Piles (Haemorrhoids): Symptoms, Causes, Treatment and Cost
Last Updated: Jul 01, 2023
What are Piles (Hemorrhoids)?
Piles, also known as hemorrhoids, are swollen veins in the anus and lower rectum. They can be internal (inside the anus) or external (outside the anus). Piles are common and can affect people of all ages.
Piles look like round, small and discoloured lumps, which a person can feel on his/her anus or protrude from the anal canal. The anal canal is the short yet muscular tube consisting of blood vessels that work as a bridge between the rectum and the anus.
There are several factors that can contribute to the development of piles, including constipation, diarrhea, pregnancy, aging, anal intercourse, chronic cough, and obstructive defecation.
Piles are generally not a serious medical condition and can often be treated with over-the-counter creams and ointments, warm water baths, and dietary changes. However, in some cases, more aggressive treatment, such as surgery, may be necessary.
Piles is a very common condition but the symptoms of the condition are not always apparent. A study in the United States suggests that about half of people above the age of 50 years experience noticeable symptoms of hemorrhoids.
Types of Piles (Hemorrhoids)
The signs and symptoms of piles depend upon its type. There are three types of hemorrhoids. Please have a look:
Just like the name suggests, internal piles are found inside the rectum, which the patient can't see or feel. They also do not cause too much discomfort like external piles. It, however, may cause the following problems while passing the stool:
- Bleeding while passing the stool. Generally, it does not cause any pain.
- A patient might feel pain and irritation while trying to push a hemorrhoid out of the anal opening
In this condition, the blood gets lodged in an external hemorrhoid and forms a clot, which is also known as thrombus. It can cause:
- Extreme pain
- Swelling in the anal region
- A solid lump around your anus
Internal vs External Piles
Internal piles are usually found inside the rectum and usually not traceable during external examination. On the other hand, external piles may grow outside of the anus of the patient. In medical terms, this condition is called prolapsed hemorrhoid.
Doctors categories internal piles on a four-point scale.
- Grade I: In this stage, the patient does not experience any symptoms, and the hemorrhoid does not protrude out of the anus.
- Grade II: In this stage, the hemorrhoid may prolapse from the anus but goes back inside on its own.
- Grade III: In this stage, the piles grow outside the anus and only go back after medical intervention.
- Grade IV: In this stage, the piles grow outside the anus and a person can not get them back inside.
In external piles, the patients experience small lumps on the outer side of the anus. They cause a lot of itching and become very painful when the blood clot develops and blocks the blood flow. When blood clots are formed due to thrombosed external piles, the patient must seek immediate medical attention.
What are the symptoms of Piles?
As already explained, piles don't always cause pain or symptoms, but the signs may include:
- Bleeding while pooping.
- Lump inside or around the anal region.
- A smelly discharge of mucus from the anus, leaving a stain on your underwear.
- Constant feeling of fullness and discomfort in the anus.
- Feeling of incomplete evacuation of bowel after you have been to the toilet.
- Severe itch or sore skin around your anus
- Pain or discomfort after going to toilet
- Fecal incontinence
The symptoms of piles in males and the symptoms of piles in females are very similar. These symptoms can vary from person to person. Internal piles symptoms and external piles symptoms are also very similar to each other. To understand your condition better, you should see a doctor once you experience any early symptoms of piles or haemorrhoids.
Moreover, these symptoms can also arise due to inflammatory bowel disease, anal fissures (tear), anal cancer and bowel cancer. If you are experiencing any of the above-discussed symptoms, you should immediately see your doctor to figure out the actual problem.
What Causes Piles?
Piles, also known as hemorrhoids, are swollen veins in the anus and lower rectum that can cause discomfort and bleeding. There are several factors that can contribute to the development of piles, including :-
- Constipation: Straining to have a bowel movement can put extra pressure on the veins in the anus and rectum, leading to the development of piles.
- Diarrhea: Frequent diarrhea can also cause irritation and inflammation of the veins in the anus and rectum.
- Pregnancy: The increase in hormone levels and pressure on the veins in the anus and rectum during pregnancy can lead to the development of piles.
- Aging: As people age, the muscles that support the veins in the anus and rectum can weaken, increasing the risk of piles.
- Anal intercourse: Engaging in anal intercourse can cause irritation and inflammation of the veins in the anus and rectum, leading to the development of piles.
- Chronic cough: Chronic coughing can put extra pressure on the veins in the anus and rectum, increasing the risk of piles.
- Obstructive defecation: Obstructive defecation, a condition in which the muscles used to have a bowel movement do not work properly, can also increase the risk of piles.
How To Prevent Piles?
There are multiple ways to reduce the chances of developing piles. With some lifestyle changes, anyone can avoid developing this discomforting and embarrassing disease.
Here are some of the ways to reduce the chances of developing piles or hemorrhoids:
- Eating healthy:People who try to stay hydrated and consume fiber-rich diets tend not to develop piles as it helps them in softening the stools and making its passage easier.
- Avoid straining while pooping: Some people tend to put a lot of strain while pooping which results in development of piles in most of them.
- Avoid heavy weight lifting: People who lift heavy weights regularly are also more prone to developing piles. You can prevent this problem by lifting moderately heavy things using a proper lifting technique.
- Maintain healthy body weight: People should maintain a healthy body weight which reduces the chances of developing piles.
- Follow an active lifestyle: Regular exercising aids in food passage through the digestive system and makes your bowel movements regular. This practice largely reduces the chances of hemorrhoids.
Do's in Piles
- Drink enough fluids and plenty of fiber-rich foods to keep your stool soft
- Wipe your bottom with a little damp toilet paper
- Have paracetamol on experiencing pain
- Take a warm bath to subside pain and itching
- Use ice pack wrapped in a towel to reduce discomfort
- Try and push a pile back inside gently
- Always keep your bottom clean and dry
- Keep exercising regularly
- Avoid consuming alcohol, tea, coffee and cola to prevent constipation
Don'ts in Piles
- Don’t wipe your bottom too hard after pooping
- Never avoid the urge to poop
- Avoid pushing too hard while pooping
- Never take painkillers containing codeine, as they can lead to constipation
- Never take ibuprofen if your piles in bleeding
- Do not spend too much time on the toilet
Piles - Diagnosis and Tests
There are several ways in which hemorrhoids can be diagnosed, including:
- Physical examination: Your doctor may examine the anus and rectum to look for swollen veins or other signs of hemorrhoids. They may also perform a digital rectal examination, during which they will insert a gloved, lubricated finger into the rectum to feel for any abnormalities.
- Anoscopy: An anoscopy is a procedure in which a doctor uses a small, lighted instrument called an anoscope to examine the anus and lower rectum. This procedure can help to identify the presence and location of hemorrhoids.
- Sigmoidoscopy or colonoscopy: These are procedures in which a doctor uses a flexible, lighted tube with a camera on the end (sigmoidoscope or colonoscope) to examine the inside of the rectum and colon. These procedures can help to identify the presence and location of hemorrhoids and rule out other possible causes of rectal bleeding or discomfort.
- Digital rectal exam (DRE): A digital rectal examination (DRE) is a procedure in which a doctor inserts a gloved, lubricated finger into the rectum to feel for any abnormalities. A DRE is sometimes used as part of the diagnostic process for piles, also known as hemorrhoids.
What Questions Your Doctor May Ask You?
Have a look at the questions your doctor may ask you to come to a conclusion:
- Did any of your close relatives have piles?
- Did you see some blood or mucus in your stool?
- Have you experienced any unexpected weight loss?
- Are you experiencing any changes in your bowel movements?
- What is the colour of your stool?
What do piles look like?
Generally, there is nothing noticeable in people who are suffering from hemorrhoids. It happens because more of the people suffer from internal piles which occurs inside your anal canal and rectum and do not hang out of your bottom.
On the other hand, larger internal piles protrude out of your bottom where they appear like a discolored rubbery lump. An external pile looks like a mushy lump right at the end of your anus.
What do piles feel like?
The patients suffering from small internal piles do not feel any pain. Larger piles, on the other hand, may cause a mucus discharge, pain, itch and irritation. The discharge can also cause a lot of irritation on the skin surrounding the anus. The patient may also feel fullness in the anus, or not feeling fully emptied after going to the toilet.
What are possible complications of Piles?
While piles are generally not a serious medical condition, there are some possible complications that can occur. These include:
- Anemia: Severe bleeding from piles can lead to anemia, a condition in which the body does not have enough red blood cells to function properly. Symptoms of anemia include fatigue, weakness, and shortness of breath.
- Thrombosed hemorrhoids: In some cases, a blood clot can form in hemorrhoid, causing it to become painful and swollen. This is known as a thrombosed hemorrhoid. Thrombosed hemorrhoids may need to be treated with surgery to remove the clot.
- Strangulated hemorrhoids: If a prolapsed (protruding) hemorrhoid becomes trapped outside the anus, it can cut off the blood supply, causing it to become strangulated. Strangulated hemorrhoids may require surgical intervention.
- Anal fissures: Piles can sometimes cause small tears in the skin around the anus, known as anal fissures. Anal fissures can be painful and may require treatment with medication or surgery.
You must be wondering, how to cure piles? Piles is treatable at home, through operation or surgery, through medicines, ayurvedic medicines and laser treatment too. Have a look at some of them:
Home Remedies for Piles
Is piles treatment at home possible? Yes, it is. There are multiple home remedies to help you subside the pain, swelling and inflammation of hemorrhoids. The results may not be permanent or quick, but they sure help you reduce the pain and some other symptoms in the early stages of piles. Here are some of the most effective ways:
- Consume high-fiber food: Eating a diet high in fiber can help to soften stools and reduce constipation, which can be a contributing factor to hemorrhoids. Doctors recommend piles patients to consume fruits, veggies and whole grains because It reduces straining, resultantly alleviating the symptoms of existing piles. Doctors, however, recommend patients to add fibrous foods gradually to prevent gas related issues.
- Apply topical treatments: You can also use an over-the-counter piles cream or suppository having hydrocortisone. You can also use pads consisting of witch hazel or a numbing agent.
- Sitz baths: Sitting in a warm water bath can help to soothe the anal area and reduce swelling. To do a sitz bath, fill a shallow bath or basin with a few inches of warm water and sit in it for 10-15 minutes. Doctors recommend piles patients to soak their bottom in plain lukewarm water at least 2-3 times everyday. The duration of each sitting should be at least 10-15 minutes.
- Have oral pain relievers: You can take medicines like acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or aspirin to alleviate pain or discomfort.
These treatments often help in getting rid of piles symptoms but it may take one to several weeks. You are advised to see your doctor if the symptoms do not go away in a week or if you still experience severe pain or bleeding.
Which are the best Medicines, Ointments and Suppositories for Piles?
There are multiple types of Piles medicine available in the market. These include suppositories, ointments and pads. These medications are available over the counter.
Some of the other common medications include:
- Zinc oxide: Doctors recommend applying creams containing zinc oxide to reduce irritation. There are some other ointments too that combine zinc oxide and menthol, which are very effective in hemorrhoid-related anal itching.
- Witch hazel: Experts assert that astringents, such as witch hazel, are also very effective in providing temporary relief.
- Steroid cream: Corticosteroids like hydrocortisone are very popular in piles treatment. They reduce inflammation but may damage the skin if used for a long period of time.
- Lidocaine: It works as a local anesthetic. Multiple researchers have proven that creams or suppositories which consist of tribenoside and lidocaine greatly help in reducing the pain and itching.
Experts recommend not to self medicate for more than a week in case of piles. You are recommended to see a doctor if the symptoms do not disappear in a week. Furthermore, these medications only subside the symptoms in the early stages of piles. They may not work as efficiently in the later stages of the disease.
Even after trying the home remedies and over the counter medications, there is a possibility that hemorrhoids do not go away. Here are some of the non-surgical methods doctors practice to treat the early stages of the problem:
- Rubber band ligation: The doctors treat internal hemorrhoids using an elastic band. It helps in stopping the blood supply to the hemorrhoid if placed in the base. This results in the hemorrhoid either shrinking or falling off completely.
- Sclerotherapy: In this procedure, the doctors inject a liquid inside the internal hemorrhoid. This procedure also cuts off blood supply to the hemorrhoid, leading it to shrink.
- Infrared photocoagulation: By flashing infrared light towards the internal hemorrhoid, the doctors heat the area, leading to formation of scar tissue. This procedure blocks the hemorrhoids' blood supply causing it to shrink.
- Electrocoagulation: Doctors also supply a low electric current into the hemorrhoid to create a scar to cut off the blood supply and shrink the hemorrhoid.
Doctors also supply a low electric current into the hemorrhoid to create a scar to cut off the blood supply and shrink the hemorrhoid.
These procedures are carried out while keeping the patient on local anesthesia.
Which are the Surgical Treatments for Piles or Hemorrhoids?
Surgery is the best and most sure-shot method of hemorrhoid removal. Instead of suffering through the pain and embarrassment of excruciating pain, discomfort, and mucus discharge, doctors recommend going straight for piles surgery.
Hemorrhoidectomy, which is an open surgery, has been a very popular procedure that helps in the complete removal of external and prolapsed internal hemorrhoids. People, however, try to avoid this method as doctors need to make a significant cut in this procedure.
On the other hand, Laser Piles Surgery requires a way smaller incision, less downtime, and amazing results.
In laser surgery for hemorrhoids, doctors use high-energy light to cut or burn the infected tissue during the piles operation. With the advancements in laser technology, this procedure has become extremely safe, scar-free, bloodless and less painful. Moreover, it hardly causes any complications.
There are several surgical options for the treatment of piles, also known as haemorrhoids. Some common surgical treatments for piles include:
- Hemorrhoidectomy: This is a surgical procedure to remove hemorrhoids. It can be done using local anesthesia, spinal anesthesia, or general anesthesia, depending on the preference of the surgeon and the patient. Hemorrhoidectomy is typically reserved for severe cases of piles that do not respond to other forms of treatment.
- Stapled hemorrhoidopexy: Also known as a procedure for prolapsing hemorrhoids (PPH), this is a less invasive surgical option for the treatment of piles. It involves the use of a special stapling device to lift and reposition the swollen veins in the anus and rectum.
- Laser or infrared coagulation: These procedures use laser or infrared energy to seal off the blood supply to the hemorrhoids, causing them to shrink. These procedures are typically done on an outpatient basis and may be less painful than other surgical options.
- Sclerotherapy: This procedure involves the injection of a chemical solution into the tissue around the hemorrhoids. The solution causes the veins to scar and shrink, reducing the size of the hemorrhoids.
What to eat in Hemorrhoids?
Some dietary recommendations for managing hemorrhoids include:
- Increasing your intake of fiber: Eating a diet high in fiber can help to soften stools and reduce constipation, which can be a contributing factor to hemorrhoids. Good sources of fiber include fruits, vegetables, whole grains, and legumes.
- Staying hydrated: Drinking plenty of water and other fluids can help to keep stools soft and reduce the risk of constipation. Aim for at least 8-8 ounces of water per day.
- Avoiding spicy foods: Spicy foods can irritate the lining of the anus and rectum, which can worsen hemorrhoid symptoms.
- Avoiding alcohol and caffeine: These substances can contribute to dehydration, which can lead to constipation and worsen hemorrhoid symptoms.
- Eating smaller, more frequent meals: Large, heavy meals can put added pressure on the veins in the anus and rectum, which can worsen hemorrhoid symptoms. Eating smaller, more frequent meals can help to reduce this pressure.
As we have already mentioned, fruits, vegetables and high-fiber foods are the best options to eat in hemorrhoids. Have a look at your options:
- Soluble and Insoluble fiber
- 8-10 large glasses of water
- Fruits and vegetables
What not to eat in Hemorrhoids?
There are several foods and beverages that may worsen hemorrhoid symptoms and should be avoided or limited if you have hemorrhoids:
- Spicy foods: Spicy foods can irritate the lining of the anus and rectum, which can worsen hemorrhoid symptoms.
- Alcohol and caffeine: These substances can contribute to dehydration, which can lead to constipation and worsen hemorrhoid symptoms.
- Processed, high-fat foods: These foods can be difficult to digest and can contribute to constipation, which can worsen hemorrhoid symptoms.
- Dairy products: Some people find that dairy products, such as milk and cheese, can worsen hemorrhoid symptoms due to their potential to cause constipation or diarrhea.
- Carbonated drinks: These drinks can cause gas and bloating, which can put added pressure on the veins in the anus and rectum and worsen hemorrhoid symptoms.
Apart from these, you also have to watch your salt intake and discuss it with your doctor before taking any iron supplements as they can cause constipation and other digestive issues.
Which doctor to consult for piles?
There are several types of doctors who can help with the diagnosis and treatment of piles, including:
- General practitioner (GP): Your GP is a good place to start if you have any concerns about your health. They can assess your symptoms, provide a diagnosis, and recommend treatment or refer you to a specialist if necessary.
- Colorectal surgeon: A colorectal surgeon is a specialist who is trained in the treatment of conditions affecting the colon, rectum, and anus, including piles. They can provide more specialized care and may recommend surgical treatment if necessary.
- Gastroenterologist: A gastroenterologist is a specialist in the diagnosis and treatment of conditions affecting the digestive system, including the rectum and anus. They may be able to provide treatment for piles or refer you to a colorectal surgeon for further care.
How to select the best doctor for piles?
With the presence of a lot of quacks out there who claim to cure piles with the weirdest methods possible, it becomes very critical to find the best doctor to actually solve your problem.
Being an anorectal disease, Piles needs specialised treatment. The best specialists to treat this problem are either Practologists or General Surgeons. There are a few things you must check before choosing the doctor for piles treatment. Have a look:
- Doctor's Certification: It is important to know that the doctor you are going for treatment has a valid certification from a recognised Medical College and a license to practice from Medical Licensing Board. A proctologist is a specialist in treating problems related to anus, colon and rectum. A General Surgeon must have a degree of Masters in Surgery to carry out the operation.
- Skills and Experience: As already discussed, there are a lot of treatment options available for hemorrhoids. Hence, you have to check for the doctors who have good experience in most advanced laser-assisted surgery. This type of surgery gives you the edge over other modes of treatment as it is very quick and has the least amount of downtime.
- Reviews: You should also check for the reviews from the previous patients who took treatment from the particular doctor. This way you will be able to know about his treatment prowess as well as behaviour with the patients and the attendants.
- Hospital and Clinic Information: All the doctors either work at a hospital, a clinic or both. The reputation of a hospital or clinic in treating a particular disease is directly proportional to the reputation of a doctor. Therefore, knowing about the credentials of a doctor can give you a fair understanding about the doctor's practice as well.
- Clear Your Doubts: Before going for a treatment, you must see if you are comfortable enough in sharing your medical history with the doctor. You should also see if the doctor is able to clear your queries, and has explained all the risks and complications that may or may not arise because of the surgery.
If your doctor passes all these criterias, you should go ahead with the treatment. If you are wondering about how to find all this information, you can directly come to Pristyn Care and find out every single detail about the doctor and his prowess in treating piles.
How long does it take to recover from Piles?
Piles or Hemorrhoids have various stages and every stage has a different time frame for recovery. In some cases of small flare-ups, it may even disappear on its own, but in several cases of large external hemorrhoids, it may require more time to heal properly with conventional methods. Surgery, on the other hand, can fix this problem in a very quick time.
What is the price of Piles treatments in India?
The treatment cost for piles or hemorrhoids depends upon various factors. For conventional methods of treatment, a patient may suffer for long but the price would not be very high. On the other hand, if you go for surgery, your suffering will go away within a day but the price would be higher.
To fill this gap in the pricing, Pristyn Care has on-boarded some of the finest surgeons in the country to provide these surgeries at a very affordable price. Basically, the cost of treatment varies from place to place and condition to condition. In India, the surgery cost for piles ranges from Rs 40,000 to Rs 55,000.
Pristyn Care has partnered with more than 400 doctors in over 40 cities across India to provide piles surgery at affordable prices. All you have to do is to come on the website and submit a query. Everything else will be taken care of by the representatives of the organisation.
Are The Results of Piles Treatment Permanent?
Home remedies and other conventional methods of piles treatment only subside the symptoms and never cure the problem permanently. A slight alteration in the doctor-recommended lifestyle can reignite the problem.
Laser surgery, on the other hand, is completely safe, fast and provides permanent results. It just takes three days or less to completely get rid of the embarrassing problem forever. Laser surgery is a daycare procedure in which the surgeon treats the affected area with laser energy. It fixes the problem in a few minutes and the patient can go home healed and conscious within a few hours on the surgery. Moreover, laser surgery does not cause any risk of infection.
Apart from being pain-free, there are negligible chances of recurrence of the disease after a laser treatment.
Who is Eligible for Piles Surgery?
Patients who are passing black stool associated with a lot of pain should immediately book an appointment with the doctor for surgery. Furthermore, people who are facing difficulty in passing stool or have already been diagnosed with internal or external piles can go for surgery.
Who is not Eligible for Piles Surgery?
People who recently had colorectal surgery can not go through with piles surgery. Plus, people who have early stage piles, which can be treated with medications, are also not advised to go ahead with surgery.
What are the Post-Treatment Guidelines?
After the laser surgery, the patient may experience a few drops of blood on stool or on the wipe tissue paper. It is completely normal during the recovery from piles. You may also experience some discharge containing mucous for a few days post surgery. It may stain your undergarments. All you need to do is to take care of some of the instructions mentioned below:
- Keep anal area clean and dry
- Take shower or sitz bath after each bowel movement
- Use wet tissues to wipe your bottom
- Avoid excessive wiping
- Wear adult diapers or sanitary napkins
- Do not indulge in hard physical activities for a few days
- Do not lift or pull weights for at least two weeks
- Go on short walks
- Eat fiber-rich foods
- Drink plenty of water
- Cut down on junk, spicy and oily foods for a few days
Laser piles surgery is one of the safest and the most successful modes of treatment available in the industry right now. If we talk about its drawbacks or side-effects, the only problem it may cause is a burning sensation which disappears gradually, and very rarely, it may lead to external skin tag thrombosis.
Piles - Outlook/Prognosis
Piles is a very discomforting, painful and embarrassing disease. It may not be life threatening but surely throws your normal life out of the window. A few years ago, with no advanced technologies, people were forced to suffer through this disease as they had to depend upon conventional methods of treatment. Now, with the introduction of laser treatment, no one has to tolerate it as apart from being extremely successful, it is also very cost effective.
Frequently Asked Questions (FAQs)
Why do piles occur?
Is piles dangerous?
What happens in piles?
How to prevent piles naturally?
When to see a doctor if suffering from piles?
What questions should I ask the doctor?
Do piles go away on their own?
How do you know if you have piles?
What food causes piles?
- Hemorrhoids- Medline Plus, Health Topics, NIH, U.S. National Library of Medicine [Internet]. medlineplus.gov 2019 [Cited 22 August 2019]. Available from:
- Hemorrhoids: Expanded Version- ASCRS, American Society of Colon and Rectal Surgeons [Internet]. fascrs.org [Cited 22 August 2019]. Available from:
- Hemorrhoids- American Academy of Family Physicians [Internet]. familydoctor.org 2017 [Cited 22 August 2019]. Available from:
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