Piles or Hemorrhoids (or Haemorrhoids) are vascular cushions, i.e. swollen veins in the anus, anal canal and lower rectum, similar to varicose veins. It is a common condition in adults. It develops due to various causes related to increased pressure in the anal canal and the lower rectum.

Causes for piles:

  • Chronic constipation
  • Chronic diarrhea
  • Heavy weight lifting
  • Low-fiber diet
  • Pregnancy
  • Sitting for a longtime on the toilet bowl
  • Straining while passing motion

Types of piles

  • External: noted in the skin around the anus
  • Internal: noted within the anal canal and lower rectum
  • Others: Thrombosed piles or Perianal hematoma

Piles can present as:

  • Anal itch or irritation
  • Anal pain or discomfort
  • Painless bleeding during bowel movements
    • It is usually self limiting and can be managed with medications
    • If it is large amount and persistent, then it is a medical emergency and requires urgent attention
  • Prolapsing or protruding anal lump


  • Defecation habit modifications
  • Dietary modifications
  • Lifestyle modifications
  • Medications
  • Other intervention:
    • If the piles are medium, the aforementioned is required, and we may give pile ligation with rubber bands.
    • If the piles are huge and prolapsing, the procedures listed above will be necessary, and the patient will need surgery.
    • Traditional or diathermy hemorrhoidectomy, ligasure hemorrhoidectomy, stapled hemorrhoidectomy, and other procedures are used to treat piles.
    • We’ll talk with the patient about which option is best for them.
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