Medically reviewed by Dr. Ramesh Gaddam, M.D. — Written by Sumalatha, D.N.H.E
Hemorrhoids (Piles)
“Piles,” also known as hemorrhoids, are swollen and inflamed blood vessels in the rectum and anus that result in discomfort and bleeding. They can be either internal or external. Internal hemorrhoids develop inside the rectum, while external hemorrhoids form under the skin around the outside of the anus.
Causes of Hemorrhoids (Piles)
The primary causes of piles, also known as hemorrhoids, are often related to increased pressure in the lower rectum. This pressure can lead to the swelling and inflammation of the blood vessels in and around the anus. Here are some common causes and risk factors:
Straining during Bowel Movements:
- This is a significant factor. Straining to pass stool, often due to constipation or hard stools, puts increased pressure on the veins in the rectal area.
Chronic Constipation or Diarrhea:
- Both conditions can contribute to the development of piles.
- Constipation leads to straining during bowel movements, while chronic diarrhea can irritate the rectal area.
Sedentary Lifestyle:
- Lack of physical activity and prolonged sitting can contribute to the development of piles.
- Physical activity helps stimulate bowel movements and maintain overall digestive health.
Obesity:
- Being overweight or obese increases the pressure on the rectal veins, making the development of piles more likely.
Pregnancy:
- Hemorrhoids are common during pregnancy due to increased pressure on the pelvic veins and the strain of the growing uterus on the rectal area.
Aging:
- The tissues supporting the veins in the rectum and anus can weaken over time, making older adults more susceptible to piles.
Genetics:
- There may be a genetic predisposition to developing hemorrhoids, meaning individuals with a family history of piles may be at a higher risk.
Heavy Lifting:
- Straining during heavy lifting can increase intra-abdominal pressure and contribute to the development of hemorrhoids.
Low-Fiber Diet:
- Insufficient dietary fiber can lead to constipation, which is a risk factor for piles. Fiber helps soften stools and promotes regular bowel movements.
Chronic Cough or Sneezing:
- Conditions that lead to frequent coughing or sneezing can increase intra-abdominal pressure and contribute to the development of piles.
Symptoms of Hemorrhoids (Piles)
Hemorrhoids, commonly known as piles, can cause a variety of symptoms. The severity of symptoms can vary from person to person. Some common symptoms of hemorrhoids include:
Pain or Discomfort:
- Hemorrhoids can cause pain, especially during bowel movements.
- This pain is often due to the strain on the swollen and inflamed veins in the rectal area.
Bleeding:
- One of the most common symptoms is the presence of bright red blood on toilet paper, in the toilet bowl, or on the surface of the stool after a bowel movement.
- The bleeding is typically associated with internal hemorrhoids.
Itching or Irritation:
- The swollen veins can cause itching and irritation in the anal region.
- Scratching can further worsen the irritation.
Swelling:
- External hemorrhoids may cause visible swelling or a lump around the anus.
- This can be felt during self-examination.
Discomfort Sitting:
- Individuals with hemorrhoids may experience discomfort or pain when sitting for extended periods, especially on hard surfaces.
Protrusion:
- In more severe cases of internal hemorrhoids, there may be a protrusion or bulging from the anus during or after a bowel movement.
Mucus Discharge:
- Some people with hemorrhoids may notice a mucus discharge from the anal area.
Types of Hemorrhoids (Piles)
Hemorrhoids, also known as piles, can be classified into two main types based on their location: internal hemorrhoids and external hemorrhoids.
The type of hemorrhoid often determines the symptoms and the appropriate course of treatment.
Internal Hemorrhoids:
Location:
These hemorrhoids develop inside the rectum, so they are not visible from the outside.
Symptoms:
- Bleeding during bowel movements, typically seen as bright red blood on toilet paper or in the toilet bowl.
- Prolapse, where the hemorrhoid extends outside the anal opening during a bowel movement and retracts afterward.
- Discomfort or pain, especially if a prolapsed hemorrhoid becomes trapped outside the anal opening (prolapsed and strangulated hemorrhoid).
External Hemorrhoids:
Location:
These hemorrhoids develop under the skin around the outside of the anal opening.
Symptoms:
- Itching or irritation in the anal area.
- Swelling or a lump around the anus.
- Pain or discomfort, especially during activities such as sitting or bowel movements.
- Sometimes, bleeding.
Thrombosed Hemorrhoids:
Description:
This is a complication of external hemorrhoids where a blood clot forms in the swollen vein.
Symptoms:
- Severe pain and swelling around the anus.
- Hard lump near the anus.
- Sometimes bleeding.
Treatment:
Thrombosed hemorrhoids may require medical attention. In some cases, a healthcare provider may need to drain the clot.
Prolapsed Hemorrhoids:
Description:
Both internal and external hemorrhoids can prolapse.
Prolapsed internal hemorrhoids may protrude outside the anal opening during bowel movements and may need to be pushed back in manually or may retract on their own.
Symptoms:
Prolapsed hemorrhoids may cause discomfort, pain, or bleeding.
Grade or Stage of Internal Hemorrhoids:
Internal hemorrhoids are further classified into four stages (grades) based on their severity:
- First Degree (Grade I): Bleeding without prolapse.
- Second Degree (Grade II): Prolapse with spontaneous retraction.
- Third Degree (Grade III): Prolapse with manual reduction required.
- Fourth Degree (Grade IV): Prolapsed and cannot be manually reduced.
Diagnosis of Hemorrhoids (Piles)
The diagnosis of hemorrhoids typically involves a medical history review, physical examination, and, in some cases, additional diagnostic procedures. Here’s an overview of the diagnostic process:
Medical History:
- Your doctor will inquire about your medical history, including any symptoms you’re experiencing, the duration of the symptoms, and factors that may contribute to hemorrhoids (e.g., diet, lifestyle, bowel habits).
- Mention any family history of hemorrhoids or other relevant medical conditions.
Physical Examination:
- A physical examination of the rectal and anal area is usually performed.
- This may include a visual inspection of the anus and surrounding skin.
- In some cases, a digital rectal examination (DRE) may be conducted, where the doctor inserts a lubricated, gloved finger into the rectum to check for any abnormalities.
Proctoscopy or Anoscopy:
- These are procedures that involve using a lighted tube to examine the inside of the rectum and anus.
- A proctoscope or anoscope is inserted into the anal canal to allow for a closer examination.
Sigmoidoscopy or Colonoscopy:
- If there are concerns about more extensive gastrointestinal issues or if bleeding is severe, your doctor may recommend a sigmoidoscopy or colonoscopy.
- These procedures involve the insertion of a flexible tube with a camera through the rectum to visualize the lower part of the colon or the entire colon.
Other Imaging Tests:
- In rare cases, imaging tests such as ultrasound or MRI may be used to assess the blood flow and anatomy of the blood vessels in the rectal area.
Treatment of Hemorrhoids (Piles)
The treatment of hemorrhoids (piles) depends on the severity of the symptoms and the type of hemorrhoids (internal or external).
In many cases, mild hemorrhoids can be managed with lifestyle changes and over-the-counter treatments, while more severe cases may require medical procedures. Here are various treatment options:
Lifestyle Modifications:
Dietary Changes:
- Increasing fiber intake through fruits, vegetables, whole grains, and legumes can soften stools and make them easier to pass, reducing strain during bowel movements.
Hydration:
- Drinking plenty of water helps prevent constipation and keeps stools soft.
Regular Exercise:
- Physical activity promotes bowel regularity and overall digestive health.
Avoid Straining:
- Try not to strain during bowel movements. If needed, use a stool softener.
Over-the-Counter (OTC) Medications:
Topical Treatments:
- Over-the-counter creams, ointments, or suppositories containing ingredients like hydrocortisone or witch hazel can help alleviate symptoms such as itching and inflammation.
Pain Relievers:
- Non-prescription pain relievers, such as acetaminophen or ibuprofen, may help manage pain.
Medical Procedures:
Rubber Band Ligation:
- This procedure involves placing a rubber band around the base of an internal hemorrhoid, cutting off its blood supply, causing it to shrink and fall off.
Sclerotherapy:
- A chemical solution is injected into the blood vessels of the hemorrhoid, causing it to shrink.
Infrared Coagulation (IRC):
- This procedure uses infrared light to coagulate the blood vessels, leading to the shrinkage of the hemorrhoid.
Hemorrhoidectomy:
- In more severe cases, surgical removal of hemorrhoids may be necessary. This is usually reserved for large internal or external hemorrhoids.
Hemorrhoid Procedures Using Laser or Bipolar Energy:
- Newer techniques involve using laser energy or bipolar energy to seal the blood vessels associated with hemorrhoids.
- These procedures are less invasive than traditional surgical methods.
Hemorrhoid Stapling (Stapled Hemorrhoidopexy):
- This procedure involves stapling the hemorrhoid to cut off its blood supply, reducing its size.
Prevention of Hemorrhoids (Piles)
Preventing hemorrhoids involves adopting a lifestyle that promotes good bowel habits, reduces straining during bowel movements, and minimizes factors that contribute to the development of hemorrhoids. Here are some preventive measures:
High-Fiber Diet:
- Include plenty of fiber-rich foods in your diet, such as fruits, vegetables, whole grains, and legumes.
- Fiber adds bulk to the stool and helps prevent constipation.
Adequate Hydration:
- Drink plenty of water throughout the day.
- Proper hydration softens stools, making them easier to pass.
Regular Exercise:
- Engage in regular physical activity to promote overall digestive health and prevent constipation.
- Even moderate exercise, such as walking, can be beneficial.
Avoid Prolonged Sitting:
- If your job requires prolonged sitting, take breaks and stretch regularly.
- Avoid sitting on the toilet for extended periods, as this can contribute to hemorrhoid development.
Maintain a Healthy Weight:
- Achieving and maintaining a healthy weight reduces the pressure on the veins in the rectal area, lowering the risk of hemorrhoids.
Good Toilet Habits:
- Establish regular bowel habits. Don’t delay or force bowel movements. If you feel the urge to have a bowel movement, go to the toilet promptly.
- Use a soft, moist toilet paper or consider using wet wipes to avoid irritation.
- Consider using a stool or a small footrest to elevate your feet while sitting on the toilet. This can help achieve a more natural bowel movement position.
Avoid Straining:
- Straining during bowel movements can contribute to the development of hemorrhoids.
- If you’re having difficulty passing stool, consider using a stool softener as recommended by your healthcare provider.
Wear Loose Clothing:
- Choose loose, breathable clothing, especially around the anal area.
- Tight clothing can contribute to irritation.
Take Breaks During Pregnancy:
- If pregnant, take breaks and avoid standing or sitting for long periods.
- Follow your healthcare provider’s advice for managing pregnancy-related hemorrhoids.
Don’t Ignore Symptoms:
- If you experience symptoms such as bleeding, pain, or discomfort in the anal area, seek prompt medical attention.
- Early intervention can prevent the worsening of hemorrhoids.
Frequently Asked Questions
What is the fastest way to heal a hemorrhoid?
There is no guaranteed “fast” way to heal hemorrhoids, as the recovery time can vary based on the severity of the condition. However, some strategies may help alleviate symptoms and promote healing:
- Over-the-counter treatments: Use creams, ointments, or suppositories containing ingredients like hydrocortisone or witch hazel.
- Warm baths: Soak in a warm bath for 10-15 minutes several times a day.
- Dietary changes: Consume a high-fiber diet to soften stools and prevent constipation.
- Hydration: Drink plenty of water to stay well-hydrated.
What causes hemorrhoids?
Several factors can contribute to the development of hemorrhoids:
- Straining during bowel movements: Due to constipation or diarrhea.
- Prolonged sitting: Especially on the toilet.
- Obesity: Excess weight puts pressure on the rectal veins.
- Pregnancy: Increased pressure on the pelvic veins.
- Aging: Weakening of tissues supporting the rectal veins.
What happens if hemorrhoids go untreated?
If left untreated, hemorrhoids can persist and may lead to complications, including:
- Thrombosis: Formation of blood clots in external hemorrhoids.
- Strangulation: When an internal hemorrhoid prolapses and becomes trapped, cutting off blood supply.
- Chronic bleeding: Prolonged bleeding may lead to anemia.
- Infection: Rarely, external hemorrhoids can develop infections.
How do you get rid of piles?
The approach to getting rid of piles depends on the severity:
- Lifestyle changes: High-fiber diet, regular exercise, and proper hydration.
- Over-the-counter medications: Creams, ointments, or suppositories.
- Medical procedures: Rubber band ligation, sclerotherapy, or surgery in severe cases.
How can I treat piles in 3 days at home?
While complete healing in three days is unlikely, you can manage symptoms:
- Over-the-counter treatments: Use creams or suppositories.
- Warm baths: Soak for relief.
- Dietary changes: Increase fiber intake and stay hydrated.
What should not to eat in piles?
To avoid aggravating hemorrhoids, consider limiting:
- Spicy foods: Can irritate the digestive tract.
- Processed foods: Often low in fiber.
- Dairy products: May contribute to constipation.
- Red meat: High fat content can be hard to digest.
It’s essential to consult a healthcare professional for personalized advice and treatment based on your specific condition.
What food should I eat if I have piles?
A high-fiber diet can help prevent and alleviate symptoms of piles. Include the following foods in your diet:
- Whole grains: Brown rice, oats, quinoa, and whole wheat.
- Fruits and vegetables: Apples, pears, berries, broccoli, carrots, and leafy greens.
- Legumes: Lentils, beans, and chickpeas.
- Nuts and seeds: Almonds, chia seeds, and flaxseeds.
Which fruit is best for piles?
Several fruits are rich in fiber and can be beneficial for piles:
- Berries: Such as raspberries, strawberries, and blueberries.
- Apples: Especially with the skin.
- Bananas: Rich in fiber and easy to digest.
- Pears: Provide a good source of soluble fiber.
Can we drink milk in piles?
- Yes, milk is generally considered safe to drink if you have piles.
- However, it’s essential to maintain a balanced diet and not rely solely on milk.
- Ensure that you are also consuming an adequate amount of fiber from fruits, vegetables, and whole grains.
Is Egg good for piles?
- Eggs are a good source of protein and generally do not worsen piles.
- However, it’s advisable to prepare them in a way that does not add unnecessary fats or spices that might irritate the digestive system.
- Boiled or poached eggs are preferable over fried or heavily seasoned preparations.
Is curd good in piles?
- Yogurt or curd can be beneficial for piles as it contains probiotics, which support gut health.
- Probiotics contribute to a healthy balance of bacteria in the digestive system.
- Opt for plain, unsweetened yogurt without additives.
Can I eat rice in piles?
- Brown rice is a better choice than white rice for individuals with piles because it contains more fiber.
- Fiber helps soften stools and promotes regular bowel movements.
- Ensure that you cook rice thoroughly to make it easier to digest.
Is chicken good for piles?
- Chicken, particularly lean and well-cooked, can be included in a diet for individuals with piles.
- It provides a good source of protein without adding excessive fats or spices.
- Grilled or boiled chicken is preferable over fried or heavily seasoned preparations.
Can I eat chapati in piles?
- Yes, chapati or whole wheat bread is a good choice for individuals with piles.
- Whole grains, including whole wheat, are rich in fiber, which helps soften stools and promotes regular bowel movements.
- Fiber is beneficial in preventing and managing piles.
Can we drink tea in piles?
- While moderate consumption of tea is generally acceptable, it’s essential to be mindful of the type of tea and additives.
- Avoid excessive caffeine and spicy or irritating ingredients.
- Herbal teas, such as chamomile or peppermint, may be gentler on the digestive system.
Is ghee good for piles?
- Ghee, or clarified butter, is considered to be a fatty food and should be consumed in moderation, especially if you have piles.
- While small amounts may not necessarily worsen symptoms, it’s advisable to be mindful of overall fat intake.
- Opt for healthier cooking oils and fats, such as olive oil.
Is potato good for piles?
- Potatoes, especially when prepared in a healthy manner, can be included in a diet for individuals with piles.
- Potatoes provide some dietary fiber, and they are generally well-tolerated.
- Boiled or baked potatoes are preferable over fried or heavily seasoned preparations.
Is papaya good for piles?
- Yes, papaya is often recommended for individuals with piles.
- Papaya is rich in enzymes, such as papain, and dietary fiber, which can aid in digestion and promote regular bowel movements.
- Including papaya in your diet may help alleviate symptoms of piles.
Is coconut water good for piles?
- Yes, coconut water is generally considered good for individuals with piles.
- It is hydrating and can help maintain proper hydration levels, which is important for digestive health.
- Additionally, coconut water is low in calories and contains electrolytes, making it a healthy beverage choice.
Is onion good for piles?
- Onions, when consumed in moderation, are typically well-tolerated and can be included in a diet for individuals with piles.
- Onions have some fiber content and can add flavor to dishes.
- However, if raw onions cause discomfort, consider cooking them or opting for milder varieties.
Can I eat banana if I have piles?
- Yes, bananas are often recommended for individuals with piles.
- They are a good source of dietary fiber, which can help soften stools and promote regular bowel movements.
- Additionally, bananas are easy to digest and provide essential nutrients.
Which breakfast is best in piles?
A healthy breakfast for individuals with piles may include:
- Oatmeal: High in soluble fiber.
- Whole grain cereal or toast: Provides additional fiber.
- Fruits: Such as bananas or berries for added fiber and nutrients.
- Yogurt: Contains probiotics that support digestive health.
Is dates good for piles?
- Dates are a good source of dietary fiber and can be included in a diet for individuals with piles.
- However, it’s important to consume dates in moderation, as they are high in natural sugars.
- Including a variety of fiber-rich foods in your diet is beneficial for managing and preventing piles.
Note:
- It’s essential to remember that individual responses to foods can vary, and it’s advisable to pay attention to your body’s reactions.
- If you have specific dietary concerns or if your symptoms persist, it’s recommended to consult with a healthcare professional or a registered dietitian for personalized advice based on your individual condition.
External References:
- Mayo Clinic – Hemorrhoids (Piles):
- WebMD – Hemorrhoids (Piles):
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) – Hemorrhoids:
- MedlinePlus – Hemorrhoids:
- American Society of Colon and Rectal Surgeons (ASCRS) – Hemorrhoids:
Medically reviewed by Dr. Ramesh Gaddam, M.D.
General Physician, Diabetologist, and Critical Care Specialist.
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