Medically known as hemorrhoids, piles are a collection of inflamed tissue in the anal canal. They contain blood vessels, muscles, elastic fibers, and support tissues. These vary in size, and can be found inside or outside of anus. Internal piles are located between and above the opening of anus, and are more common. These are usually 2 to 4 cm in size. External piles are found on the outside edge of the anus.
Piles are caused by increased pressure on the rectum. The blood vessels around anus and in the rectum will stretch under pressure and may eventually bulge and swell, forming piles. Piles may develop due to many reasons, such as:
Chronic constipation
Chronic diarrhea
Lifting heavy weighs, and
Straining when passing a stool
Piles can be classified into the below four categories:
Grade I: These piles are not visible as they usually lie inside the lining of the anus. These piles only cause small inflammation.
Grade II: These piles are larger than grade I piles but they do not remain confined to the inside of the anus. They may be pushed outside while passing stool and are returned inside after the bowel movement.
Grade III: Also known as prolapsed hemorrhoids, these appear outside the anus. These piles may get appear outside the anus in some patients who will feel them hanging from the rectum. However, these piles can be easily re-inserted.
Grade IV: These piles cannot be pushed back and need treatment. These are large and remain outside the anus.
Symptoms of piles include:
A hard or painful lump that may be felt around the anus that may contain coagulated blood.
The person with piles will have the feeling that the bowel is still full.
The area around the anus is sore, red and itchy.
Bright red blood is if often seen after a bowel movement.
The person experiences pain while passing stool.
Piles, if not treated, can cause some severe symptoms, such as:
Excessive anal bleeding, that can also lead to anemia or shortage of red blood cells
Inability to control bowel movement or fecal inconsistence
Anal fistula, in which condition a new channel is created between the surface of the skin near the anus, and the inside of the anus.
Infection of anus and rectum
Blood supply to the hemorrhoid may be cut off, causing blood clot, a condition known as strangulated hemorrhoid.
Diagnosis of piles
To diagnose your piles, your doctor may ask you questions, like if there is any blood in the stool, have the bowel movements changed recently, the color of the stool, of any of the close relatives have piles. However, if you have internal piles, your doctor may need to perform a digital rectal examination (DRE), or use a proctoscope for this purpose. A protoscope is a hollow tube which is fitted with light, and allows the doctor to see the close up of the inside of the canal cap. The doctor can take a small tissue sample from inside the rectum. This process is known as biopsy. The sample of biopsy can be sent for lab analysis.
Treatment for piles
The treatment of piles may include lifestyle changes, such as change in diet. The doctor may ask you to eat more fiber, such as fruit and vegetables, or primarily eating bran-based breakfast cereals. Losing weight may also help in improving piles. The doctor may also suggest you some exercises, or avoid straining while passing stool. The medications for piles include OTC (over the counter) medications such as ointments, painkillers, and creams. Carticosteroids can reduce inflammation and pain, while laxatives can be prescribed to help easily pass stool. Surgeries such as banding, sclerotherapy, hemorrhoidectomy and infrared coagulation may be required in some cases.
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