pressure in the lower rectum due to:

  1. Straining during bowel movement
  2. Sitting for a long period on the toilet
  3. Having chronic diarrhoea or constipation
  4. Having anal intercourse
  5. Eating a low-fibre diet
  6. Regular heavy lifting

Piles causes image 

Piles Risk Factors

Though anyone can develop the piles condition as its formation is unclear. The following are the potential risk factors for piles that might put an individual at a higher chance of developing the disease: 

  1. Age between 45-65 years (can occur in all age groups; however, it is more common during this period) 
  2. Being obese or overweight
  3. Do things that can strain more, such as heavy lifting
  4. Sedentary lifestyle 
  5. Have a family history of haemorrhoids
  6. PregnancyPiles risk factors image

Prevention of Piles

There might not be a definitive way to prevent piles. Still, there are measures to reduce the risk of developing piles or worsening the condition. Below mentioned are some of the measures for the prevention of piles:

  1. Limit the amount of sitting time on the toilet
  2. Work with the healthcare provider to manage constipation and prevent straining
  3. Maintaining a moderate weight
  4. Eating a fibre-rich diet
  5. Avoiding heavy lifting
  6. Staying physically active by doing regular exercise 
    Piles prevention image

How is Piles diagnosed?

The primary care doctor will generally be able to diagnose piles based on symptoms and a physical examination. The doctor will do a complete physical examination to carefully examine the anal area. The doctor may ask the following questions:

  1. Do any close relatives have piles?
  2. Has there been any blood or mucus in the stools?
  3. Has there been any recent weight loss?
  4. Have bowel movements changed recently?

However, in a few cases, the following additional tests may also be recommended to confirm the presence and severity of the piles.

  1. Digital Rectal Exam: The doctor will insert a gloved, lubricated finger into the rectum to feel for swollen blood vessels.
  2. AnoscopyThe doctor will use an anoscope (lighted tube) to view the lining of the anus and rectum. 
  3. Sigmoidoscopy: The doctor will use a sigmoidoscope (lighted tube with a camera) to view the lower part of the colon and rectum. This technique includes two types: flexible sigmoidoscopy and rigid sigmoidoscopy
  4. Stool Guaiac Test: A stool sample is analyzed to find any traces of blood in it.
  5. Colonoscopy: The doctor may want to examine the entire colon by using a colonoscope (long, flexible, lighted tube) to check for any abnormal growths, the tissue that is red or swollen, sores (ulcers), or bleeding.

Diagnostic Tests for Piles Image

How to prepare for the doctor's consultation?

  1. List down symptoms including any that may seem unrelated to the condition.
  2. The patient must inform the doctor about key personal information, including dietary habits and typical bowel movement.
  3. The patient must tell the doctor about all the medications, vitamins or supplements that he/she takes.
  4. The following questions should be asked the doctor:
    1. What's the likely cause of the condition?
    2. Is this condition likely to be temporary or permanent?
    3. Will there be any complications related to this condition?
    4. What treatment approach do you recommend?
    5. If the first line of treatments doesn't work, which treatment would work?
    6. Am I a candidate for surgery? Why or why not?
    7. Are there additional self-care steps that might help?
    8. I have other medical problems. How can I manage these along with haemorrhoids?

Piles Treatment

In most cases, piles resolve on their own without needing any treatment. However, if an individual has piles for an extended period, the lumps may grow in size and the symptoms may also worsen leading to significant pain, discomfort and reduced quality of life. In that case, the proctologist may suggest one of the following methods for piles treatment: 

Home Remedies for Piles

An individual can often relieve the pain, swelling and inflammation of piles by following home treatments:

  1. By using an ice pack or taking a warm bath (also called a sitz bath).
  2. Ensure that your anal region is clean and dry.

Medications for Piles

Depending on the severity of haemorrhoids, the proctologist would prescribe the following:

  1. Pain reliever medications: pain-relieving medicines such as acetaminophen, aspirin or ibuprofen can temporarily help relieve the discomfort.
  2. Stool Softeners: these would help ease the constipation issues.
  3. Over-the-counter topical haemorrhoid creams or suppositories containing hydrocortisone, or use pads containing witch hazel or a numbing agent.

Ayurvedic treatments for Piles

Several ayurvedic preparations are available for managing haemorrhoids, such as Vijaya Churna and Pathyadi Kwatha.

Piles treatment without surgery

If haemorrhoids do not improve by home remedies and prescription medicines, then the following non-surgical treatment methods for piles can be considered:

  1. Rubber band ligation: In this procedure, the surgeon places a rubber band around the haemorrhoids. This causes necrosis (tissue death) of the haemorrhoids, and they drop off.
  2. Sclerotherapy: The surgeon injects a liquid called a sclerosant into the haemorrhoids, which decreases the blood supply and causes the haemorrhoids to shrink. 
  3. Electrotherapy: The surgeon applies a gentle electric current to the haemorrhoids, which helps shrink the haemorrhoids.
  4. Infrared coagulation: This method works similarly to that of sclerotherapy. Instead of a liquid, infrared light is used to shrink the haemorrhoids.

Piles treatment with surgery

Surgical treatment of haemorrhoids is recommended if any of the therapies mentioned above do not work. The various surgical treatment methods for haemorrhoids include:

  1. Haemorrhoidectomy: It is done to remove the prolapsed internal or large external haemorrhoids. 
  2. Stapled haemorrhoidopexy: The surgeon uses a stapling instrument to pull prolapsed internal haemorrhoids back inside your anus or remove an internal haemorrhoid. 
  3. Haemorrhoidal artery ligation: The surgeon cuts the blood supply to the haemorrhoids using stitches. Cutting the blood supply causes the haemorrhoids to shrink. 
  4. Laser surgery for piles: The surgeon cuts the blood supply to the haemorrhoids using a laser. Cutting the blood supply causes the haemorrhoids to shrink.

Refer to page recovery rates for piles to know more about the recovery rate after a patient has undergone the above-mentioned treatment methods for piles.

Surgery Name Surgery Cost
Rubber Band Ligation ₹25,000 to ₹60,000
Sclerotherapy ₹25,000 to ₹80,000
Open Haemorrhoidectomy ₹30,000 to ₹1,00,000
Stapler Haemorrhoidectomy ₹35,000 to ₹1,10,000
Haemorrhoidal artery ligation ₹38,000 to ₹90,000
Laser Haemorrhoidectomy ₹40,000 to ₹1,50,000

Treatment for piles image

Risks and Complications of Piles

If piles are not treated in time, they can be uncomfortable and painful, but they don’t tend to cause serious problems. Rarely people with piles can develop some other problems. The risks and complications of piles include:

  1. Blood clots in the swollen vein
  2. Bleeding
  3. Iron deficiency anaemia is caused by blood loss
  4. Infection of an external haemorrhoid
  5. Skin tags, or excess skin when an external haemorrhoid goes away
  6. Development of strangulated haemorrhoids (muscles in the anus cut off blood flow to a prolapsed internal haemorrhoid)

When to see a doctor?

The patient can consult the doctor if he/she experiences:

  1. Haemorrhoids do not improve after a week
  2. Severe pain
  3. Bleeding during bowel movement
  4. Itching
  5. Inflammation and swelling

Diet for Piles

The dietary habits of an individual play the main role in developing any disease condition. Staying hydrated and eating a diet rich in minerals and vitamins will help reduce the risk of developing any disease condition. Below mentioned are some dietary measures for individuals with piles:

  1. Consuming foods that are high in dietary fibre such as wheat, brown rice, oatmeal, bran, etc., can help keep stools soft and make their passing easier.
  2. Include fresh fruits and vegetables in the diet.
  3. Drinking plenty of water prevents constipation which in turn decreases the need to strain while passing a bowel movement.
  4. Avoid caffeine (found in coffee and cola) and tea intake.
  5. Avoid alcohol consumption.Diet for piles image

Frequently Asked Questions about Piles

What is piles?

Piles or haemorrhoids are swollen, enlarged blood vessels that form inside or outside the anus and rectum. They are the most common anorectal condition. They can be painful, uncomfortable and cause rectal bleeding.

How common are piles disease?

Piles affect people of all ages and genders. But, this condition is highly common in people within the age group of 50-60 years.

What is the main cause of piles?

Piles can develop from increased pressure in the lower rectum due to: straining during bowel movement, sitting for long periods on the toilet, having chronic diarrhoea or constipation.

Who might get piles disease?

Anyone can develop piles or haemorrhoids. As you grow old, your risk of developing piles disease increases. That's because the tissues and blood vessels in the anal region can weaken and stretch. You are more likely to get haemorrhoids if you: are pregnant, obese, sit on the toilet for too long, have a family history of haemorrhoids, or are between 45 and 65 years old.

What are the different types of piles?

Piles can happen inside or outside the anal region. The type depends on where the swollen vein develops. Types include external piles: when the swollen blood vessels form underneath the skin around the anus; internal piles: when the swollen blood vessels form inside the rectum; prolapsed piles: when both the internal and external piles stretch and bulge outside of the anus.

What are the most common symptoms of piles?

Symptoms of piles disease can range in severity from mild to severe but mainly the presence of swelling and inflammation can cause pain, itching, irritation, discomfort, and bleeding. If you have any of these symptoms, contact HexaHealth for a free consultation with our experienced doctors.

Can piles go away on their own?

Piles will usually go away on their own but, if they don't, you might need to have a procedure to deal with the problem. Contact HexaHealth for a free consultation with our experienced doctors.

What happens if piles is not treated?

If piles are left untreated, they can cause bleeding, severe pain, irritation, and discomfort. External haemorrhoids can cause thrombosis (blood clotting), leading to severe pain from haemorrhoidal strangulation.

Can home remedies provide relief from piles?

Yes, home remedies can manage and provide some relief from the symptoms of piles. Home remedies like topical ointments, sitz baths temporarily relieve painful piles symptoms.

When should I call the doctor?

You should call your doctor if you suspect haemorrhoids and experience abdominal pain, fever, chills, nausea, vomiting, chronic constipation or diarrhoea, severe rectal bleeding and pain.

Which is the best treatment for piles?

Laser treatment for piles is the most opted treatment as it is painless. It involves no stitches, minimal blood loss and other postoperative complications, and quick recovery with no chances of recurrence.

What are the advantages of laser surgery for piles?

Laser treatment for piles offers the following advantages over conventional surgery: painless & stitchless, minimally invasive, quick recovery, early return to daily life, and excellent success rate.

Does insurance cover treatment for piles disease?

Yes, all health insurance plans cover the treatment for piles disease. Paperwork is facilitated by our team on your behalf ensuring smooth approval and a cashless facility. Contact HexaHealth for a simple cashless and hassle-free experience.

What is the cost of piles surgery?

The cost of piles surgery is variable, considering the type of hospital chosen, the grade and stage of piles, the technique recommended, the patient's medical condition based on age and other health factors, etc. Contact HexaHealth for price transparency.

What are the myths versus facts about piles?

  1. Myth: All types of haemorrhoids are always painful.
    Fact: Not necessarily. People can have both types of haemorrhoids i.e., internal haemorrhoids that develop inside the anus which generally are not painful and external haemorrhoids that bulge out of the anus which can be very painful.
  2. Myth: Everyone is equally at risk of getting haemorrhoids.
    Fact: Generally, certain groups are more at risk of developing haemorrhoids. People with chronic constipation, obesity and pregnancy are often at the risk of developing haemorrhoids. Men and women are both at increased risk of getting them if he/she:
    1. strain during bowel movement
    2. sit on the toilet for long periods of time
    3. are older than age 50
  3. Myth: Changing the diet won’t help haemorrhoids.
    Fact: Changing the diet is one of the best ways to prevent any disease condition. Drinking more water, eating more fibre, and eating fresh fruits and vegetables all decrease your chance of getting constipation which eventually prevents the development of haemorrhoids.
  4. Myth: Piles treatment needs surgery.
    Fact: In most cases, piles don't need surgery to be treated. The doctor recommends surgery only when the condition is severe and if causes discomfort and pain.
  5. Myth: Piles treatment needs surgery.
    Fact: Generally, when an individual has symptoms such as consistent itching, inflammation near the anus or a streak of blood, then the person must consult a urologist immediately. The doctor will be able to perform tests to see if the symptoms belong to colorectal cancer or piles and recommend the person the appropriate treatment method.
  6. Myth: Exercising must be avoided if you have piles.
    Fact: Exercising, in fact, reduces the risk of getting piles. Generally, a person should ensure that he/she does not lift heavy weights incorrectly by putting pressure on the bottom muscle. 

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