What are piles: Causes, symptoms and treatment tips for haemorrhoids

Haemorrhoids are one of those health conditions that, despite being widespread, remain surrounded by embarrassment, often preventing people from seeking timely help. Studies suggest nearly half of the Indian population will face this issue by the time they turn 50. From mild irritation to severe pain and bleeding, piles can cause a range of uncomfortable symptoms if left untreated.

Piles occur when the veins in and around the anus or lower rectum become swollen and inflamed. There are two types, says Dr Nikhil Yadav, HOD, Minimal Access and Robotic Surgery, Manipal Hospitals Dwarka,  New Delhi, internal and external. “Internal piles usually don’t cause pain but may lead to painless rectal bleeding, often spotted on toilet paper or in the toilet bowl. External piles are more painful and noticeable, often appearing as lumps around the anus. Common symptoms include itching, discomfort during bowel movements, tenderness, and in some cases, noticeable bleeding,” he says.

The most common trigger for piles is excessive strain during bowel movements, often caused by chronic constipation. “Sitting on the toilet for too long can also aggravate the veins around your anus. Obesity, pregnancy, and a sedentary lifestyle add further pressure, making some people more prone. Lifting heavy objects repeatedly, a low-fibre diet, and ageing can also play a role in weakening vein walls over time,” Dr Yadav warns.

Also read | Piles causes, symptoms and cure: Increase fibre intake with vegetables in diet, drink water and fruit juices

The expert suggests the following ways to treat piles with diet tweaks, home care and simple procedures:

• Home remedies and lifestyle changes: If your symptoms are mild, you can start with easy home-based solutions. “A high-fibre diet along with adequate water intake can soften stools, reducing strain during bowel movements,” he suggests. Warm sitz baths for 10–15 minutes a few times a day may ease discomfort and itching by improving blood flow in the affected area.

• Relieve the pain: Use over-the-counter creams and pain management methods. For more stubborn cases, topical treatments like haemorrhoid creams, ointments, or numbing agents can reduce swelling and irritation. “Oral painkillers can provide temporary relief, but they don’t treat the root cause. Always consult a doctor before prolonged use of any medication,” Dr Yadav advises.

• Opt for non-surgical fixes: If home treatments for internal piles don’t help, a non-surgical procedure like rubber band ligation may be recommended. “This is a day-care technique where rubber bands are placed at the base of the haemorrhoid to cut off its blood supply,” explains Dr Yadav. Over a few days, the haemorrhoid shrinks and falls off naturally without any need for hospital admission.

• Go for surgery: Choose haemorrhoidectomy for large or complicated cases. For larger or prolapsed piles that don’t respond to simpler methods, surgical removal might be necessary. Haemorrhoidectomy is a common procedure done under anaesthesia where the affected tissue is removed. “Minimally invasive techniques like laser surgery are now available, offering faster recovery and less postoperative pain compared to traditional methods,” says Dr Yadav.

• Reduce internal pressure: Explore lateral internal sphincterotomy for chronic fissures
  In cases where piles are accompanied by painful anal fissures, doctors may recommend a lateral internal sphincterotomy. This involves a small incision in the anal sphincter to relieve muscle spasm and improve blood flow, promoting faster healing. “This is especially useful when chronic fissures complicate the haemorrhoid condition,” adds Dr Yadav.

• Prevent recurrence: Adopt healthier bowel habits and long-term care strategies. To avoid future flare-ups, lifestyle changes are essential. Increase dietary fibre through fruits, vegetables, and whole grains, stay hydrated, and avoid straining during bowel movements. Dr Yadav advises regular physical activity and not ignoring the urge to pass stools, as delaying can worsen constipation and pile symptoms over time.