Piles are painful, swollen veins in the lower portion of the rectum or anus. This condition is very common, especially during pregnancy and after childbirth. Piles result from increased pressure in the veins of the anus. The pressure causes the veins to bulge and expand, making them painful, especially while sitting. The most common cause is straining during bowel movements. Hemorrhoids may results from constipation, sitting for long periods of time, and anal infections. In some cases, they may be caused by another disease such as liver cirrhosis. Classification Piles are classified mainly in to Internal piles - occur just inside the anus, at the beginning of the rectum. External piles - occur at the anal opening and may hang outside the anus. Causes of piles Repeated pressure on the anal or rectal veins, which causes them to stretch. Risk factors involved A diet lacks fiber Prolonged sitting or standing Overweight people Pregnancy Chronic constipation Chronic diarrhea Loss of muscle tone in older adults Rectal surgery or episiotomy Liver disease Anal intercourse Colon cancer Sign and symptoms Although piles may be asymptomatic, they characteristically cause painless, intermittent bleeding, which occurs on defecation. Bright red blood appears on the stool. These first degree piles may itch because of poor anal hygiene. When second degree piles prolapse, they are usually painless and spontaneously return to the anal canal following defecation. Third-degree piles cause constant discomfort and propalse in response to any increase in intra-abdominal pressure. They must be manually reduced. Thrombosis of external piles produces sudden rectal pain and a subcutaneous, large, firm lump that the patient can feel. If piles cause severe or recurrent bleeding, they may lead to secondary anemia with significant pallor, fatigue, and weakness; however, such systemic complications are rare. Diagnosis of piles Diagnosis mainly includes physical examination which confirms external piles. Proctoscopy is mainly done in the case of suspected internal piles and rectal polyps. Homeopathic treatment of piles Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using a holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat piles but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat piles that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of piles: Aesculus Hip. - abdominal plethora; throbbing deep in abdomen, particularly in hypogastric region; piles, bleeding or not, with feeling of dryness in rectum; as though little sticks or splinters were pricking the folds of the mucus membrane; weak feeling at sacro-iliac symphysis; though the legs were about to give out, worse by stooping forward and when walking; aching between shoulders; desire to strain at stool for a long time, pain shoot up the rectum; from the tumors, with lameness and aching in back, purple piles; depressed and irritable. Dark red congestion of fauces, with dryness and soreness, from abdominal plethora. Collinsonia - excellent remedy for piles; obstinate cases of piles; especially used in females with the inertia of the rectum and a congestive tendency to the pelvic organs; it suits pregnant women who suffer from piles, and pruritus may be a marked symptom. The indicating symptoms are chiefly a sensation of sticks in the rectum, with constipation from the inertia of the lower bowel. It is specially applicable to heart pains resulting from a suppression of a habitual haemorrhoidal flow. Hamamelis - one of the best remedies for piles; bleeding piles; the flow of blood is quite copious, and the greatly characterized indication is excessive soreness. Aloes - one of the most useful remedies for piles; indicated where the piles protrude like a bunch of grapes, bleeding often and profusely, and are greatly relieved by the application of cold water. There is a very marked burning in the anus, the bowels feel as if scraped. There is a tendency to diarrhea, with the well known uncertain feeling in the lower bowel. Nux Vomica - if the piles are large and blind, with a burning, stinging and constricted feeling in the rectum and a bruised pain in the small of back, and especially if excited by sedentary habits or abuse of stimulants, than Nux Vomica may be prescribed. Itching piles keeping the sufferer awake at night, relieved by cold water, or bleeding piles with constant urging to stool. And a feeling as if the bowel would not empty itself are further indications. Capsicum - bleeding or blind piles, protruding swollen, itching, throbbing and burning as if pepper were sprinkled on them. Sore feeling in the anus. Piles with mucus discharge, bloody mucus stool. Great thirst followed by shuddering after stool. Associated symptoms are persistent thoughts of suicide, lack of vital heat, craving for warm things, stimulants and pungent things. Muriatic acid - piles large, swollen, dark purple or blue haemorrhoides which are extremely sensitive and pains to touch. Inflamed piles, hot and pulsating, must lie with limbs wide apart, too sore, to bear the least touch even the bed sheet is uncomfortable. Piles while urinating or with stool, bleeding piles with burning and cutting during and after stool. Ameliorated by the warm application; aggravation by cold application. Sulphur - sulphur is a very good remedy for piles when the constitutional symptoms are there. External and internal piles, great bunches that are sore and raw, burning and tender, and bleed and smart with loose stool, complaints aggravate when standing when washing and from the warmth of bed. Ammonium carb - piles protrude, independent of stool; protrusion of piles after stool with long lasting pains; cannot walk, or the piles protrude during a stool and recede when lying down; they are usually moist and pain as if excoriated; bloody discharge during and after stool.