Piles, or haemorrhoids, are areas in the anal canal where the tissue, which contains lots of bloodvessels, has become swollen. They can be internal, occurring inside the anus, or external, whenthey can be seen and felt on the outside of the anus. When visible they look like round pink swellings, the size of a pea or a grape. Piles are common in pregnant women, but are rare inchildren.
What causes piles?
Straining to empty the bowels when constipated.Chronic diarrhoea.Pregnancy
the weight of the fetus on the abdomen and the increased blood flow, as well as theeffect of hormones on the blood vessels.Childbirth
pushing during childbirth increases the pressure in the veins.Straining to pass urine, especially in men with prostate problems.Cancer or growths in the pelvis or bowel, which may exert pressure in a similar way to apregnancy. Family history
piles can run in families and are potentially hereditary, perhapsbecause of weak veins in the anal area.Obesity.Varicose veins
many people with these also develop piles, although piles are not varicoseveins.
Different types of piles
Piles are classified according to their position. First-degree piles remain inside the rectum or analcanal. Second-degree piles protrude (or prolapse) from the anus when the bowels are opened, butreturn of their own accord afterwards. Third-degree piles are similar, but only return inside whenpushed back. Fourth-degree piles hang permanently outside the anus.
What are the symptoms?
Most people affected have internal piles and may not have any symptoms at all. The earliestsymptom is often bleeding of fresh, red blood from the anal passage when the bowels areopened. There may be itchiness around the anal area. Third and fourth degree piles may be morepainful and tend to produce a slimy discharge of mucus that leaks from the exposed lining of thepile.There are conditions other than piles that can cause bleeding from the anus, so anyone whonotices bleeding in their stool should visit a doctor for advice.
The doctor will ask about your health and carry out a physical examination.If there are external piles, these will be spotted on examination. A rectal examination, where agloved finger is gently inserted into the anal canal, will be performed. Internal piles cannotnormally be felt in this way, but the examination can reveal other problems such as an analfissure - a painful tear of the lining of the anus. These other conditions need to be excludedbefore a diagnosis can be made.