Hemorrhoids, also known as piles, are swollen veins around the anus and rectum. They can be caused by constipation, pregnancy, obesity, diarrhea, and sitting for long periods. Symptoms include pain and bleeding, and medical investigation is necessary. Treatment includes lifestyle changes, over-the-counter creams, and medical procedures such as rubber band ligation or surgery.
The term piles is synonymous with hemorrhoids and is in common use in the UK. Typically in the United States, people tend to refer to hemorrhoids just like this. Whatever the name, hemorrhoids can be uncomfortable to live with and are a relatively common occurrence, especially in people over 50 and many younger people as well.
Piles or hemorrhoids refer to small swollen veins around the anus and rectum. They can be visible, often resembling small bunches of grapes, or they can be located inside the rectum and feel more than they see. There are a number of causes of hemorrhoids, which include the following:
Hard bowel movements or constipation
Pregnancy, labor and delivery
Obesity
Long bouts of diarrhea
Having to strain to produce bowel movements
Sitting for long periods of time, especially on toilets
Some people also seem more prone to hemorrhoids than others and may inherit the genetic likelihood of having hemorrhoids
Symptoms of hemorrhoids include pain when you go to the bathroom and after having a bowel movement. Some people may notice small drops of blood on toilet paper when wiping. In very severe cases, a blood clot can form in an external hemorrhoid, causing a stroke. For this reason alone, any suspected case of hemorrhoids requires medical investigation.
Hemorrhoids are often diagnosed simply by looking at the anus. A doctor may choose to perform an anal exam if no external hemorrhoids are present. If you’ve noticed blood in your stool or on tissue after bowel movements, this may lead your doctor to do a colonoscopy or rectal exam with a camera to check for internal bleeding caused by polyps rather than hemorrhoids. Black stools or excessive bleeding may not be caused by hemorrhoids, but they can be caused by internal bleeding or could indicate bowel or colon cancer, which requires more immediate testing, especially if the blood loss is significant.
Treatment of the condition can be home-based and involves changes in behavior as well as several steps used to reduce discomfort while the hemorrhoids are healing. For example, staying hydrated, taking fiber supplements, and getting more exercise are recommended for mild cases. People with this condition are advised not to strain when trying to have a bowel movement and to avoid long periods of sitting. Over-the-counter hemorrhoid creams and products like witch hazel may be recommended to help with immediate relief. You can also ice the area, for no more than 20 minutes at a time, several times a day to help reduce inflammation.
In some cases, the hemorrhoids are large and require removal. There are several techniques used to remove or reduce them. The most common of these is rubber band ligation, when a doctor places tight bands around each set of inflamed veins to cut off circulation in the veins, causing the veins to die.
A doctor may also use infrared light to achieve the same effect in a shorter period of time, or a procedure called sclerotherapy, in which chemicals are injected into the hemorrhoid to make it shrink. Some people still have big piles that don’t get fixed. These can be surgically removed in a procedure called a hemorrhoidechotomy.
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