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Understanding piles: what they are and how to manage them

Understanding piles: what they are and how to manage them

Did you know that many people have piles, but the symptoms are not always obvious?

Piles, otherwise known as haemorrhoids, swollen veins in the lower anus and rectum. This swelling can cause localized inflammation of other tissues. This is a result of swollen veins in the lower anus and rectum. They can cause tissue growths of varying size and location in and around the anus and can lead to significant discomfort.

Internal piles occur within the rectum and are usually not visible during an external examination. However, in some cases, an external pile may grow to protrude outside of the anus. The medical term for this is prolapsed haemorrhoid.


In most cases, the symptoms of piles are not serious and resolve on their own.

An individual with piles may experience the following symptoms:

painful lumps in and around the anus

itching and discomfort around the anus

discomfort during and after passing stools

bloody stools

In severe cases, symptoms of piles include:

excessive anal bleeding, possibly leading to anaemia


faecal incontinence

anal fistula

strangulated haemorrhoid, in which anal muscles cut off blood supply to the haemorrhoid

However, many people with piles may not experience any symptoms.


Piles result from increased pressure in the lower rectum.

The blood vessels around the anus and the rectum will stretch under pressure and may swell or bulge, forming piles. This may be due to:

chronic constipation

chronic diarrhoea

lifting heavy weights

straining when passing a stool

Risk factors

Certain factors may increase a person’s risk of developing piles, including:

Pregnancy: Up to 50% of people experience haemorrhoids during pregnancy. This is due to increased pressure on the pelvis, a person having a higher blood volume, and a higher incidence of constipation.

Age: Piles are more common in older adults. Around half of people over the age of 50 develop piles.

Weight: Research suggests that being overweight may increase a person’s chance of developing piles.

Diet: Eating a diet low in fibre may increase the likelihood of a person having piles.


In most cases, piles resolve on their own without the need for any treatment. However, some treatments can help significantly reduce the discomfort and itching that many people experience with piles.

Lifestyle changes

A doctor will initially recommend some lifestyle changes to manage piles.

Piles can occur due to straining during bowel movements. Excessive straining is the result of constipation. A change in diet can help keep the stools regular and soft. This involves eating more fibre, such as fruit and vegetables, or primarily eating bran-based breakfast cereals.

A doctor may also advise the person with piles to increase their water consumption. Losing weight may help reduce the incidence and severity of piles.

To prevent piles, doctors also advise exercising and avoiding straining to pass stools. Exercising is one of the main therapies for piles. 


People can lower their risk of developing piles with a range of lifestyle alterations, including:

Eating a healthful diet: Staying hydrated and eating a diet rich in high-fiber foods can help keep stools soft and make their passing easier.

Avoiding straining when passing stools: Straining when passing stools can increase the risk of developing piles.

Avoiding heavy lifting: Regular heavy lifting is a risk factor for piles. Limiting heavy exertion and practicing proper lifting techniques can help a person prevent the development of piles.

Maintaining a moderate weight: Being overweight raises the risk of having piles.

Staying active: Exercise can help food passage through the digestive system and make stools more regular. This can reduce the risk of piles.

When to contact a doctor

A person should seek medical assistance if their piles persist for more than one week of home treatment or if they experience consistent bleeding from their rectum.

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