Piles (hemorrhoids) - causes and symptoms

What are Piles (hemorrhoids)?

Piles are  hemorrhoids that become inflamed. Hemorrhoids are masses, clumps, cushions of tissue in the anal canal - they are full of blood vessels, support tissue, muscle and elastic fibers. Although hemorrhoids are thought of as unpleasant inflammations, we all have them. It is when the hemorrhoids cushions become too big (inflamed) that problems occur - when this happens they are called piles or pathological hemorrhoids. Put simply,"piles" are the swollen ones that are painful and cause problems, hemorrhoids can refer to the simply the normal structure. However, in most cases these days, the words piles and hemorrhoids are nearly always used interchangeably. Piles can be of various sizes and may be internal or external. Typically, internal piles occur from 2 to 4cm above the opening of the anus. External piles occur on the outside edge of the anus. The internal ones are more common.

Internal hemorrhoids: Internal hemorrhoids lie far enough inside the rectum that you cannot see or feel them. They do not usually hurt because there are few pain-sensing nerves in the rectum. Bleeding may be the only sign that they are there. Sometimes internal hemorrhoids prolapse, or enlarge and protrude outside the anal sphincter. If so, you may be able to see or feel them as moist, pink pads of skin that are pinker than the surrounding area. Prolapsed hemorrhoids may hurt because the anus is dense with pain-sensing nerves. They usually recede into the rectum on their own; if they do not, they can be gently pushed back into place.


External hemorrhoids: External hemorrhoids lie within the anus and are often uncomfortable. If an external hemorrhoids prolapses to the outside (usually in the course of passing a stool), you can see and feel it. Blood colts sometimes form within prolapsed external hemorrhoids, causing an extremely painful condition called a thrombosis. If an external hemorrhoid become thrombosed, it can look rather frightening, turning purple or blue, and could possibly bleed. Despite their appearance, thrombosed hemorrhoids are usually not serious and will resolve themselves in about a week. If the pain is unbearable, the thrombosed hemorrhoid can be removed with surgery, which stops the pain.

Piles (hemorrhoids) facts 

Internal hemorrhoids are clumps of tissue within the anal canal that contain blood vessels, muscle, and elastic fibers. External hemorrhoids are enlarged blood vessels surrounding the anus. Internal hemorrhoids cause problems when they enlarge. The cause of the enlargement is not known. 


Complications of internal hemorrhoids include bleeding, anal itchiness, prolapse, incarceration, and gangrene. Pain is not common. The primary complication of external hemorrhoids is pain because of blood clotting in the hemorrhoidal blood vessels.

When dealing with hemorrhoids, it is important to exclude other diseases of the anus and rectum that may cause similar symptoms like polyps, cancer, and diseases of the skin. Treatment of piles or hemorrhoids include over-the-counter topical medications, sclerotherapy, rubber band ligation, heat coagulation, cryotherapy, anal dilation, doppler ligation, sphincterotomy, and surgical hemorrhoidectomy.

The newest treatment for piles (hemorrhoids) is stapled hemorrhoidectomy.