Piles (Hemorrhoids) | بواسیر

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Piles (Hemorrhoids)

Hemorrhoids, commonly referred as Piles, is a condition in which blood vessels (veins) around the lower rectum or anal passage (passage from where stool is passed out) are swollen or enlarged. The swollen blood vessels can form lumps of tissues, which can be painful and irritating, especially during passing stools.

Symptoms may include formation of lumps in the rectal passage and bleeding (after or during passing stool) from rectal passage. The blood is of bright red colour.

Piles are common; by age 50 approximately one in every two adults experience pain, irritation and anal bleeding that can signal the presence of piles (hemorrhoids). The patient may feel the protruded or swollen tissues outside the anal passage.

There are two types of hemorrhoids:

1. Internal hemorrhoids (enlarged veins located inside the lower rectum)

2. External hemorrhoids (enlarged tissues or veins are felt outside the anal passage)

Most hemorrhoids get better itself. Fortunately, effective treatments are available.

Most cases of piles are not serious though the patient experience irritation and discomfort. Generally most piles cases get better themselves without requiring any treatment.

However, it should be noted that rectal bleeding may also occur due to many other conditions that may be serious. Do not ignore rectal bleeding, and consult the doctor. Also if the patient passes black, tarry stools or stools with blood clots; contact the doctor immediately, as it signals internal bleeding somewhere in the body.


Commonly symptoms may include:

  • Rectal bleeding (bright red colour blood) during or after passing stool, sometimes when the stools are very hard.
  • Ache, redness and inflammation around anus area
  • Usually internal hemorrhoids do not cause pain. Intermittent bleeding is common from internal hemorrhoids and happens due to excessive straining that damages the delicate surface of the swollen veins.
  • External hemorrhoids result in pain and discomfort due to the formation of a lump, which is felt outside the anus. Sometimes, the external hemorrhoids can remain outside as an irritating tissue tag
  • Piles may also cause mucous discharge from the anal area
  • Patient may experience less control on bowel movement and sometimes leakage of feaces
  • Straining too hard during passing stools affects the veins in the lower rectum area to become swollen and form lump
  • Sitting for long period on toilet seat straining to completely empty the rectum
  • Prolonged constipation – passing hard stools or by repeated straining during bowel movement affects the tissues and veins in the anus area
  • Recurring diarrhea – may also cause the veins to enlarge or swell
  • Ageing – as age progresses, tissues around the lower rectum area get weakened and less supportive
  • Pregnancy – during pregnancy women may suffer with piles that usually gets better after childbirth

Some patients feel embarrass to discuss their condition with the doctor; they should not be embarrass as doctors are used to diagnose and treat these types of conditions.

Doctors usually perform visual examination of the anal area to diagnose piles. The doctor may also perform physical examination by inserting gloved finger to feel the presence of hemorrhoids.

Rectal bleeding occurs in many other illness such as anal fissures, abscess, polyps and colorectal cancers. To rule out other digestive diseases, additional testing may be required, such as:

Colonoscopy - inserting a flexible thin tube containing the camera through the anal passage to view the internal part of the rectum and colon.

Sigmoidoscopy - Similar to colonoscopy but uses shorter tube to allow viewing the internal tissues of rectum.

Most cases of piles get better themselves without any specific treatment.

Simple life-style changes and diet modifications improve the condition and relieve symptoms in most patients.

If constipation is the cause of hemorrhoids; eating high fiber diet soften the stools and regular exercise/ walking helps in passing the stool. Patients strain because they feel that they have not completely emptied their rectum. Avoid straining while passing stool and do not sit longer on toilet seat. Other steps that can be taken at home are:

  • Drinking plenty of water
  • Sit in luke-warm water bath for 10-15 minutes, 3-4 times a day
  • Use cold press or ice pack at the anal area to reduce inflammation

Many over the counter topical creams provides temporary improvement in pain and irritation symptoms, but they do not provide the cure. Do not use topical creams for more than one week.

Medical Treatment

When above home remedies do not help, patient would require one of the below medical treatment:

Banding or Rubber banding ligation

This is a minor procedure in which the doctor places a special type of tight band at the base of the hemorrhoid.  As a result, the blood supply to the tissue is blocked resulting in shrinkage of the hemorrhoid.

Injections (Sclerotherapy)

In this procedure the doctor directly injects a special chemical in the swollen tissues in the anal area. This causes the numbness in the swollen tissue and thus reducing pain. Additionally, the chemical helps in reducing the size of the swollen tissues.

Infra-red Coagulation

In this procedure infrared radiations generates the heat which is used to treat hemorrhoids.

Surgical removal of large external and internal hemorrhoids is required when above treatment options do not seem to work.

  • Avoid straining while passing stools
  • Eat plenty of fruits and vegetable to have enough fiber in the diet to avoid constipation
  • Drink 8-12 glass of water on daily-basis
  • Perform regular exercise
  • Go to the bathroom as soon as possible when you feel the urge of passing stool


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