The anal canal is a part of the rectum (segment of the large intestine) and the terminal portion of the bowel, which regulates the passage of fecal excretion. The final opening at the end of the anal canal is the anus.

The anal canal contains many vascular structures that act as a cushion while passing stools. The vascular bed in the anal canal consists of small blood vessels (sinusoids), smooth muscles, and loose connective tissue.

What Are Piles or Hemorrhoids?

Piles, otherwise called hemorrhoids, are inflamed veins at the anus or rectum. They arise from congestion of the internal or external venous plexus around the anal canal. They are extremely common in adults. Nearly every person would have faced minor problems with hemorrhoids at some point in time. Both the sexes equally experience the incidence of hemorrhoids.

What Causes Piles?

Although the cause of piles is usually unknown, sometimes piles could be a result of:

Bowel movement irregularity.
Constipation.
Straining while passing stool.
Pregnancy.
Chronic diarrhea.
Lifting heavyweight.
After giving birth to a baby.
Lack of physical activity or exercise (sedentary lifestyle).
Eating less fiber in the diet.
Increased pressure in the abdomen due to any disease.
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Genetical predisposition.

What Are the Types of Piles?

There are two types of piles, depending on the location,

Internal Piles: It is usually located about 2 cm to 5 cm above the anal opening.
External Piles: It is located around the edge of the anus.

Sometimes, the piles can be mixed (internal-external) involving the area of both types.

Piles can also be classified based on the findings in their location. They are,

Primary: The hemorrhoids are located in the anal cushions.
Secondary: They typically occur in between the cushions or in the circumference.

Less frequently, hemorrhoids can be expressed as prolapsing and non-prolapsing in relation to disease symptoms and progression.

What Are the Grades of Piles?

Piles have four grades or degrees classified based on the degree of prolapse and appearance,

First Degree - Here, piles bleed but do not prolapse even during defecation.
Second Degree - When piles prolapse and retract (goes back inside) themselves, it falls under the second degree (remains inside the rectum).
Third and Fourth Degree - Here, piles require manual replacement after prolapsing (visible and easy to feel around the anus).

How Do Piles Develop?

There are many theories proposed to understand the development of piles. Some of them are discussed below,

Varicose veins were initially attributed to being associated with the development of piles, but the theory became obsolete.
The most well-accepted theory is the sliding anal canal, where there is the disintegration of the anal cushions. The displacement of the anal cushion leads to abnormal venous dilatation, one of the significant pathological changes in piles.
Neovascularization (new vessel formation) may increase the density of the microvascular structure that has been found in the hemorrhoidal tissue.
Hypervascularization of the anal cushion from the terminal branches of the arteries supplying the anal canal is co-linked with the severity of piles. Hence it was proposed that the dynamics of blood flow change the development of piles.
There exists a sphincter-like structure in the veins of the anal canal, which regulates venous drainage efficiently. Therefore, any disturbance in the sphincter mechanism can result in piles formation.
Imbalance in inflammatory mediators and hormones may play a role in the dysregulation of hemorrhoidal tissue, leading to piles.

What Are the Symptoms of Piles?

Patients suffering from piles may have the following symptoms:

Pain in the rectum before or during, or after passing stool.
Burning in the rectum before or during, or after passing stool.
Pricking sensation in the rectum.
Bright red bleeding after passing stool. This is mostly seen in the second and third degrees.
Discomfort while sitting.
Pruritus ani (chronic itching in the perianal region).
Mucus discharge from the rectum.
Incomplete bowel action because of pain.
Hard stool.
Sometimes piles lead to severe bleeding, which might cause anemia.
Backache.

How to Manage Piles?

The primary goal of treating piles is to diminish the acute symptoms based on the type and severity of the piles.

Conservative Method:

Most of the cases respond well to conservative management.
Dietary changes and lifestyle modifications are the initial treatment protocol suggested, and it is an integral part of the management of piles.
Oral flavonoids and Calcium Dobesilate are venotonic drugs used to reduce the excruciating symptoms of piles.
Topical ointments could subsequently control the symptoms.
Medical therapies like rubber band ligation, sclerotherapy, radiofrequency ablation, infrared coagulation, bipolar diathermy, and cryotherapy have been recommended to manage mild to moderate grade piles.

Surgical Method:

Surgical management has opted when there is no improvement in symptoms from conservative management.
Surgical intervention includes hemorrhoidectomy, plication, Doppler-guided hemorrhoidal artery ligation, and stapled hemorrhoidopexy.

Homeopathy Method:

Homeopathy is a popular alternative medicine. They treat the patients with individualized treatment based on their symptoms and severity issues.
Studies suggested that with the use of custom-made individualized homeopathic treatment, there was a significant reduction in the piles symptoms like pain, itchiness, heaviness, and bleeding.
Hence homeopathy remains a promising solution for piles problems.

What Are the Preventive Measures for Piles?

A few steps to avoid discomfort in piles are as follows:

Have a fiber-rich diet to treat constipation.
Drink plenty of liquids.
Consume enough water to avoid constipation.
Do not strain when you defecate. It is better to wait for 2 minutes than to strain to empty the bowel. Or just sit up and try again. Straining will worsen your pain, itching, and burning.
Apply coconut or castor oil to reduce the burning, pain, and itching.
Banana, figs, and raisins have laxative effects, so include them in your diet.
Load your plate with vegetables because they are a good source of fiber.

Conclusion:

Sometimes, piles reappear even after surgery. But with the help of homeopathy and natural remedies, you can get rid of piles easily without surgery. So, follow some lifestyle changes and follow these tips to get rid of piles.

Frequently Asked Questions

1. How to Alleviate Piles Symptoms?

- Drink loads of fluids and eat plenty of fiber to keep your poop soft.
- Using damp toilet paper to wipe your bottom.
- If you have piles, take paracetamol.
- To relieve itch and pain, take a warm bath.
- To relieve pain, wrap an ice pack in a towel.
- Maintain a clean and dry bottom.
- Regular exercise.
- Reduce the intake of alcohol and caffeine (such as tea, coffee, and cola) to avoid constipation.

2. How Are Piles Treated?

The primary goal of treating piles is to reduce the acute symptoms, which vary depending on the type and severity of the piles. The initial treatment protocol suggested is dietary and lifestyle changes essential to piles management. Oral flavonoids and Calcium Dobesilate are venotonic drugs used to alleviate piles' agonizing symptoms. In addition, medical therapies such as rubber band ligation, radiofrequency ablation, sclerotherapy, bipolar diathermy, infrared coagulation, and cryotherapy have been recommended to treat mild to moderate-grade piles. When conservative treatment fails to improve symptoms, surgical intervention is considered.

3. Which Food Can Worsen Piles?

Limit foods low in fiber, such as dairy products, white flour, red meat, processed meat, and fried and salty foods. These can aggravate constipation, which can lead to piles. Spicy foods should also be avoided. While spicy foods are not necessarily low in fiber, they may increase the pain and discomfort associated with hemorrhoids. Caffeinated beverages, particularly coffee, may harden your stools and cause pooping pain. Alcoholic beverages can dry out your stools and make piles worse.

4. Which Foods Help Piles Symptoms?

Foods that help to relieve piles symptoms include:
- Legumes.
- Whole grains.
- Broccoli and other cruciferous vegetables.
- Artichokes.
- Root vegetables like turnips, sweet potatoes, beets, carrots, rutabagas, and potatoes.
- Bell peppers.
- Celery.
- Cucumbers and melons.
- Pears.
- Apples.
- Raspberries.
- Bananas.
- Stewed prunes.

5. Is It Possible to Check Piles at Home?

Piles symptoms to look out at home for include:
- Bright red blood after pooping.
- An itchy sensation in the anus.
- Feeling as if you still need to poop after using the restroom.
- After wiping your bottom, you may find mucus in your underwear or toilet paper.
- Lumps around the anus.
- Pain around the anus.

6. How Long Do Piles Symptoms Last?

There is no time limit for how long piles will last. Some minor flare-ups resolve on their own after a few days, whereas larger external hemorrhoids may take longer to heal and may necessitate medical attention. Small hemorrhoids usually disappear on their own after a few days. However, larger hemorrhoids, especially those that cause a lot of itchiness, swelling, and pain, cannot heal on their own and may require to be treated by a doctor.

7. How Are Piles Removed?

Haemorrhoidectomy is a surgical procedure used to remove severe hemorrhoids or piles. Usually, it is a day procedure that is performed under general anesthesia. The procedure is common and safe, but recovery can take several weeks and be painful.

8. Can Stress Trigger Piles?

Stress can cause digestive issues, and straining from constipation or diarrhea can cause hemorrhoids to flare up. When people are stressed, their sphincter muscle tightens and puts pressure on the rectum. This pressure can aggravate hemorrhoids.

9. What Do Piles Look Like?

The anal canal is a short, muscular tube with blood vessels that connects the rectum (back passage) to the anus. Piles are round, small, discolored lumps that form inside and around the anus. You might feel them on the anus or hanging from the anal canal.

10. Do Piles Burst?

External hemorrhoids or piles can burst if they become thrombosed, which means that a blood clot has formed within them. People who experience this may notice a hard, painful lump outside their anus. A thrombosed hemorrhoid can burst if too much pressure builds up inside it.

11. Are Piles Contagious?

No, hemorrhoids do not spread from person to person. They cannot be passed on to others through any form of contact, including sexual contact. Hemorrhoids form as a result of increased pressure in the lower rectum.

12. What if Piles Are Left Untreated?

Though the hemorrhoids may retract back inside by themselves or with assistance, prolapsed hemorrhoids worsen over time. The internal prolapsed hemorrhoid may become trapped outside the anus if left untreated, causing serious irritation, bleeding, itching, and pain.