- Signs and Symptoms
- When to See the Doctor
What are piles (hemorrhoids)?
Piles, or hemorrhoids, occur when the veins within the rectum and anus (organs at the end of your digestive tract that pass stools) become inflamed and swollen. Piles usually aren’t serious and heal within a week, but severe cases may require medical treatment.
Signs and symptoms of piles (hemorrhoids)
Mild piles can often go unnoticed, but they have a range of symptoms, especially regarding your bowel movements.
Piles can range from painless to severely painful. Sharp pain or a pinching feeling may occur when you’re sitting on the toilet or passing a stool. The anus or area between your buttocks may also feel sore, especially after a bowel movement.
Piles can cause an itching sensation around the anus. Often, scratching can make it itch more.
All types of piles can bleed, even if you’re not experiencing any pain. Bright red blood can appear in the stools and the water surrounding it, or on used toilet paper.
Tender lumps of skin can develop outside the anus. You may be able to see one, or feel it as you wipe after a bowel movement.
Types of piles (hemorrhoids)
Piles can be internal or external. Internal piles develop inside the anus and are not visible on the skin around it, while external piles develop on the skin outside the anus. Internal piles fall under four grades, I to IV.
- Grade I: The pile is completely internal—it doesn’t extend out of the anus. You can’t see or feel it on the skin.
- Grade II: The pile is internal but can extend outside of the anus while straining or passing a stool. After passing a stool, the pile goes back inside by itself.
- Grade III: Like grade II, this type of pile extends outside the anus while straining but won’t go back inside on its own — you must push it back in.
- Grade IV: The pile extends outside the anus and cannot be pushed back in. See a doctor immediately if you think you have this type.
Causes of piles (hemorrhoids)
Piles can have several different causes, usually having to do with increased pressure and strain around the pelvis and rectum. This increased pressure can push more blood to the veins in that area, causing them to swell.
During pregnancy and childbirth, the enlarged uterus and expanded vaginal canal increase pressure on the nearby pelvis and rectum, creating piles. Hormonal changes during pregnancy can also cause piles.
Over-long bathroom trips
The angle of your backside on the toilet seat is low enough to cause blood to pool in your anal veins if you sit in the same position for too long.
The strain of constipation can also cause too much blood to flow to your anal tissue, creating swollen veins.
Like constipation, lifting heavy objects increases blood flow to your muscles. This includes your rectal and anal muscles, even if you’re not using them directly.
When to see the doctor for piles (hemorrhoids)
Usually, piles heal on their own and don’t require medical attention. But contact your doctor if you notice blood while you’re passing a stool. Bright red blood generally comes from the lower digestive tract (intestines, anus), while black or tarry-appearing blood comes from higher up in your body.
The most common reasons for bright blood in the stool are usually not serious, but sometimes it can indicate a more serious underlying illness. If your piles often reappear, don’t heal on their own at home, or cause you severe pain, contact your doctor.
Diagnosis of piles (hemorrhoids)
A doctor can perform a rectal exam to determine whether you have piles. With a gloved and lubricated finger, they will gently feel inside and around your anus to look for any growths or lumps, internal or external piles, leakage, or other symptoms.
Treatments for piles (hemorrhoids)
You can treat most piles at home, but severe cases might require a doctor's help.
Since constipation is a common cause of piles, keeping stools soft and easy to pass is key. Try to eat foods containing fiber, a nutrient that helps your body digest food.
High-fiber foods include whole grains and bran, fruits and vegetables, and beans. Limit the amount of low-fiber foods you eat, like chips, meat, ice cream, and cheese.
Drinking lots of water and clear liquids, like chicken soup, can also help soften your stools.
A sitz bath—sitting in warm water so it surrounds your anal area—can reduce pain and itching. You can use a sitz bath bowl or a bathtub.
For severe piles, a doctor may perform rubber band ligation (tying a small band to the base of the pile to cut blood flow), sclerotherapy (chemical injection), or cryotherapy (freezing with special gas or liquid). Surgery may be necessary for piles that don’t respond to other treatments.
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American Society of Colon & Rectal Surgeons: "Pruritus Ani Expanded Version."
Aurora Health Care: "Hemorrhoid Treatment."
GI Society: "Hemorrhoids."
Canadian Family Physician: "Hemorrhoids in pregnancy."
Geisinger: "How long is too long on the potty?"
Harvard Health Publishing: "Hemorrhoids and what to do about them."
National Institute of Diabetes and Digestive and Kidney Diseases: "Diagnosis of Hemorrhoids."
National Institute of Diabetes and Digestive and Kidney Diseases: "Eating, Diet & Nutrition for Hemorrhoids: What should I eat if I have hemorrhoids?."
Saint Luke's: "Taking a Sitz Bath."
SCL Health: "Hemorrhoids."
UnityPoint Health: "Blood in Stool: What Does it Mean?"
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Does Pushing a Hemorrhoid Back in Help?Hemorrhoids are very common and appear when the veins under the lining of the rectum and anus become swollen and bulge. Yes, you can push a hemorrhoid back in.
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Hemorrhoids (piles) are swollen veins in the rectum and anus. Causes include pregnancy, obesity, diarrhea, low-fiber diet, and prolonged sitting on the toilet. Treatment varies depending upon the severity of the hemorrhoids. Some treatment options include over-the-counter creams and suppositories, stool softeners, warm sitz baths, and hemorrhoidectomies.
How to Get Rid of Hemorrhoids: Types, Causes, and TreatmentsLearn how to get rid of hemorrhoids, the difference between internal hemorrhoids and external hemorrhoids, what causes hemorrhoids, how long hemorrhoids last, and hemorrhoids treatment.
Hemorrhoids QuizDoes everyone have hemorrhoids? Test your knowledge of this and many other facts about Hemorrhoids.
Home Remedies for HemorrhoidsHemorrhoids are enlarged, swollen veins in the lowest part of the rectum and anus. These veins bulge and get irritated, especially when the patient defecates, and cause bleeding. Hemorrhoids are also commonly called piles. It is one of the most common causes of rectal bleeding.
How Do Hemorrhoids Go Away?Hemorrhoid symptoms may go away with diet and lifestyle modifications. You must, however, seek immediate medical care if your symptoms do not go away in a week or you experience symptoms.
How Do You Cure Piles?Learn what medical treatments can help ease your piles symptoms and speed up your recovery
How Long Do Thrombosed External Hemorrhoids Last?Many thrombosed external hemorrhoids may go away within a few weeks. An external thrombosed hemorrhoid develops under the skin surrounding the anus and causes discomfort due to the presence of a blood clot in the vein. The pain of thrombosed hemorrhoids may improve within 7-10 days without surgery and may disappear within two to three weeks.
How Long Does it Take Hemorrhoids to Heal?If you've ever had hemorrhoids, you know that they can be very painful and irritating. Learn what hemorrhoids are, how doctors treat them, and what you can do to speed up their healing.
How Should You Sleep With Hemorrhoids?Hemorrhoids happen when pressure causes veins in your rectum and anus to stretch, swell, and bulge. Sleep with hemorrhoids by pushing them back in, taking a sitz bath before bed, using topical creams and using other strategies.
What Causes Hemorrhoids?Piles or hemorrhoids generally happen when there is a lot of pressure on the veins around the anus.
What Happens If You Leave a Hemorrhoid Untreated?If you have mild hemorrhoids, leaving them alone can be fine. The swelling and discomfort will usually go away within a few days. Occasionally, though, there may be complications related to hemorrhoids.
What Should You Not Do if You Have Hemorrhoids?Swollen veins located in or around the anal canal are known as hemorrhoids. If you have hemorrhoids avoid foods that are fatty or low in fiber; don't pick at hemorrhoids; avoid lifting heavy objects; avoid stress and anxiety; and avoid overusing laxatives.