Piles

Piles, also known as haemorrhoids, are swollen and inflamed veins in the lower part of the rectum and anus. They are a common medical condition that can cause pain, itching, bleeding, and discomfort during bowel movements. Piles may develop inside the rectum (internal piles) or around the anus (external piles).

• Piles are caused by increased pressure in the lower rectum due to chronic constipation, prolonged sitting, pregnancy, obesity, or straining during bowel movements. 
• Although they are rarely dangerous, they can cause significant discomfort and affect daily life. 
• Early treatment and lifestyle changes, such as eating a high-fibre diet, drinking plenty of water, and avoiding straining, can help manage and prevent piles effectively.
• So many people silently struggle with piles. By the age of 45 or 50, almost half of adults go through it. 
• Symptoms such as pain, itching, or bleeding can be upsetting, but they’re not usually dangerous. 

1.0Types of Piles

Piles are of two main types:

• Internal piles: Located inside the rectum. They usually don’t hurt, but may bleed.
• External piles: Form around the anus. These are often painful because the area has many sensitive nerves.

2.0Common Causes of Piles

Piles happen when pressure in the lower rectum makes veins swell. Common causes include:

• Chronic constipation or diarrhoea. 
• Straining during bowel movements
• Carrying a baby, which adds pressure down below
• Extra body weight that pushes on the abdomen
• Straining too often with weights
• Ageing, as tissues around the rectum weaken
• Family history can increase susceptibility

3.0Recognising Piles Symptoms

Piles don’t always show obvious signs. Symptoms can vary depending on whether the haemorrhoids are internal or external and on their grade.

• You might notice bright red blood when you go to the toilet
• Some pain or discomfort while passing stools
• Itching or irritation around your bottom
• Swelling or small lumps near the anus
• A hard, painful lump caused by a blood clot (thrombosed piles).
• Mucus discharge from the anus.
• A feeling of incomplete evacuation.
• Anaemia in severe cases is due to chronic blood loss.

For many, piles symptoms may disappear within a few days with lifestyle adjustments, but persistent or severe cases need medical attention.

4.0Diagnosis and Tests

Piles diagnosis usually begins with a clinical examination. For internal haemorrhoids, doctors may recommend additional diagnostic tests, including:

• Digital rectal examination (DRE): A gloved finger is inserted into the rectum to feel for swollen veins, lumps, or other issues.
• Proctoscopy: A quick, straightforward test where a small lighted tube helps your doctor see inside the anal canal.
• Colonoscopy: Recommended only if your symptoms suggest another digestive problem or a potential cancer risk.

5.0Treatment Options for Piles

For many people, piles can be managed with simple lifestyle changes and home remedies. But if the symptoms keep hanging around, it’s time to see a doctor for treatment of piles.

Lifestyle Changes

• Adding more fibre to your diet, like vegetables, fruits, beans, and whole grains
• Drinking lots of water and cutting back on coffee
• Getting in some regular exercise
• Not spending ages on the toilet
• Staying clean and taking warm sitz baths for comfort

Medications and Non-Surgical Procedures

• Ointments and creams to reduce itching and pain.
• Stool softeners to prevent straining.
• Rubber band ligation: Small bands are placed around the piles to cut off blood flow.
• Sclerotherapy: Injection of a chemical solution to shrink piles.
• Infrared coagulation: Gently uses heat to shrink swollen piles.

Surgical Treatments

In more advanced cases of piles, specifically Grade III or IV, surgery may be required.

• Hemorrhoidectomy: Complete surgical removal of the haemorrhoids.
• Stapled hemorrhoidopexy: A surgical procedure that lifts prolapsed piles back into place and reduces blood flow to them.

6.0Foods That Help in Pile Prevention

Diet plays a huge role in both managing and preventing piles. Fibre- and water-rich foods can keep your stools soft, so going to the bathroom is easier and less uncomfortable.

For better digestion and gut health, add these fibre-rich foods:

• Legumes (beans, lentils, chickpeas)
• Whole grains (brown rice, oats, barley)
• Cruciferous veggies (broccoli, cauliflower, cabbage)
• Root veggies (carrots, beets, sweet potatoes)
• Squash, bell peppers, celery, and artichokes