Hemorrhoids (Piles): Causes, Symptoms, Types & Effective Treatments

Hemorrhoids, also known as piles, occur when the anus veins and lower rectum become swollen and enlarged, leading to discomfort, pain, and rectal bleeding. While everyone has hemorrhoidal tissue naturally, problems arise only when these veins swell and cause symptoms. Similar to varicose veins, hemorrhoids can develop internally within the rectum (internal hemorrhoids) or externally under the skin around the anus (external hemorrhoids). Fortunately, various treatment options exist, ranging from home remedies and lifestyle adjustments to medical interventions, helping many individuals find relief.

Types

There are three different types of hemorrhoids: Internal, External, and Thrombosed Piles.

Internal Piles

Internal hemorrhoids develop deep inside the rectum, making them invisible and difficult to detect. Since this area has very few pain-sensing nerves, they typically don’t cause pain. However, their presence can lead to other symptoms, such as bleeding or discomfort, especially if they become irritated or enlarged.

External Piles

External hemorrhoids develop in the anal area, often causing discomfort. When they protrude through the anus, they become visible and can be felt. In some cases, blood clots may form within the swollen mass, leading to severe pain, especially if the hemorrhoid slips downward.

Thrombosed Piles

When blood collects in an external hemorrhoid, it can form a clot known as a thrombus. It can cause intense pain, swelling, inflammation, and a firm, discolored lump near the anus.

Symptoms

In most cases, hemorrhoid symptoms are mild and resolve without treatment. However, individuals with hemorrhoids may experience symptoms such as:

• Painful lumps in and around the anus
• Itching and irritation in the anal area
• Discomfort during and after bowel movements
• Blood in the stool

In some instances, hemorrhoids can worsen and lead to serious complications, including:

• Excessive anal bleeding, which may cause anemia
• Infections
• Fecal incontinence
• Anal fistulas
• Strangulated hemorrhoids, where the anal muscles restrict blood flow to the swollen tissue

Despite these potential complications, many people with hemorrhoids experience no noticeable symptoms.

Causes

Straining puts pressure on the veins in the anus or rectum, causing hemorrhoids. Increased pressure on the abdomen or lower extremities is prone to inflammation and swelling of the anal and rectal veins. Hemorrhoids may develop due to:

• Pushing hard to have a bowel movement due to constipation.
• Pelvic pressure from weight gain, especially during pregnancy.
• Straining to lift heavy objects or weightlifting.

Treatment

Non-surgical medication

Several therapeutic options are available to make symptoms more manageable for an individual with piles.

Over-the-counter (OTC)

Over-the-counter and online medications, including painkillers, ointments, creams, and soothing pads, can help reduce redness and swelling around the anus. While these treatments do not cure hemorrhoids, they provide symptom relief. Avoid using them for more than seven consecutive days, as prolonged use may cause skin irritation and thinning. Additionally, do not combine multiple medications unless directed by a healthcare professional.

Corticosteroids

These can reduce inflammation and pain.

Laxatives

The doctor may prescribe laxatives if a person with piles suffers from constipation. These can help the person pass stools more efficiently and reduce pressure on the lower colon.

Minimally Invasive Procedures

For continuous bleeding or painful haemorrhoids, the doctor might recommend one of the minimally invasive procedures available. These treatments are usually carried out in a doctor’s office or outpatient clinic and generally do not need anesthesia.

Rubber Band Ligation

The doctor wraps one or two small rubber bands around the internal hemorrhoid to block its blood flow. The haemorrhoid shrinks and falls off within a week. Haemorrhoid banding can be uncomfortable and cause bleeding, which is rarely severe.

Injection (Sclerotherapy)

The specialist administers an injection of a chemical solution into the hemorrhoid to shrink the tissue. Although the injection is generally painless or causes minimal discomfort, it may not be as effective as rubber band ligation.

Coagulation (infrared, laser, or bipolar)

Coagulation techniques use laser, infrared light, or heat. They cause slight, bleeding internal hemorrhoids to harden and wither.

Warm Bath

Warm baths can help soothe irritation from hemorrhoids. A sitz bath, a small plastic tub that fits over a toilet seat, can immerse the affected area. Trying a warm or sitz bath for 20 minutes after each bowel movement, and adding Epsom salt to the tub can provide further relief.

Cold Compress

Applying ice packs or cold compresses to the anus can relieve swelling for 15 minutes at a time. For large, painful haemorrhoids, cold compresses can be highly effective. Make sure to wrap ice in a cloth or paper towel. Avoid placing anything frozen directly on your skin, as it can cause injury or damage.

Do Not Scratch

Scratching damages the skin and worsens the irritation and itching.

Apply Coconut Oil

Coconut oil is a natural emollient that may soothe and ease hemorrhoid discomfort. Applying coconut oil can also help calm irritation and swelling while lessening the urge to scratch.

Try Squat

Adopt a squatting posture by placing a small stool or bench under your feet while using the toilet. Elevating your knees while seated on the toilet alters the alignment of your digestive tract, making bowel movements smoother and easier.

Frequently Asked Questions