Piles or Hemorrhoids: Causes, Types, Symptoms, Prevention, Diagnosis and Treatment

Piles or hemorrhoids are increases that develop in and around the anus.

The anal canal is the last part of the large intestine and is about 4 cm long. At the lower end of the anal canal is the opening to the outside (usually referred to as the anus), through which the stool passes. At the upper end, the anal canal connects with the rectum (also part of the large intestine).

There is a network of small veins (blood vessels) in the lining of the anal canal . These veins sometimes get bigger and have more blood than normal. The veins fill with blood and the tissue that covers later can form in one or more small protuberances called piles.

Some people develop internal and external hemorrhoids at the same time.


The symptoms vary from mild and temporary, to persistent and painful . In many cases, the piles are small and the symptoms disappear without treatment. If necessary, the treatment is usually effective. There are several treatment options, which we detail later.

  • Bleeding without pain
  • Itching or irritation in the anal area.
  • Discomfort and pain in the same area.
  • Lumps and swelling in the anal region.
  • Stool leakage.

The symptoms can be unpleasant or alarming, but generally they are not a cause for concern.

What causes the piles?

The exact reason why they are caused is not clear. Some seem to develop for no apparent reason. However, it is believed that an increase in pressure in and around the anus and anal canal can be an important factor in many cases.

Certain situations increase the possibility of developing piles:

Constipation, and the effort in the toilet. These increase the pressure in and around the veins in the anus and appear to be a common reason to develop piles.

The pregnancy. They are common during pregnancy. This is probably due to the effects of the baby’s pressure that is above the rectum and anus, and the effect that the change in hormones during pregnancy can have on the veins.

Aging. The tissues of the anus wall may be less flexible as we get older. The hereditary factors. Some people can inherit a weakness of the wall of the veins in the anal region.

How can we avoid them?

Eating a lot of fiber, such as fruits, vegetables, cereals, whole grain bread, etc.

You should drink more liquids. Adults should try to drink at least two liters (6-8 glasses) per day. Most of the fluid will pass in the form of urine, but some pass into the intestine and this softens the stool.

The fiber supplements . If a diet high in fiber is not helping, you can take fiber supplements (bulking agents) such as ispaghula, methylcellulose, bran or sterculia.

Avoid analgesics that contain codeine such as co-codamol, as they are a common cause of constipation. However, simple analgesics such as paracetamol can help.

Go to the bathroom as soon as possible after feeling the need. Some people suppress this feeling and plan to go to the bathroom later. This can result in larger, harder stools that are formed and then more difficult to pass. Do not strain on the toilet.

Always remember that when they are detected in early stages, piles or hemorrhoids can disappear if we follow a balanced diet based on fibers, fruits and vegetables, taking enough fluids throughout the day.


Hemorrhoids can be internal or external.

Internal hemorrhoids:

The internal hemorrhoids are inside the rectum and are not visible from the outside. They are usually painless. Often, the first sign that there are internal hemorrhoids is rectal bleeding.

The effort can sometimes push an internal hemorrhoid so that it protrudes through the anus. This is called a hemorrhoid that protrudes or prolapses and can be painful.

External hemorrhoids:

The external hemorrhoids are under the skin around the anus and, therefore, are visible. Because there are more sensitive nerves in this part of the body, they are usually more painful. Effort when passing a stool can make them bleed.


Anyone who experiences the symptoms described above should contact a doctor. Keep in mind that other things, including colorectal and anal cancers , can cause rectal bleeding.

A doctor can perform a physical examination and perform other tests to determine whether or not there are hemorrhoids present. These tests may include a digital rectal exam. This is a manual inspection performed by the doctor using a gloved and lubricated finger.

If the symptoms include significant amounts of bleeding, dizziness, and fainting, the person should seek emergency care immediately.


In most cases, simple measures will relieve symptoms while hemorrhoids improve without treatment. However, sometimes medications and even surgery may be needed.

Home treatments:

The symptoms can be alleviated in the following ways. However, they will not eliminate hemorrhoids:

Topical creams and ointments: Over-the-counter (OTC) creams or suppositories containing hydrocortisone are available . There are also pads that contain witch hazel or an anesthetic agent that can be applied to the skin.

Packages of ice and cold packs: applying these on the affected area can help with swelling.

A sitz bath with warm water: a toilet seat is placed over the toilet. Some pharmacies sell them and can relieve the burning or itching symptoms.

Wet wipes: Dry toilet paper can aggravate the problem.


Most medications for hemorrhoids are over the counter. These include ointments, pads or suppositories.

It is known that active ingredients such as hydrocortisone and witch hazel relieve itching and pain. Consult a doctor if these medications do not show results after one week of treatment.

Non-surgical treatment options:

The most common type of non-surgical hemorrhoids removal technique is elastic band ligation.

This is an outpatient procedure for internal hemorrhoids, where an elastic band is placed at the base of the hemorrhoid to cut off the blood supply. The hemorrhoid will shrink or fall off.

Another procedure is sclerotherapy , where a solution is injected into an internal hemorrhoid. This produces a scar that cuts off the blood supply to the hemorrhoid.

Infrared photocoagulation and electrocoagulation are two other options.

How to eliminate hemorrhoids?

Surgery may involve the complete elimination of hemorrhoids, known as hemorrhoidectomy .

It can also involve stapling, where a prolapsed hemorrhoid is put back in place. These procedures are performed under general anesthesia, and most people can go home the same day of surgery.

The procedure of Hemorrhoidectomy:

A hemorrhoidectomy is usually done in a doctor’s office, clinic or surgical center.

You may receive local anesthesia (a small area of ​​your body is numbed), a spinal block (the lower half of your body is numbed), or general anesthesia (you will not be conscious).

There are different ways to perform the procedure, depending on your condition.

In a typical hemorrhoidectomy, a surgeon makes small incisions around the hemorrhoids.

Then use a knife, scissors or a cautery pencil (a high-heat instrument) to eliminate hemorrhoids.

Sometimes, it is possible to staple a hemorrhoid or place a rubber band to block its blood flow. This causes the hemorrhoid to shrink.

Other techniques involve the injection of a chemical solution or the use of a laser to reduce hemorrhoids.

Talk to your doctor about which procedure is the best option for you.

How to relieve hemorrhoids?

Drinking water:

Drinking enough amounts of water, which can be between 2 and 3 liters per day, helps not only to hydrate our body but also to lighten and smooth the bowel movements.

Certain techniques for gentle bowel movement can be practiced at home.

Drinking at least a liter of water first thing in the morning helps stimulate soft bowel movements.

The sudden flow of water in the stomach puts pressure on the intestines and helps create peristaltic movement and the water that runs inside the intestines moves the waste in gentle movements.

High fiber diet:

A diet rich in fiber helps create softer bowel movements and easy bowel movements.

This, in turn, decreases the irritation caused by hemorrhoids. A diet high in fiber includes consuming most vegetables, herbs, fruits and cereal.


An enema is a very easy and effective remedy to relieve hemorrhoids. Enemas can be administered with warm water. The water that enters the intestine loosens the stool to evacuate easily and effortlessly.

Cotton clothes:

Simple cotton clothing that fits comfortably is better because tight clothing can aggravate irritation in the area of ​​hemorrhoids.

They can also absorb sweat, which keeps the area dry and helps prevent any bacterial infection.


Radishes are considered one of the best home remedies to relieve hemorrhoids. A half cup of radish juice consumed twice a day will help the relief of these swollen veins.

The local application of radish paste mixed with honey can also alleviate the pain caused by hemorrhoids.


In Ayurvedic medicine, figs have been used to treat many diseases, including hemorrhoids.

The dried figs should be soaked in water overnight and then consumed the next day along with the water to give positive results towards the relief and reduction of hemorrhoids.


Hemorrhoids can be treated with the help of probiotics or friendly bacteria. The best source for such probiotic bacteria is none other than yogurt!

You should consume yogurt every day because the bacteria found in yogurt promote the proper functioning of the gastrointestinal organs.

Flax seed:

Flaxseed rich in fiber content and omega-3 fatty acids is very useful for hemorrhoids and constipation . Flaxseed can be consumed regularly in powder form.

Mango seeds:

It is known that mango seeds are a good home remedy to relieve hemorrhoids. These seeds should be dried, pulverized and stored.

This powder should be taken (1-2 teaspoons) twice a day. The powder is known to relieve swelling, pain and itching sensation.

Chestnuts from the Indies:

The chestnut horse or Aesculus hippocastanum is known to contain a compound called Escin saponin.

Escin has anti-inflammatory properties, antiedema and venotonic effects. Relieves inflammation and strengthens blood vessels.

Java plums:

The Java plum fruit is known to relieve bloody stools that are associated with internal hemorrhoids.

This fruit should be eaten early in the morning for a period of approximately 2-3 months for best results.

Butcher’s Broom:

The use of the butcher’s broom, also known as Ruscus aculeatus, has shown good results in the control of hemorrhoids.

It has ruscogenins, which are known to have anti-inflammatory properties.

Pomegranate seeds:

Take some shells of pomegranate seeds and immerse them in water for a while and then boil this mixture.

Strain this brew and take it twice a day in the morning and at night. This will help relieve the symptoms and pain of hemorrhoids.

Aloe vera:

Aloe vera has been used for many centuries to treat burns due to its emollient, demulcent and anti-inflammatory properties.

Aloe vera secretions should be applied locally to external hemorrhoids to relieve pain and swelling.


The ripe banana fruit is excellent for treating constipation, as well as for hemorrhoids.

Blend a banana with milk and consume this mixture at least 3 or 4 times a day to relieve the pain of hemorrhoids.


Witch hazel, known scientifically as Hamamelis virginiana, has shrinking properties of blood vessels swollen to its normal size and therefore acts as a natural remedy for hemorrhoids.

A witch hazel paste can be applied locally to relieve swelling.

Sesame seeds:

Make a paste of boiled sesame seeds and add a very small amount of butter and consume every day.

Sesame seeds act as a very good medicine for a spectrum of diseases ranging from blood production, dental problems and burns, to the regulation of the menstrual cycle of women and the cure of hemorrhoids.

Cumin seeds:

Cumin seeds can be used in various ways to cure hemorrhoids. Black cumin seeds are especially useful for treating hemorrhoids.

Mix black cumin seeds with equal proportions of cane sugar (2-3 teaspoons) every day.

After taking this mixture, one has to drink at least 3-4 glasses of water for best results.

Bitter gourd:

Bitter gourd is known for its health benefits, such as the fight against diabetes , the possible prevention of cancer and the control of cholesterol.

Its leaves are also used to provide relief from hemorrhoids.

Make a juice of bitter gourd leaves and add it to the buttermilk, which should be taken every morning.

In addition to the juice, you can prepare a paste of leaves and apply it to external hemorrhoids.

Ginger, honey, lime and mint:

Take two tablespoons of ginger juice, lime juice and mint juice and mix with 2-4 tablespoons of honey. Take this mixture every morning.

It is believed to be a good cure for hemorrhoids.


Turnips are another plant that is used as a home remedy for hemorrhoids.

Take the juice from the turnip leaves and add the juices of radish, watercress and carrot in equal proportions.

Drink a glass of this juice every day to get rid of hemorrhoids.

Indian gooseberry:

It is another wonderful fruit of India. It is believed that it has the highest concentrations of vitamin C than any fruit, as well as many medicinal properties, and is consumed in fresh or canned form.

Indian gooseberry is good for many gastrointestinal problems, including hemorrhoids.


There are different poses in yoga that can help in conditions such as hemorrhoids.

Sarvanga asana, malasana, viparita karani and balasana are some of the yoga postures that can be practiced to cure hemorrhoids.


Turmeric is one of the ancient herbs that have been widely mentioned in Ayurveda to have anti-inflammatory, antibacterial, antiseptic, antioxidant and anti-allergic properties.

Its anti-inflammatory properties make it very effective in curing hemorrhoids.

Soft toilet paper:

Other remedies include the use of simple and soft tissue paper instead of the fragrance-filled tissues.

Note: Fragrant tissues may contain chemical sprays that can increase irritation and worsen the condition.

The high sensation of itching causes patients to scratch uncontrollably. Scratching can break those healing wounds or scars and return wounds to their original painful levels.

For any unforeseen complication, it is advisable to consult a doctor.

Hemorrhoids during pregnancy

Hemorrhoids are common during pregnancy, particularly in the third trimester, when the enlarged uterus puts pressure on the pelvis and veins near the anus and rectum.

Increased levels of the hormone progesterone during pregnancy can also contribute to the development of hemorrhoids: progesterone relaxes the walls of the veins, which makes them more likely to swell.

Some women have hemorrhoids for the first time when they are pregnant. But if you’ve had hemorrhoids before, you’re more likely to have them again when you’re pregnant.

Fortunately, hemorrhoids are usually not harmful to your health or the health of your baby, and usually go away on their own once you give birth.

You can often relieve symptoms with home care, but check with your doctor first to make sure any treatment is safe during your pregnancy.