Piles are another term for hemorrhoids. Hemorrhoids are collections of inflamed and swollen tissue in the anal area. They contain blood vessels, support tissue, muscle, and elastic fibers. They can have a range of sizes, and they may be internal or external.

Internal Piles are normally located between 2 and 4 centimeters (cm) above the opening of the anus, and they are the common type. External piles occur on the outside edge of the anus. Hemorrhoids are graded on a scale from 1 to 4.

External piles form small lumps on the outside edge of the anus. They are very itchy and can become painful if a blood clot develops, as the blood clot can block the flow of blood. Thrombosed external piles, or hemorrhoids that have clotted, require immediate medical treatment.

GRADES OF PILES

• Grade I: There are small inflammations, usually inside the lining of the anus. They are not visible.
• Grade II: Grade II piles are larger than grade I piles, but also remain inside the anus. They may get pushed out during the passing of stool, but they will return unaided.
• Grade III: These are also known as prolapsed hemorrhoids and appear outside the anus. The individual may feel them hanging from the rectum, but they can be easily re-inserted.
• Grade IV: These cannot be pushed back in and need treatment. They are large and remain outside of the anus.

Symptoms of Piles/Hemorrhoids

In most cases, the symptoms of piles are not serious. They normally resolve on their own after a few days

An individual with piles may experience the following symptoms;

• A hard, possibly painful lump may be felt around the anus. It may contain coagulated blood. Piles that contain blood are called thrombosed external hemorrhoids.
• After passing a stool, a person with piles may experience the feeling that the bowels are still full.
• Bright red blood is visible after a bowel movement.
• The area around the anus is itchy, red, and sore.
• Pain occurs during the passing of a stool.
• Piles can escalate into a more severe condition. This can include:
• Excessive anal bleeding, also possibly leading to anemia
• Infection
• Fecal incontinence, or the inability to control bowel movements
• Anal fistula, in which a new channel is created between the surface of the skin near the anus and the inside of the anus
• A strangulated hemorrhoid, in which the blood supply to the hemorrhoid is cut off, causing complications including infection or a blood clot.

Causes of Piles/ Hemorrhoids

Piles are caused by increased pressure in the lower rectum.

The blood vessels around the anus and in the rectum will stretch under pressure and may swell or bulge, forming piles. They can occur for the following reasons:

• Pregnancy: They occur more commonly in pregnant women because, as the uterus enlarges, it presses on the vein in the colon, causing it to bulge.
• Aging: Hemorrhoids are most common among adults aged 45 to 65 years. This does not mean, however, that young people and children do not get them.
• Chronic Diarrhea: Hemorrhoids can occur after cases of chronic diarrhea.
• Chronic Constipation: Straining to move stool puts additional pressure on the walls of the blood vessels.
• Sitting for too long: Staying in a seated position for long periods of time can cause hemorrhoids, especially on the toilet.
• Lifting heavy weights: Repeatedly lifting heavy objects can lead to hemorrhoids.
• Anal intercourse: This can cause new hemorrhoids or worsen existing ones.
• Obesity: Diet-related obesity can cause hemorrhoids.
• Genetics: Some people inherit a tendency to develop hemorrhoids.

What are the complications of Piles?

The complications of piles include:

• Bleeding during bowel movements
• Anemia
• Pain during bowel movements
• Piles cause complications associated with hygiene, as the anal area becomes difficult to clean after defecation

Poor hygiene around the anal area can lead to several infections

• Itchiness around the anal area
• Gangrene, if the blood supply to an internal hemorrhoid is cut off

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