“Piles,” also known as hemorrhoids, are swollen veins in the lower part of the rectum and anus. They can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). Piles are a common condition and can be caused by increased pressure in the lower rectum due to straining during bowel movements, pregnancy, sitting for long periods, or a low-fiber diet.

Types of Hemorrhoids

1. Internal Hemorrhoids:
   • These develop inside the rectum. They are usually painless and may cause bleeding during bowel movements. Internal hemorrhoids can protrude (prolapse) outside the anus if they become enlarged.
2. External Hemorrhoids:
   • These form under the skin around the anus. They can be felt as a lump or swelling around the anus. External hemorrhoids can cause pain, itching, and discomfort, especially during bowel movements.

Causes

Several factors can contribute to the development of hemorrhoids, including:

• Straining during bowel movements: This can occur due to constipation or diarrhea.
• Pregnancy: Increased pressure on the veins in the lower rectum due to the growing uterus.
• Sitting for long periods: Especially on the toilet.
• Obesity: Excess weight can increase pressure on the rectal veins.
• Low-fiber diet: A diet low in fiber can lead to constipation, which can worsen hemorrhoids.

Symptoms

Symptoms of hemorrhoids can vary depending on the type and severity but commonly include:

• Bleeding: Bright red blood on toilet paper or in the toilet bowl after a bowel movement.
• Itching: Irritation in the anal region.
• Pain or discomfort: Especially during bowel movements.
• Swelling or lumps: Around the anus, in the case of external hemorrhoids.

Diagnosis

Diagnosis typically involves a physical examination of the anus and rectum. In some cases, further tests such as a digital rectal exam, sigmoidoscopy, or colonoscopy may be recommended to rule out other conditions or to examine internal hemorrhoids more closely.

Treatment Options

Treatment depends on the severity and symptoms of hemorrhoids:

• Self-care measures: Increasing fiber intake, drinking plenty of fluids, and using over-the-counter creams or suppositories.
• Medical procedures:
  • Rubber band ligation: A procedure to cut off blood flow to the hemorrhoid, causing it to shrink and fall off.
  • Sclerotherapy: Injection of a chemical solution to shrink the hemorrhoid.
  • Infrared coagulation: Using heat to shrink internal hemorrhoids.
  • Surgical removal: In severe cases or for large hemorrhoids that do not respond to other treatments.

Here are some common treatments:

1. Lifestyle and Home Remedies:
   • Dietary Changes: Increasing fiber intake (fruits, vegetables, whole grains) to soften stools and reduce constipation.
   • Hydration: Drinking plenty of fluids to keep stools soft.
   • Regular Exercise: Promotes bowel movements and overall digestive health.
   • Avoid Straining: Prevents worsening of hemorrhoids.
2. Medications:
   • Over-the-counter creams and ointments: Provide temporary relief from itching, pain, and swelling.
   • Suppositories: Inserted into the rectum to provide relief and promote healing.
3. Non-surgical Procedures:
   • Rubber Band Ligation: A common outpatient procedure where a rubber band is placed around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off within a week.
   • Sclerotherapy: Injection of a chemical solution into the blood vessel to shrink the hemorrhoid.
   • Infrared Coagulation: A heat treatment that causes the hemorrhoid to harden and shrivel.

Prevention

To prevent hemorrhoids or reduce symptoms:

• Maintain a high-fiber diet with plenty of fruits, vegetables, and whole grains.
• Drink plenty of fluids to keep stools soft and prevent straining during bowel movements.
• Exercise regularly to improve circulation and reduce pressure on veins.

When to See a Doctor

It’s advisable to see a doctor if you experience rectal bleeding, persistent pain or discomfort, or if you notice any lumps or swelling around the anus. Early diagnosis and treatment can help alleviate symptoms and prevent complications.

Overall, while hemorrhoids can be uncomfortable and sometimes painful, they are treatable and often improve with simple lifestyle changes and self-care measures.