or piles are abnormally enlarged and dilated blood vessels (mainly veins) near
They occur in both men and women, most often
between the ages of 20 and 50 years. Several factors like Age, Heredity factors,
Diet and fluid intake are responsible for the development of
In many cases, hemorrhoids are very small and the
symptoms usually settle down without treatment.
are effectively treated with over-the-counter medications, good fluid intake,
and by following a diet rich in fiber
to avoid constipation. In
severe cases, the piles may require surgical
What are the Types of
Hemorrhoids can be of two types and are classified as
external or internal.External Hemorrhoids occur on
the outside edge of the anus. They are often painful.
They are dilated
veins forming swellings at the outer side of the external sphincter are known as
external piles or perianal hematoma.
They are less common
than internal hemorrhoids. External hemorrhoids are very itchy and cause intense
pain if a blood clot forms inside the hemorrhoid (thrombosed external
. A thrombosed external hemorrhoid often requires surgical.
It may heal with scarring and leave a skin tag protruding from the
- are much more
common that external hemorrhoids. Internal are dilated veins beneath the mucous
membrane and occur 2 to 4 cm above the opening of the anus within the anal
sphincter. They are above a line called the dentate line in the
anus.They are usually painless because there are
few pain-sensing nerves in the rectum.
Bleeding may be the only sign
of internal piles.
Internal hemorrhoids are
classified into four grades:Grade
- Hemorrhoids are small swellings inside the lining of the anus.
They are not visible externally. They may bleed but do not protrude through the
- Hemorrhoids are larger
than Grade 1 hemorrhoids. They extend inside the anus and may get pushed out
when passing a stool, but soon return back inside the
- Hemorrhoids are often
called 'prolapsed hemorrhoids’. They appear outside the anus and can be pushed
back on pressing with the finger.Grade 4
- Hemorrhoids cannot be pushed back and remain outside the anus all
the time. They are large and generally require a surgical treatment for their
What are the Causes of Hemorrhoids?
Several factors are responsible for the development of
due to weakness of the tissues that support the blood vessels in the anal region
and are commonly associated with the following:
- Heredity - They can be hereditary due to
congenital weakness of the vein walls.
- Sitting posture -
Sitting for long hours can predispose to piles.
heavy weights regularly.
- Chronic constipation or
diarrhea - Straining by constipation and over purgation can cause hemorrhoid.
Dysentery may aggravate latent hemorrhoids.
- Pregnancy -
Hemorrhoids are common among pregnant women. The pressure of the fetus in the
abdomen, as well as hormonal changes causes the hemorrhoidal vessels to
- Diseases like liver
diet- Eating junk food and a diet lacking in fiber contribute towards
- Age - generally seen in the age group from
30 to 50 years.
- Persistent cough and sneeze.
- An obstruction or abnormal growth on the way to the
What are the Symptoms of
Many people with hemorrhoids do not experience any
symptoms and do not even know they have them.
In majority of
the cases, Hemorrhoids are not serious and go away on their own within a few
Symptoms of hemorrhoids include:
- Bleeding from the anus, which is more
common with internal than external hemorrhoids. It can occur before, during, or
- Anus appears red and
- Itching, burning, swelling or pain is present
near the anus.
- Itching may be present due to swelling
and irritation produced by the hemorrhoids.
of the hemorrhoidal tissue
- Mucus discharge may appear
during bowel movement.
- Protrusion of the hemorrhoids
from the anus occurs frequently. This usually occurs after defecation, prolonged
standing, or unusual physical exertion.
- Sense of
fullness in the anus and straining while passing stools may be
- Anemia - If bleeding is profuse or long term,
the patient may have anemia.
How can we
Diagnosis of hemorrhoids is made on the basis of
history and rectal examination.
usually questions the patient regarding any family history of piles, appearance
of stools and bowel movements. The patient is also asked to explain the type of
bleeding they experience. If it is fresh blood or dark blood. In piles generally
the blood is fresh and bright red mixed with stools.
- The examination
Digital rectal examination, where the doctor
examines the piles with a gloved finger.Proctoscopy
- A hollow, lighted tube, known as a proctoscope, is used
to look at hemorrhoids and examine the lining of the rectum. The doctor may ask
the person to strain during this examination to see the
Blood test is done to check the hemoglobin to rule
The doctor may recommend a
colonoscopy if the signs and symptoms are suggestive of another digestive system