Hemorrhoids: How Can I Get Rid Of Piles?

Hemorrhoids known as piles, are swollen and inflamed veins in the lower rectum and anus. They are a very common condition, affecting about 4.4% of the global population. According to the Journal of Coloproctology case report,  hemorrhoids are more prevalent in adults aged 45-65 years, with no significant gender differences. While hemorrhoids can occur in children, they are less common, with the peak prevalence occurring between ages 45-65. Approximately 10 million people in the United States seek medical treatment for hemorrhoids each year.

Hemorrhoids are a widespread condition, with an estimated global prevalence of 4.4%. In the United States, up to one-third of the 10 million people with hemorrhoids seek medical treatment, resulting in 1.5 million related prescriptions per year.

The prevalence of hemorrhoids increases with age, with a peak in persons aged 45-65 years. There is no known sex predilection, although men are more likely to seek treatment. Pregnancy can also predispose women to developing symptomatic hemorrhoids due to the increased pressure on the pelvic region.

Other risk factors for developing hemorrhoids include chronic constipation, diarrhea, a low-fiber diet, prolonged sitting, heavy lifting, and anal intercourse.

Types of Piles and Symptoms

Depending upon the situation, piles (hemorrhoids) can be divided into four types:

External Piles (Hemorrhoids)

External Piles(hemorrhoids) are developed at the margins or outside of the anal opening and are covered by skin. Usually, they are painful and may rupture and bleed especially due to the passage of hard stools eroding the already dilated blood vessels. They may also become thrombosed (presence of blood clots and are felt as a small, painful lump around the anal opening.


  • Pain – Pain is common in external piles which will be worse while straining at stool.

  • Protruding mass – In external piles the swelling can be felt around the anal orifice. However, in comparison, the swollen effect can’t be felt in internal piles initially. As the disease progresses the piles protruding during stool will go inside automatically. Also, the condition might become worse causing the protruded piles not to go back in to the anus.

  • Dilatation of the veins related to anus – This is common in people leading a sedentary lifestyle. A bluish cushion-like ring around the anus appears while straining at the stool.

  • A thrombosed external hemorrhoid or pile is commonly known as a Perianal hematoma. It is a small clot that occurs outside of the anal canal on the anus. The condition is very painful and appears all of a sudden. If untreated, it might suppurate (pus formation), fibrosis and might give rise to a tissue tag, or it may burst or continue to bleed.

  • Sentinel piles (hemorrhoids) – The form of the pile is commonly seen with anal fissure (painful longitudinal ulcer).

Prolapsed Hemorrhoids

Prolapsed hemorrhoids occur when internal hemorrhoids enlarge and protrude outside the anus. They can be graded according to the extent of the protrusion:

  • Grade 1: Small swellings on the inside lining of the anal canal
  • Grade 2: Larger hemorrhoids that may be partly pushed out from the anus during bowel movements but go back inside on their own
  • Grade 3: Hemorrhoids that hang out from the anus and can be pushed back inside with a finger
  • Grade 4: Permanently prolapsed hemorrhoids that cannot be pushed back inside

The main symptom of a prolapsed hemorrhoid is the visible and protruding hemorrhoid itself, which may be accompanied by pain, burning, and itching

Internal Piles (Hemorrhoids)

Internal piles are located on the inside lining of the rectum and cannot be felt unless they prolapse and push through the anus opening thus – causing pain and itching. It is covered by mucous membrane is red or purple in colour and are often painless.


  • Bleeding is a common symptom associated with internal piles that come in splashes while pressing for stool. The earliest symptoms of internal piles appear in a slight or red colour and may be profuse in some cases.

  • In some cases, there will be a discharge of mucus with itching around the anal orifice.

  • A slimy whitish discharge,(in the internal pile) frequently accompanies the protrusion of the anal lining.

  • Itching or general discomfort in and around the anus.

  • Anemia is rare but can be due to persistent heavy bleeding from the internal piles (hemorrhoids).

Thrombosed Hemorrhoids

Thrombosed hemorrhoids are internal or external hemorrhoids in which a blood clot, called a thrombus, has formed. This is a serious complication of an untreated hemorrhoid and causes more severe symptoms, including:

  • Intense pain
  • Burning
  • Itching
  • Redness and swelling around the anus

While not life-threatening, thrombosed hemorrhoids require immediate medical attention

Note: An individual can have both internal and external piles which is known as interoexternal piles. In this case, the person has both internal hemorrhoids inside the rectum as well as external hemorrhoids around the anus.
Interoexternal hemorrhoids are a combination of the two main types and can exhibit symptoms of both internal and external piles. This is an important distinction, as the treatment approach may need to address both the internal and external components.

Factors Responsible for Piles

  • Pile is a familial disease, especially internal piles which can be hereditary or passed on from one generation to the next. It resides in a genetic mutation that is transmitted by either parent (or both) through the gametes to their offspring.

  • Piles are seen only in animals that maintain an erect posture. This is due to congestion in the rectal veins due to the effect of gravity.

  • It is common in individuals having chronic constipation. It can also affect those who have an Infection or often visit the toilet due to frequent urge for stooling.

  • Too much intake of chicken, prawns, spicy food and more can cause piles. Those who take vegetables and fibrous food are rarely affected.

  • Piles can occur during pregnancy due to compression of rectal veins by the uterus.

  • Cancerous lesions in the rectum can obstruct blood flow and result in piles.

  • Loss of muscle tone in the rectum due to old age and after rectal surgery can be a factor.

  • Lifting heavy-weight objects can also trigger piles due to pressure.

  • Eating more processed food may cause constipation and predispose you to piles. However, eat foods high in fiber to remain unaffected.

  • A sedentary lifestyle with no exercise can cause piles.

  • Straining at urination due to enlarged prostrate in males or urethral stricture (narrowing of the urinary opening) can lead to piles.

  • Conditions such as childbirth, chronic cough, and Obesity which increases intra-abdominal pressure cause piles.

  • Excessive straining at bowel movements.

Possible Complications

  • Infection – The infection can spread to deep veins resulting in septicaemia.
  • Fibrosis – Here the piles become fibrosed with hardening of anal orifice.
  • Thrombosis – The blood inside the piles will form clots and can obstruct blood flow.
  • Gangrene – Here the tissues in the piles and nearby skin die due to lack of blood supply.
  • Suppuration – When the piles suppurate it can produce abscess with discharge of pus.
  • Anemia – chronic blood loss from hemorrhoids may cause anemia, in which you don’t have enough healthy red blood cells to carry oxygen to your cells.

How to Prevent Piles

The best way to prevent piles (hemorrhoids) is by ensuring your stools remain soft, that way you can easily pass it out without pressure. To achieve this, you need to:

  • Keep a regular time for food.
  • Drink a sufficient quantity of water.
  • Keep a regularity in bowel habits.
  • Take treatment for constipation.
  • Eat a high-fiber diet with fruits, vegetables, whole grains, and legumes
  • Avoid excess intake of meat, prawns, crabs etc
  • Use laxatives containing psyllium if needed
  • Go to the bathroom when you feel the urge, don’t delay
  • Don’t spend too much time on the toilet
  • Avoid holding your breath or pushing too hard
  • Wipe gently with moist toilet paper
  • Take warm baths to soothe the area
  • Use over-the-counter creams/ointments if symptoms arise
  • Physical activity helps keep bowels regular
  • But avoid heavy lifting which can increase abdominal pressure
  • Maintain a healthy weight
  • Limit alcohol and caffeine intake
  • Avoid prolonged sitting or standing

The Prevention steps mentioned will only keep you away from having piles if you keep to the rules. Many people don’t have that consistency in keeping to these rules. Some give several excuses with ‘I don’t have the time’ taking the lead.

However, prevention they say is better than cure, but in a situation the disease has occurred, it’s better you use the natural method of treatment first. Treating Piles naturally comes with no side effect and the ingredients can easily be found around your environment.

Furthermore, the natural treatment for piles is very effective during the earliest stage. If your pile case is severe, then modern treatment is needed. All information about modern pile treatment is available in this article. Piles that have existed for more than 2weeks will not respond positively to the natural treatment but to modern treatment. Therefore, watch out for these warning signs of hemorrhoids above to avoid it staying too long in the body.


Medscape. Hemorrhoids: Background, Anatomy, Etiology and Pathophysiology. https://emedicine.medscape.com/article/775407-overview.

Medical News Today. Hemorrhoids: Symptoms, causes, and treatments. https://www.medicalnewstoday.com/articles/73938.

Lohsiriwat V. Hemorrhoids: From basic pathophysiology to clinical management. World J Gastroenterol. 2012;18(17):2009-2017. doi:10.3748/wjg.v18.i17.2009. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342598/.

Garg P. Grade IV hemorrhoids: Current management. World J Gastrointest Surg. 2015;7(8):78-81. doi:10.4240/wjgs.v7.i8.78. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755769/.

Colorectal Practice. Different Types of Piles. https://www.colorectalpractice.com/blog/different-types-of-piles.html.

NHS. Piles (haemorrhoids). https://www.nhs.uk/conditions/piles-haemorrhoids/.

Last Updated on June 28, 2024 by shalw

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