Jo has been an ITU nurse at the London North West NHS Trust for 14 years. She obtained her RN at University College London Hospital.
Recently I received a call from an old friend who was rather distressed and needed advice on a delicate matter. My friend was obviously embarrassed as she found it difficult to explain the exact cause of her predicament. She used words and phrases like 'down below, ' . . . ' well . . . er . . .you know . . . in my . . . er.' before finally she asked 'well it's cancer, isn't it?'
She had piles, but at that time she did not know it. She went to the toilet and was horrified to find that there was evidence of fresh blood from her back passage after passing stool.
My friend immediately thought the worst. She was surprised to learn that the most obvious and most common cause of rectal bleeding is 'piles,' also known as hemorrhoids (haemorrhoids.)
Piles are often the butt of many jokes (pardon the pun) or well-meaning advice like 'don't sit on cold cement.' However, if you are the individual suffering from piles it is not a joking matter. This condition can be the source of much embarrassment and stress as people imagine the worst case scenario.
I asked my friend a few pertinent questions, and soon I was able to reassure her. I explained that she should contact her doctor for an appointment to confirm the problem and to rule out potentially serious conditions. However, chances are she may be suffering from a small crack or tear in the anus or maybe even bleeding piles.
I received another call from my very relieved friend after her trip to the doctor. informing me that she was indeed suffering from piles.
This article will cover the following topics:
- What Are Piles/Hemorrhoids
- Types of Piles
- Causes and Symptoms of Piles
- Prevention of Piles
- Treatment of Piles
- Over-the-Counter Treatment Options
- Home Remedies for Piles
What Are Piles or Haemorrhoids?
Haemorrhoids comes from the Greek word haimorrhois meaning 'liable to discharge blood.' They are caused by the abnormal swelling of tissue containing veins and tiny arteries within the lining of the anus and lower rectum.
These vessels can become dilated and engorged with an excess of blood quite like varicose veins. The engorged vessels and surrounding tissue can develop into small swellings known as haemorrhoids or piles.
It is estimated that 50% of people in the UK and around 10.4 million people in the US suffers from piles. 50% of us will develop piles by the age of 50, there are 1 million new cases of piles each year in the US, but only a small proportion will seek treatment.
The reason we get piles is not exactly clear. In some cases it occurs for no apparent reason, but the general consensus is that the condition occurs when there is an increased intra-abdominal pressure exerting force in and around the anus.
In many cases the piles are mild and are present without any sign of other symptoms. However, in severe cases symptoms can include:
- Bleeding of bright red blood after passing stool
- Itching around the anus
- Mucous discharge after passing stool
- Inflammation and soreness around the anus
- Feeling like the bowels remains full and still need to be emptied
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Types of Piles or Haemorrhoids
There are two types of piles: internal and external.
Internal piles often remain along the anal wall with no obvious symptoms; people with internal piles are normally unaware of their presence unless it breaks through the anal wall. When this occurs, the swelling needs to be pushed back after passing stool, also known as protruded or prolapsed haemorrhoids or piles. Internal piles are not usually painful but can be associated with other conditions such as fissure.
Fissure is a tear in the lining of the anal canal which can be further extended when stool is passed during a bowel movement; it can be painful, bleeds and itches.
- External piles consists of small soft pads along the opening of the anus, normally the same colour as the skin. When external haemorrhoids form a blood clot, it can appear blue, accompanied by severe pain, itching, and inflammation.
Piles can become strangulated and bulge outside of the anus; the anal muscles tighten around the pile causing it to become hard and painful.
Perianal haematoma is associated with external blood clots under the skin.
Thrombosed external haemorrhoid is a hard lump consisting of blood clots that develop around the anus and can be painful.
How Do You Get Piles? Causes and Symptoms
Certain factors are thought to increase the chances of developing piles; they include:
- Chronic Constipation passing large hard stool can cause straining that increases the pressure in and around the anus to form piles.
- Pregnancy and childbirth: Piles are a common occurrence in pregnancy, this is probably due to the pressure of the baby lying above the rectum and anus. Hormonal changes during pregnancy can also affect the veins in the anus to cause piles
- Age: The tissue lining the anus, can become less supportive with age, increasing the risk of piles
- Hereditary: Some people may inherit a weakness in the wall of the anal region.
- Other factors include chronic diarrhea, prolonged sitting or standing, heavy lifting and obesity.