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Piles: Causes And Symptoms

by Dr. Surya Bhagwati on Aug 01, 2021

Piles: Causes And Symptoms

Piles or hemorrhoids are common problems. They cause discomfort, pain, and bleeding. We will know what piles are, their common causes, symptoms, and complications in this blog.

What Are Piles?

Piles, also called hemorrhoids, are swollen or dilated veins in your lower rectum and anus. These swollen veins cause stretching and irritation of the membranes that line the rectum and anus. Piles are one of the most common anorectal conditions seen in general practice.  

If you are looking for relief from Piles, Herbopile from Dr. Vaidya's is the Ayurvedic solution to piles and fissures for you.

Types Of Piles

There are two types of piles- Internal piles and External piles based on their location in the rectum. 

Internal Piles:

They are more common and occur inside the rectum between 2 and 4 centimetres (cm) above the anus opening. 

Internal hemorrhoids are of four grades or stages based on the degree of prolapse:

  • Grade I: These small swellings lie inside the anus linings and are not visible as they do not protrude out of the anal canal.  
  • Grade II: Larger than grade I pile but remain inside the anus. They come out during defecation but retract back on their own.   
  • Grade III: These are prolapsed hemorrhoids and come outside the anus. They protrude during defecation and need to push back manually. 
  • Grade IV: These cannot be pushed back manually and remain outside of the anus.  

External Piles:

External piles form small lumps on the outer edges of the anus. They are often itchy and painful.

What Are The Most Common Piles Causes?

Certain conditions increase pressure in the lower rectum and interfere with blood flow to and from the area. These cause blood pooling and swelling or bulging of the veins forming a pile mass. During pregnancy, the uterus enlarges and presses on the veins causing hemorrhoids. 

List of Piles causes

  • Straining when passing a stool
  • Chronic constipation or diarrhea
  • Pregnancy
  • Lifting heavyweights
  • A habit of postponing the bowel movements
  • Colon cancer
  • Spinal cord injury

Who Can Get Piles?

Piles are common in adults and teenagers. You can be at a high risk of getting hemorrhoids if you: 

  • Have excess weight or are obese.
  • Eat low-fiber and more junk food. 
  • Regularly lift heavy objects.
  • Do a job requiring prolonged sitting.
  • Strain while having bowel movements.
  • Advanced age weakens tissues around the anus.
  • Have a family history of piles.

Symptoms Of Piles

Hemorrhoid symptoms are not severe or life-threatening. Mild symptoms can go away on their own with slight modifications in the diet and lifestyle. 

Here are common piles symptoms:

  • Pain and itching in the anal region. 
  • Blood in the stools or after defecation.
  • A hard lump around the anus.

Internal hemorrhoids symptoms:

Excess straining or irritation when passing stool can cause:

  • Painless bleeding during bowel movements.
  • If piles prolapse, pain, and irritation.

External hemorrhoids symptoms include:

  • Itching around the anus.
  • Painful fleshy lump near the anus.
  • Pain or discomfort on sitting.
  • Rectal bleeding.

Diagnosis Of Piles

A doctor diagnoses hemorrhoids after taking a careful history and examining the anal area. A digital rectal examination (DRE) or the use of a proctoscope (a hollow tube fitted with a light) can help confirm the diagnosis of internal piles.  

Complications Of Piles

Piles generally do not lead to dangerous complications. Few complications are: 

  • Anemia, if blood loss is significant and prolonged.
  • Intense pain caused by thrombosis (a blood clot in hemorrhoid).
  • Secondary infection, abscess, or ulceration.  

Piles - Ayurvedic View

Piles are described as ARSHA in Ayurved. This disease tortures the patient like an enemy and hence named Arsha. An unhealthy diet and lifestyle reduce digestive fire resulting in indigestion and imbalance in the doshas around the anorectal region. These produce Arsha or piles. 

Ayurved has divided piles into two groups viz. Shushkarsha (Dry piles) and Sravi Arsha (exudating or bleeding piles) from the treatment point of view.  

Signs and Symptoms of Piles in Ayurved

Fleshy swelling in the anus, obstruction to the passage of gases, pain during defecation, and reduced appetite are the common signs and symptoms of piles mentioned in Ayurved.  

Final Word On Piles Causes & Symptoms

Piles are inflamed and swollen collections of tissues in the anal area caused by increased pressure in the rectum. They can be external or internal. Hemorrhoid symptoms include itching, pain, or bleeding while defecating. They can be managed well by medicines and rarely cause complications. 


What are the symptoms of piles cancer?

Piles cancer or anal cancer symptoms are:

  • Bleeding from the rectum.
  • Itching or pain around the anus.
  • A mass around the anal opening.
  • Unsatisfactory bowel evacuation.
  • Mucus or slippery discharge from the anus.

Blood in stool, is it a pile symptom?

One of the symptoms of the pile is bright red blood after passing motions. Watch for other hemorrhoids symptoms like pain, itching, and mucus discharge. You must visit a doctor to get physically checked and confirm the diagnosis. 

Back pain, is it a pile symptom?

Back pain is not a common symptom of piles or hemorrhoids. However, both can be present together. 

Do symptoms differ as per pile stages?

Piles symptoms differ as per the stages. Painless bleeding is the main symptom of the first-stage piles. As it progresses to second grade, along with bleeding, you can experience mild pain. Mucus discharge is also present in addition to pain and bleeding in third-grade piles. In the fourth stage, hemorrhoids can have blood clotting or strangulation with all other symptoms.

Do bloody piles pain more?

Piles occur when veins in the rectum and anal region swell and dilate. Bleeding is seen mainly in internal piles that are often painless. 

Do piles in pregnancy more painful?

An enlarged uterus puts pressure on the vein and causes piles in the later duration of pregnancy. The existing hemorrhoids can get worse during pregnancy.


  1. Mishra N, Sharma HP. Hemorrhoids–(Arsha): a Comprehensive Review on Its Causes And Treatment. UJAHM 2013, 01 (03):31-33.
  2. Agnivesha, Charak Samhita With Vidyotini Hindi Commentary of Pt. Kasinatha Sastri and Dr. Gorakha Natha Chaturvedi Ji, Chaukhambha Bharati Academy, Varanasi. Reprint year: 2005.
  3. Dr Akriti Komal and Dr Devjani Majumadar, Hemorrhoids: Incidence & Risk. Factors in a Corporate Hospital of Eastern, IAR J Med &Surg Res, 2021, 2(1):9-13.
  4. Staroselsky A, Nava-Ocampo AA, Vohra S, Koren G. Hemorrhoids in pregnancy. Can Fam Physician, 2008; 54(2):189-190.
  5. Gami, Bharat,  Hemorrhoids - a common ailment among adults, causes & treatment: A review. International Journal of Pharmacy and Pharmaceutical Sciences, 2011, 03: 5-12.
  6. Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol. 2012;18(17):2009-2017. 

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