Piles: Causes, Symptoms, and Treatment


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What is piles?

Piles are swellings or swollen haemorrhoids that occur inside and around the anus, and along the anal canal. Haemorrhoids are masses, clumps, cushions of tissue full of blood vessels, support tissue, muscle and elastic fibers in the anal canal.
Everyone has haemorrhoids. However, when the haemorrhoids guarding the anal passage become too big due to inflammation, so that the vein walls become stretched, thin, and irritated by passing bowel movements, that is when piles develops.

In most cases, piles goes away on its own.

Piles can be broadly classified into two categories:

  • Internal Piles - are located far within the rectum, and can’t be seen or felt. The only symptom is usually bleeding.
    Internal piles can be classified into 4 grades:  

    • Grade1: These are tiny haemorrhoids within the lining of the anus.

    • Grade 2: These haemorrhoids too lie within the anus and are slightly larger than grade 1 haemorrhoids. These haemorrhoids may get pushed out while passing stool but return to the original position on their own.

    • Grade 3: These are also known as 'prolapsed haemorrhoids'. They appear outside the anus. The patient can push them back in by pressing against them with his fingers.

    • Grade 4: These haemorrhoids cannot be pushed back and stay outside the anus at all times. They need to be treated by a doctor who usually suggests a surgery.

  • External Piles -  are located around the anus right under the skin, where there are many pain-sensing nerves. They, therefore, hurt as well as bleed.

Anyone at any age can be affected by piles. Though it has been observed that people over 45 years of age usually get affected by piles.

About 50% of people experience this condition at some time in their life. Women who are pregnant too experience it. Though it is not clear what causes haemorrhoids, researchers think this might be an inherited condition of weak veins or varicose veins leading to haemorrhoids.

Who are the right specialists for performing Piles Surgery?

You can find a list of top Piles Surgery doctors & centers in your city at the following links:

Top Piles Surgery doctors in Bangalore

Top Piles Surgery doctors in Hyderabad

Top Piles Surgery doctors in Delhi

Top Piles Surgery doctors in Mumbai

Top Piles Surgery doctors in Pune

Top Piles Surgery doctors in Chennai

Top Piles Surgery doctors in Gurgaon

What is the cost of Piles Surgery?

Piles surgery cost varies based on location and hospitals.

You can find more information on Piles Surgery cost in your city at the following links:

Cost of Piles Surgery in Bangalore

Cost of Piles Surgery in Hyderabad

Cost of Piles Surgery in Delhi

Cost of Piles Surgery in Mumbai

Cost of Piles Surgery in Pune

Cost of Piles Surgery in Chennai

Cost of Piles Surgery in Gurgaon

How does piles occur?

Haemorrhoids are masses, clumps, cushions of tissue full of blood vessels, support tissue, muscle and elastic fibers in the anal canal. Piles are haemorrhoids that have become inflamed.

Internal haemorrhoids form when blood vessels inside the rectum become swollen and engorged.

External haemorrhoids can occur due to increased pressure caused by obesity, pregnancy, sitting or standing for long hours at a stretch, straining on the toilet, coughing, sneezing, vomiting, and holding your breath while straining to do strenuous physical labour.

Who is prone to piles?

Some people are more prone to developing piles than others. There could be a variety of reasons for it:

  • genetic predisposition to piles, meaning weak veins can be genetic leading to weak rectal vein walls or week venous valves

  • less fiber in the diet can cause constipation which can lead to the formation of piles

  • poor bathroom habits

  • pregnancy

  • excessive coughing or sneezing

  • constant sitting or standing for long hours at a stretch

  • excessive straining, rubbing or cleaning around the anus

  • regularly holding breath while straining to perform some physical labour

  • being obese

What are the causes of piles?

The primary causes of piles include:

  • genetic predisposition to piles

  • lack of fiber in the diet

  • inadequate fluid intake

  • sedentary lifestyle

  • stress

  • straining while passing stool

  • constipation and diarrhea

  • constant sitting or standing for long hours at a stretch

  • sitting for long periods of time on the toilet

  • anal intercourse

  • pregnancy

  • constant heavy lifting

  • being obese

  • previous surgery of bowel

  • constriction of intestine following a surgery

  • spinal cord injury that leads to bladder and rectal dysfunction

  • dysfunction of the floor of pelvis

What are the symptoms of piles? How is piles diagnosed?

The symptoms of piles include:

  • bright red bleeding from the anus. Blood may streak the bowel movement or the toilet paper.

  • pain during bowel movements

  • painful swelling or a lump near the anus

  • anal itching

  • mucous discharge from the anus

  • hard lump around the anus

  • area around the anus becomes red and sore


If the doctor suspects you have piles, he will perform a visual examination of your anus to diagnose haemorrhoids. He may also perform a digital rectal exam to check any sign of piles within the anus.
The doctor may also prescribe an additional test called a sigmoidoscopy.

A sigmoidoscopy (a small fibre-optic camera) involves your doctor using a small camera to diagnose an internal haemorrhoid. The sigmoidoscope is fitted into a small tube and inserted into your rectum.

It provides a clear view of the inside of your rectum and displays the abnormalities if any within the rectum. The doctor may also prescribe other tests such as colonoscopy, anoscopy, and proctoscopy which can clearly show internal haemorrhoids if any.

What are the complications of piles?

The complications of piles include:

  • bleeding during bowel movements

  • anemia

  • pain during bowel movements

  • piles cause complications associated with hygiene, as the anal area becomes difficult to clean after defecation

  • poor hygiene around the anal area can lead to several infections

  • itchiness around the anal area

  • gangrene, if the blood supply to an internal haemorrhoid is cut off

What is the treatment for piles?

Medical Treatment

Piles often clear up on their own but may require treatment or even surgery if the symptoms are severe.

The treatment of piles varies for internal and external piles.

Grade one, and two, of internal haemorrhoids, is usually treated with medicine and a planned diet of fibrous non-spicy food. In some cases, the doctors may also prescribe a topical cream.

Grade three of internal haemorrhoids is also treated with medicine and a change of diet but may require surgical intervention if the symptoms are severe. Treatment of grade four internal piles requires prompt surgical intervention especially if gangrenous tissue is found.

To treat external piles your doctor might suggest hemorrhoid creams, or ice packs to reduce the swelling. If the case is too severe, the doctor may suggest surgery which can include:

  • removal of haemorrhoids

  • using an infrared photo, laser, or electrical coagulation to burn tissue affected by piles

  • sclerotherapy to eliminate varicose veins which could be the cause of piles


Exercising can easily reduce the symptoms of piles. You can go for exercises such as :

  • brisk walking

  • deep breathing exercises

  • stretching exercises

  • aerobics

  • kegel exercises 3 times everyday -  the steps for which are:

    • contracting your pelvic muscles. It is akin to the action you do when you hold urination.

    • squeeze and hold for three seconds then relax for another 3 seconds.

    • repeat the exercise 10 times each session, until you can do as many as 15 repetitions.

In The Spotlight

Here are some of the latest news on piles/haemorrhoids from around the world: 

Would you like to consult a doctor for Piles ?

Patient Experiences

Laser Treatment for Piles
I was being treated for piles and had undergone operation multiple times for that but always had recurring problems with the same. After a friend of mine recommended me bengaluru smiles, i visited the place. The ambience and staff is awesome while meeting the doctor himself was an eye opener. Not only he examined me as an expert would but also could sense his deep understanding of the subject. Indeed as a Colo Rectal Surgeon , he was indeed an expert and arrived to the root cause of my problem and also offered me a totally painless, bloodless infact no cutting treatment of piles. Now having done this Laser for piles, been almost 1 year and am sure that I have been cured completely for life while following the advice given by him. Was not knowing that there are such experts in this field and also didnt know there are so many treatment options available in this field. ...Read Less
Doctor in this story :Dr. Yuvrajsingh
Bengaluru Smiles Hospital
Completely Cured of Piles
From 5-6 months, I suffered from Piles in my anus. I couldn't able to eat anything due to fear of unbearable pain at the time of motion. Their was burning sensation and pain which was unbearable. Then I went to a Bangali doctor and start treatement but they take so much of time and there was so much of waiting time i.e. from 8am to 1pm daily by which I suffered from lots of loss too. He just put medicine in my anus and never start treatement of the problem and daily he said, "I will start treatement from tom. definitely" from which I got irritated. Then one of my friend told me about Dr. Hemlata soni at Kriti Clinic in Ranibagh. I went to this doctor and she start treatment and said about LIFETIME GUARANTEE. I start treatment and seriously in just few days the pain gone. In just 1 month my treatment becomes over and M fine. After that I got my GUARANTEE CARD for this. NOW, I m absolutely fine and I can eat anything without any fear of pain. This is very painfull diseases and this doctor have the ability to distroy this disease from its root....Read Less
Doctor in this story :Dr. Hem Lata Soni
Kriti Clinic
Om prakash prajapati
90% relief From Piles After Homeopathic Treatment
I am suffering from piles since 3year no relief after taking a allopathy than take a homoeopathy by Dr s.n. tripathi sir is a good Dr in homoeopathy my trouble 90% relief only 2month ...thnx to u sir for treatment.....Read Less
Doctor in this story :Dr. Surendra Nath Tripathi
Tripathi's Computerized Homoeopathy Clinic
Homeopathic Treatment for Piles
After various treatment with allopathic and Ayurveda my problems with piles was same as day one . Finally I thought of going for surgery , a article in internet on homeopathy for piles treatment made me.think of final try on homeopathy. Finally after seeing good reviews about Banerjee clinic I decided to go there , doctor gave lot of advices on food habits etc.. finally I after ,3 months of teatment I can say my struggle with piles is almost getting over , now I feel like normal no pain no blood ..it's one good decision I had taken , thanks doctor..still having medicine hope I will completely recover from this in few month.. I recommend him for people like me who suffers from piles before going for surgery......Read Less
Doctor in this story :Dr. Joy Krishna Banerjee
Dr. Banerjee Multi Speciality Homeopathy
Effective Treatment for Piles
Excellent treatment for bleeding piles. I was_suffering from piles since 2 years , get fast results within a week,will surely recommend friends and family to Dr.kamlesh giri...Read Less
Doctor in this story :Dr. Kamlesh Giri
Dr. Kamlesh Giri's Homeopathic Clinic
Akash Soni
Bleeding Stopped After a Week of Treatment
I had the problem of bleeding piles since one and half year. My bleeding stopped just in one week after start of my homeopathic treatment from Dr Ravi sir, I am very happy with treatment....Read Less
Doctor in this story :Dr. Ravi Singh
Dr. Ravi's Multispeciality Homoeopathic Clinic

Questions answered by trusted doctors

Verified User
Actually suffering from piles pain from so many months what is the reason for this and what can be done to get rid of this ..Please help doctor please
Dr. Varun Kumar J
Gastroentrology Surgeon, Bangalore
Need physical examination
If required laser treatment or conservative treatment
Call us
Dr. Anil Kumar Jain
General Physician, Bangalore
Hello there.

I can understand your problem. First of all you need to consider the following points to be out of pain and out of the whole situation.

1. Drink lots of water.
2. Have a high fiber diet.
3. Avoid oily and spicy foods.
4. Lose weight if you are overweight.
5. Don't sit for long durations.
6. Have small meals frequently rather than having huge amount of foods at one time.
7. Inculcate the habit of walking around for time time after dinner.
8. Avoid smoking and alcohol.
9. Have a bowl of curd everyday.
10. You could sit in a tub of hot water to which a antiseptic like dettol is added when you get pain.

If you do as per the above mentioned advice, you will be avoiding the whole situation of piles. But if it still persists, consult a surgeon in person for further help.

Verified User
I want to know if piles can be cured permanently, in age of 18 year, and please suggest me the medical for it.
Dr. R. N. Biswas
Ayurveda, Delhi
Ayurvedic Kshara Sutra therapy is a minimal invasive Ayurvedic Parasurgical procedure and time-tested Ayurvedic technique in the management of Anorectal disorders. It is a safe, sure and cost effective method of treatment for haemorrhoids (Piles).
In this technique, a specially prepared thread is used to cure diseases. Kshar Sutra acts by "Herbal Chemical Cauterisation" and removes the disease from the body. 
Amisha Mirchandani
Homoeopath, Thane
Hello I understand your concern
We have many good homeopathic medicines for piles or haemorrhoids to treat it completely from the root itself without any sideffects that are part of conventional medicines
Please contact me directly or ask me at dramisha.com
Online consultation and medicines at your doorstep are also delivered nationally and internationally
Warm regards
Dr Amisha Mirchandani
09819      055014
Dr. Chethan R S
General Physician, Bangalore
Hi..... Soak regularly in a warm bath or sitz bath. Soak your anal area in plain warm water 10 to 15 minutes two to three times a day....
Don't use dry toilet paper. To help keep the anal area clean after a bowel movement, use moist towelettes or wet toilet paper that doesn't contain perfume or alcohol.

Apply cold. Apply ice packs or cold compresses on your anus to relieve swelling.

With these treatments, hemorrhoid symptoms often go away within a week. See your doctor if you don't get relief in a week, or sooner if you have severe pain or bleeding.
Consult surgeon....

Ask health queries and get free answers from doctors in 24 hrs

Did you know?

Constipation can lead to piles

According to a survey 14% people in urban India suffer from chronic constipation which can lead to piles.

People with chronic constipation are prone to piles

65% of the people with chronic constipation did not pass motion for three or more consecutive days.

People between 45 years to 65 years are prone to piles

20% (two out of 10) people in the age group of 45 to 65 suffered from chronic constipation with symptoms of piles.

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Home Remedies

Take Psyllium Husk

This supplement will increase your fiber intake, and soften your stools. It will make your bowel movements more smooth. Too much intake can cause gas or stomach cramping.

Take Triphala Powder

Take 4 grams of triphala powder, mix in a glass of hot water and drink every night before going to bed. This works like magic to reduce your piles symptoms and do away with constipation, which is a major cause of piles.

Castor Oil

Consuming castor oil regularly and also applying it topically in affected areas helps to alleviate the symptoms of piles.

Increase in Water intake

This is the most simple way to cure piles. Drinking 8-10 glasses of water each day will prevent constipation and regulate your digestive system.

Eat a Light Dinner

One of the main causes of piles is the diet we eat. Refrain from eating a heavy dinner. Have a light dinner and which is not too high in fibrous content, or too hot and spicy. Consuming these foods especially in case of bleeding piles, can cause excruciating pain and hence must be avoided.

Eat Salads

Consume salads such as cucumber, carrots, broccoli, every day, especially right after breakfast. Carrots have anti-oxidant and anti-inflammatory properties, which are beneficial for curing piles.