Hemorrhoids also referred to as piles, are a common medical condition. Anal itching, pain, and rectal bleeding can be caused by swollen veins outside or inside the rectum. Ailments often improve with at-home piles treatment, but medical procedures become necessary depending on severity. Consuming more fiber can help prevent hemorrhoids.

Internal vs. external

Internal piles form within the rectum and are typically not visible on an external examination. However, in some cases, it may protrude from the anus. A prolapsed hemorrhoid is the medical term for this.

Internal piles are graded on a four-point scale by medical professionals.

• Grade I: The growth is asymptomatic and does not protrude from the anus.
• Grade II: The piles may prolapse from the anus, but they will return inside all by themselves.
• Grade III: The piles’ prolapse. It gets removed manually from the anus.
• Grade IV: The hemorrhoids prolapse outside the anus, and pushing it back gets ruled out. 

External piles are small lumps that form on the anus’s outside edge. They are extremely itchy and painful if a blood clot forms because the clot can obstruct blood flow. External piles that have thrombosed or clotted hemorrhoids require immediate medical attention.

Piles can deteriorate into a more grave condition. These include: 

• Too much anal bleeding could lead to anemia
• Infection
• Urinary incontinence 
• Anal fistula
• Strangulated hemorrhoid, in which the anal muscles cut off the hemorrhoid’s blood supply

Piles Symptoms 

In most cases, piles symptoms are minor and resolve on their own. Symptoms are:

• Throbbing lumps in and around the anus
• Itchiness and discomfort in the anus
• Discomfort while passing stools and afterward
• Bloody feces

Causes

Pile formation happens by increased pressure in the lower rectum. The capillaries surrounding the anus and rectum stretch and swell or bulge under pressure, forming piles. It could be because of:

• chronic constipation
• chronic diarrhea 
• heavy lifting 
• straining when passing stool

Risk factors

A person’s risk of developing piles may get increased by several factors, including:

• Pregnancy: Hemorrhoids affect up to half of all pregnant women. It is due to increased pelvic pressure, a higher blood volume, and a higher incidence of constipation.
• Age: Piles are more common in the elderly. Approximately half of all people over the age of 50 develop piles.
• Weight: According to research, being overweight may increase a person’s risk of developing hemorrhoids.
• Diet: A low-fiber diet may increase a person’s chances of developing hemorrhoids.

Diagnosis

After a physical examination, a doctor can usually diagnose piles. First, they will examine the anus of the person suspected of having piles.

• Do you also have any family members who suffer from piles?
• Is there any mucus or blood in your stools?
• Have you lost any weight recently?
• Have your bowel movements recently changed?
• What color are the stools?

Piles Treatment

Piles usually resolve on their own without the need for treatment. However, some piles treatments can significantly reduce the discomfort and itching many people experience with hemorrhoids.

Changes in lifestyle

To manage piles, a doctor will first recommend some lifestyle changes.

Piles can develop due to bowel movement straining, and constipation is the cause of excessive straining. A dietary change can help keep stools regular and soft. Consuming more fiber, such as fruits and vegetables, or primarily eating bran-based breakfast cereals, is one way to accomplish this. A doctor may also advise people suffering from piles to drink more water. In addition, weight loss may help reduce the occurrence and severity of the issue. Doctors also recommend exercising and avoiding straining to pass stools to control piles.

Surgical options

Surgery may be required if a person has severe prolapsed piles or internal bleeding piles. Surgical procedures include the following:

• Banding: To cut off the pile’s blood supply, the doctor rolls an elastic band around the base. Within a week, hemorrhoids will usually fall off.
• Sclerotherapy is a procedure in which a doctor injects medicine into a hemorrhoid to cause it to shrink and eventually shrivel up. It is an effective alternative to banding for grade II and III hemorrhoids.
• Infrared coagulation: A surgeon will use an infrared light device to burn the hemorrhoid tissue during this procedure.
• Hemorrhoidectomy: This procedure involves the removal of all hemorrhoid tissue. It is the most effective method for completely removing piles, but there is a risk of complications, such as stool passing difficulties.
• Hemorrhoid stapling: A surgeon will use staples to stop blood flow to the hemorrhoid tissue during this procedure.

Prevention

• Eating a healthy diet: Staying hydrated and eating a diet high in fiber can help keep stools soft and make them easier to pass.
• Avoid squeezing when passing stools: Squeezing when passing stools increases the risk of developing piles.
• Avoiding heavy lifting: Heavy lifting regularly is a risk factor. Preventing hemorrhoids can be accomplished by limiting heavy exertion and practicing proper lifting techniques.
• Maintaining a healthy weight: Being overweight increases the likelihood of having piles.
• Staying active: Exercise can aid in the passage of food through the digestive system and forming more regular stools. It can reduce the likelihood of piles.

Summary

Swollen veins in the lower region of the anus and rectum can cause anus lumps. Hemorrhoids vary in size and location, and many people are unaware they have them.

Chronic constipation, overexertion, and straining during passing stool can cause piles. Many piles go away on their own but visible, painful ones may require piles treatment, such as surgery to remove.