Hemmorrhoids ( Piles )

PILES / HEMORRHOIDS ++++ + + Piles
ANAL FISSURE ++ ++++ + Fissure
ANAL FISTULA + ++ ++++ Fistula

Haemorrhoids, generally known as Piles, is a very common disease affecting almost 70% of the population.

Understanding Piles

Haemorrhoids / Piles is nothing but swollen and inflamed veins in the anus or the lower rectum. The actual cause is not known however the main causes of piles are believed to be

  1. Long standing
  2. Chronic diarrhoea or constipation
  3. Straining while defecation
  4. Obesity
  5. Pregnancy
  6. Weakening of muscles due to ageing etc
  7. Hereditary tendencies

CausesAs described earlier, hemorrhoids develop because of increasing pressure in the veins of the lower part of the rectum and anus. This increasing pressure can be due to various reasons like Pregnancy, Straining during chilled birth, Obesity, Lifting heavy weights over a long period, Sitting or standing for a long time, Chronic constipation accompanied with straining to evacuate the bowels Repeated diarrhea and dysentery, A habit of suppressing the urge to defecate, There may also be an inherited tendency to develop Hemorrhoids / Piles.


Haemorrhoids / Piles are mainly classified in to two types based on location

  1. External Haemorrhoids / Piles :

    External Haemorrhoids or pile mass occur below the dentate line which are usually very painful in nature causing irritation and itching around the anus. They may be thrombosed sometimes (Thrombosed Piles) with pool of blood forming a clot resulting in inflammation and severe pain.

  2. Internal Haemorrhoids / Piles :

    Internal Haemorrhoids or Pile mass occur above the dentate line and are usually painless but present with severe bleeding per rectum during or after defecation. As per the stages of the disease, they can be classified in to four.

  3. First Degree Haemorrhoids - Pile mass projects slightly into the lumen of the anal canal during defecation due to congestion of the veins.
  4. Second Degree Haemorrhoids - Pile mass projects out of the anal canal while defecation but returns in to the anal canal spontaneously after defecation.
  5. Third Degree Haemorrhoids - Pile mass protrude outside of the anus during defecation and remain protruded until manually reduced within the anus.
  6. Fourth Degree Haemorrhoids - Large Pile mass always remain protruded outside and cannot be manually reduced in to the anal canal.


About 40% of people suffering from Haemorrhoids show no significant symptoms. However, the common symptoms include

  1. Bleeding per rectum (Prolonged or severe bleeding may lead to anaemia)
  2. Discomfort especially during defecation and sitting
  3. Itching
  4. Swelling

Conservative Treatment / Self Care

  1. Intake of high fibre supplements
  2. Ice packs
  3. Drinking plenty of fluids
  4. Losing body weight for obese persons
  5. Avoid strenuous physical activities
  6. Sitz bath