Piles (Haemorrhoids) Symptoms, Causes, and Treatment

A Comprehensive Guide for Piles (Haemorrhoids) Symptoms and Treatments 

Piles, also known as Haemorrhoids, are veins in the rectum and around the anus that have swollen. This causes patients extreme discomfort while passing stool because of enlarged blood vessels that lead to bulging out of veins. Let us understand the pile's symptoms in detail, including types, stages, causes, diagnosis, and treatment.

What are the Types of Piles?

Piles are classified into four types:

• Internal Haemorrhoids: This refers to swollen veins inside the rectum, often caused by increased pressure due to straining during bowel movements, prolonged sitting, pregnancy, or chronic constipation. It leads to painless bleeding and discomfort due to irritation or prolapses. 
• External Haemorrhoids: swollen veins under the skin around the anus that can cause pain, itching, and bleeding. They may become more painful if a blood clot (thrombosis) forms, leading to a thrombosed external haemorrhoid, which might require medical intervention like a thrombectomy for relief.  
• Prolapsed Haemorrhoids: These are also known as Bulging Haemorrhoids and occur when the swollen veins in the lower rectum or anus bulge outside the anus.   
• Thrombosed Haemorrhoids: It is also known as perianal thrombosis, which occurs when blood starts to clot in a haemorrhoid. This creates a painful swollen lump near the anus. 
  Depending on these types, symptoms of piles may vary. Let’s discuss them further.

What are the Different Piles Symptoms?

Depending on the type, the symptoms can be classified as follows:

1.Internal Piles Symptoms

Internal Piles are known to be painless unless the swollen veins do not prolapse. This type of pile does not exhibit prominent symptoms, making it difficult for the patient to identify that they are suffering. 

However, someone suffering from internal piles might see blood on toilet paper, in stool or in the toilet bowl. These instances are signs of rectal bleeding. Watching out for early symptoms of piles in males and females will make diagnosis and treatment effective.     

2.External Piles Symptoms

External Piles Symptoms are more prominent than internal piles because there are a range of indicative symptoms. From the symptoms itself, one can identify the severity of or Stage of Piles. Listing down below some common symptoms:

• Constant itch around the anus or rectal area.
• The skin around the anus might have one or a few blue colour tender lumps.
• Experiencing pain or ache around the anus, especially within 24 to 48 hours of onset and when seated down. 
• Blood on the toilet paper or after using the toilet. 
• After using the toilet, these lumps might feel swollen, and the larger haemorrhoids might be restrictive in keeping the anal area clean.

In certain cases, external haemorrhoid symptoms might go away because the body reabsorbs the haemorrhoid, gradually subduing such symptoms. However, one must not conclude based on these symptoms because they might be occurring due to other reasons. 

3. Thrombosed External Piles Symptoms 

Pile symptoms depend on their type and their level of severity. Let us know more about each of these piles types and symptoms:

• Discomfort or Burning Sensation: Here, the symptoms are usually uneasiness or a burning sensation around the rectum opening post-excretion. However, external piles are said to be more painful. Out of the other symptoms of piles in females, it causes the most pain.       
• Itching along with Irritation: The areas around the anus become sensitive due to swollen blood vessels. This becomes bothersome over a period, leading to more discomfort.  
• Formation of Lumps or Swelling: The presence of lumps or bulges in the rectal opening is an indication of piles symptoms. This is also an early pile symptom in females.  
• Bleeding: The most common piles symptoms in females are passing blood along with stool after bowel movements. This symptom is painless and, therefore, needs observation either on the toilet paper or toilet bowl.    
• Mucous Discharge: Certain women experience mucus and a slimy texture that has a foul smell from the anus. This further sensitise the skin due to extreme irritation.        
• Prolapse: When the severity of piles is high, females might experience internal piles to protrude outside of the anus. This toughens the regular activities such as sitting, walking and so on. 
• A feeling of Incomplete Bowel Movement: Even after a bowel movement, the patient might have a heavy bowel feeling. 

4. Prolapsed Piles Symptoms

Some of the common Prolapsed Piles symptoms include:

• On wiping after bowel movement, the soft, painless bumps will protrude outside of the opening of the rectum.
• Bright red blood discharging with stool is a common piles symptom. However, dark red blood indicates that there is bleeding in the large intestine. 
• Patients might also experience anal itching. This leaves the skin around the anus highly sensitive and irritated. 
• Inflammation results in the development of whitish, pasty, goo-like mucus, causing an unpleasant foul odour.
• Even after passing stool, patients might feel their bowels are full, causing discomfort.
• There might arise a situation of stool leakage due to protrusion of tissues outside of the anus. This condition is known as Faecal Leakage or Faecal Incontinence.       
   

What are the Stages of Piles? 

It gets severe over some time, starting with the early-stage piles symptoms. Let us discuss the stages in detail hereunder:
Stage 1: Internal Piles with Mild Symptoms: At this stage, the patient discovers piles, which is the first stage of symptoms. They occur inside the rectum and cause mild uneasiness. There might be blood in the bowel movement, but the piles will not be visible.
Stage 2: Piles Protruding During Bowel Movements: At this stage, lumps are visible after bowel movement however, they retract soon after. This causes itchiness around the rectal opening. It is more severe than early-stage symptoms of piles. 
Stage 3: Prolapsed Piles: This is a serious stage where prolapsed piles might stay outside the anus and will require manual pushing. 
Stage 4: Severe Prolapsed Piles: At this stage, piles permanently remain outside, causing discomfort during day-to-day activities. 
 

What are the Causes of Piles? 

Understanding what causes piles will help manage their occurrence and reduce them. Let us know what causes piles in females as well as what causes piles in males:

1.Pregnancy

Pile symptoms for females start to show up during pregnancy around 36 weeks when the baby starts to descend into the pelvic cavity. With this descent, there is extreme pressure that women feel in their pelvic region. The symptoms of piles in pregnancy are the same. 

2.Going into Labour

Similar to pelvic pressure during pregnancy and during childbirth, extreme strain and pressure lead to swelling up of blood vessels or worsening already existing ones. During this phase, most of the women experience swelling up of rectal veins due to high pressure of pushing during childbirth. 

3.Genetic Factors

Some women are susceptible to developing lumps because of an existing genetic condition that prevails in the family. The genetic factors contribute to the strength and resilience of vein walls.

4. Experiencing Constipation and Strain

When men strain excessively during bowel movements over time, the rectal opening weakens, allowing blood to pool in the swollen veins, forming piles. This increased pressure can lead to pain, discomfort, and bleeding, affecting both internal and external haemorrhoids. Apart from that, straining during constipation might expose the veins to too much pressure on the veins around the anus. 

5. Suffering Obesity

When blood vessels experience too much pressure, it causes piles. However, if a person is overweight, it is a contributing factor to the development of piles. Men who work in offices have to sit and work for longer hours and are prone to it. One has to watch for these early symptoms of piles in males.
 

What is the Diagnosis Procedure for Piles? 

These are the procedures that medical experts take to diagnose piles:

• Genetic History: This inquiry is to know whether the person has a medical history of developing piles within the family. Other information that might be taken are extended constipation, cough, liver disease or long-term anal intercourse. These contribute to the risk of getting piles.
• Recent Changes: They track any type of changes in weight, bowel movements, colour of stool, any sight of bleeding or mucus in stool or irritation.
• Examining the Health Condition: Then the expert checks weight, obese, pregnant and those with anal infections or ascites to evaluate the risk of having piles.
• Inspection of Weight: They perform Digital Rectal Examination to check any discomfort in the rectal area or around the anus.
• Proctoscopy: For this procedure, the experts insert a hollow tube known as a protoscope, which inspects the inner lining of the rectum.
• Biopsy: Experts usually conduct it along with Proctoscopy. A sample from the affected area and then stained on a slide under the microscope to check for piles cancer symptoms. 
   

What is the Treatment for Piles?

Depending on the severity of the condition, your healthcare provider may suggest a necessary treatment. The most common ones are:

1. Home Remedies and Medication

Certain piles symptoms, such as inflammation and swelling, are treatable at home. 

• Having high-fibrous food to soften the stool prevents creating high pressure along the rectal walls of the blood vessels.
• Taking over-the-counter pills as per doctor’s prescription, like acetaminophen, aspirin, or ibuprofen, may help with the associated pain.
• Using tropical medicine, such as piles of ointment that contains hydrocortisone, can offer relief.

2. Invasive Procedures

Piles, or haemorrhoids, can be treated through various invasive methods without surgery depending on severity:

• External Haemorrhoid Thrombectomy: If a painful blood clot forms in an external haemorrhoid, a doctor can remove it within 72 hours to provide immediate relief.
• Sclerotherapy: A chemical solution is injected into the haemorrhoid to shrink it. This procedure is less painful but may be less effective than rubber band ligation.
• Coagulation Techniques: Laser, infrared light, or heat is used to harden and shrink small, bleeding internal haemorrhoids.
• Rubber Band Ligation: A small rubber band is placed around an internal haemorrhoid, cutting off blood flow. The haemorrhoid shrinks and falls off within a week.

3. Surgical Procedures

In extreme cases, doctors may recommend the following surgeries:

• Haemorrhoidectomy: A surgical procedure to remove large or severe haemorrhoids. It is the most effective method but may cause temporary urinary difficulties.
• Stapled Haemorrhoidopexy: This surgery blocks blood flow to internal haemorrhoids but has a higher risk of recurrence and rectal prolapse.
   

Final Words 

One should consider taking these initial symptoms of piles seriously, as they severely impact daily livelihood. Soaking in a warm bath at the first sign of piles symptoms may help reduce the lumps. However, any delay might lead to medical assistance.