What Are Piles or Haemorrhoids?
Piles, also known as haemorrhoids (or hemorrhoids in American English), are swollen blood vessels located in the lower rectum and anus. Normally, these vascular structures act as cushions that help control bowel movements. However, when they become enlarged, swollen, or inflamed, they lead to discomfort and are referred to as haemorrhoidal disease. Common symptoms include pain, itching, bleeding, and difficulty during stool passage.
Hemorrhoids: Prevalence, Risk Factors, and Dietary Impact
Symptomatic hemorrhoids affect over one million people each year in the Western world. While hemorrhoidal disease can occur in individuals of any age or gender, increasing age is considered a significant risk factor. Interestingly, the condition is less common in underdeveloped countries, likely due to differences in diet and lifestyle.
One major contributor to the high prevalence in developed nations is the typical Western diet, which is often low in fiber and high in fat. This type of diet is associated with constipation and straining during bowel movements—two key factors that increase the risk of developing symptomatic hemorrhoids.
Understanding the Causes of Haemorrhoids: Myths, Facts, and Modern Insights
For centuries, misconceptions about the vascular anatomy of the anal canal led to various outdated theories about the development of primary internal haemorrhoids. Early beliefs linked haemorrhoids to man’s upright posture, absence of valves in the portal venous system, and increased abdominal pressure—suggesting that these factors caused anal varicosities.
However, modern studies have debunked many of these theories. If raised portal pressure were a true cause, haemorrhoids would be far more common in patients with portal hypertension. While such individuals often develop anorectal varices, these are clinically and anatomically distinct from haemorrhoids and do not occur more frequently than in the general population.
In the past, haemorrhoids were also thought to be similar to vascular growths, such as hemangiomas, or related to changes in erectile tissue involved in continence—like hyperplasia of the so-called corpus cavernosum recti. Some experts even hypothesized that repeated infections or trauma from bowel movements weakened the venous walls in the anal region. But the anal canal is remarkably resistant to infection, and its mucosa is known for its exceptional healing ability—even after surgery—despite constant exposure to bacteria.
A more widely accepted cause of haemorrhoids is chronic constipation and the straining it induces. A low-fiber diet slows gut transit time and leads to small, hard stools that require greater effort to pass. Straining, prolonged sitting on the toilet, and a relaxed perineum may all interfere with venous return, leading to engorged anal veins. However, constipation alone doesn’t explain the entire picture. Interestingly, haemorrhoids are also found in individuals with diarrhoeal conditions, showing that both extremes of bowel function can contribute.
Another factor is anal hypertonia—elevated resting pressure in the anal canal. It’s unclear whether this increased tone causes haemorrhoids or results from them. Although surgical removal of haemorrhoids often normalizes anal pressure, this does not definitively prove causation. In contrast, some patients with haemorrhoids have a lax anal canal and mucosal prolapse, sometimes linked to perineal descent or pudendal nerve issues.
Age is another contributing factor. In youth, the anal cushions are supported by strong, elastic connective tissue. Over time, these structures become fragmented and lose elasticity, primarily due to repeated straining during defaecation. While these degenerative changes are most common in older adults, they are also found in younger individuals with severe haemorrhoids.
Today, the prevailing view is that mechanical shearing forces during bowel movements lead to the downward displacement of the anal cushions. Repeated trauma and pressure eventually weaken the supporting tissues, preventing the cushions from retracting after defaecation. This leads to the characteristic bulging, discomfort, and symptoms associated with haemorrhoidal disease.
Classification of Piles (Haemorrhoids): Internal and External Types Explained
Haemorrhoids, commonly known as piles, are classified into two main types based on their location relative to the dentate (pectinate) line in the anal canal: external and internal haemorrhoids.
External haemorrhoids develop below the dentate line and are covered by squamous epithelium, the same type of skin found outside the body. These haemorrhoids are often associated with an internal component but become particularly painful when thrombosed—meaning a blood clot has formed inside them. This can cause swelling, tenderness, and acute discomfort.
Internal haemorrhoids originate above the dentate line and are covered with mucosa and transitional epithelium. They are typically painless, even when bleeding, due to the lack of pain receptors in this area. Internal haemorrhoids represent the majority of cases and are the primary focus in clinical classification systems.
The standard medical classification of internal haemorrhoids is based on how far they prolapse or extend outside the anus:
Grade I – No prolapse; visible only through endoscopy.
Grade II – Prolapse during straining but retracts spontaneously.
Grade III – Prolapse during defaecation and requires manual reduction.
Grade IV – Permanently prolapsed and cannot be manually reduced.
External and Internal Haemorrhoids: Symptoms, Diagnosis, and Severity
External haemorrhoids form below the dentate line and are covered by skin-like tissue. In many cases, they cause few or no symptoms unless they become thrombosed (develop a blood clot). When thrombosed, they can become extremely painful, with swelling and tenderness around the anus.
Pain and Swelling: The pain is typically sudden and intense but often subsides within 2–3 days. However, the swelling may persist for a few weeks.
Skin Tags: After healing, a skin tag may remain.
Irritation and Itching: Large external haemorrhoids may make personal hygiene difficult, leading to skin irritation and itching around the anus.
Internal haemorrhoids develop above the dentate line and are usually painless, even when they bleed, due to a lack of pain-sensitive nerves in the area.
Bleeding: The most common and earliest symptom is bright red bleeding during or after a bowel movement. The blood may be seen on toilet paper, coating the stool, or dripping into the toilet.
Prolapse: Internal haemorrhoids may protrude outside the anus, presenting as a perianal lump. They may reduce spontaneously or require manual assistance.
Other Symptoms: These may include mucous discharge, itching, anal irritation, and, in some cases, fecal incontinence.
Pain: Pain is uncommon unless the haemorrhoid becomes thrombosed or necrotic. If pain is present with bleeding, it may suggest another condition.
Internal haemorrhoids are classified based on the degree of prolapse:
Grade I: No prolapse; bleeding may be the only symptom.
Grade II: Prolapse during defecation but spontaneously retracts.
Grade III: Prolapse requires manual reduction.
Grade IV: Prolapsed permanently and cannot be pushed back in.
As haemorrhoids progress, the pile masses may become enlarged and edematous, leading to more significant discomfort and the development of cutaneous (skin) components.
Patients with advanced haemorrhoids may also experience:
Persistent irritation and itching due to mucus secretion from prolapsed rectal mucosa.
Difficulty with hygiene, caused by an irregular anal verge.
Minor leakage, due to reduced effectiveness of the anal seal.
In rare cases, chronic bleeding may lead to anemia.
A proper diagnosis includes both visual and physical examinations:
External Haemorrhoids: Can often be seen by a doctor during a physical exam.
Digital Rectal Examination (DRE): A gloved, lubricated finger is inserted into the rectum to feel for abnormal growths or masses.
Anoscopy or Proctoscopy: Because internal haemorrhoids are usually too soft to detect by touch, your doctor may use instruments like an anoscope, proctoscope, or sigmoidoscope to visually inspect the anal canal and lower rectum.
.
A healthy diet and lifestyle routine are essential for managing haemorrhoids and preventing their recurrence. By making simple changes to what you eat and how you live, you can significantly reduce symptoms such as pain, swelling, itching, and bleeding. Below are expert-backed dietary recommendations and daily habits that can help provide relief and improve overall digestive health.
Why: A high-fiber diet softens stool and promotes smoother bowel movements, reducing the need to strain—one of the leading causes of haemorrhoids.
What to Eat:
Whole grains (oats, brown rice, whole wheat bread)
Fruits (apples, pears, bananas, berries)
Vegetables (carrots, spinach, broccoli, kale)
Legumes (lentils, chickpeas, black beans)
Nuts and seeds (flaxseeds, chia seeds, almonds)
Why: Drinking enough water helps keep your stools soft and prevents constipation.
Tip: Aim for 8–10 glasses (2–2.5 liters) of water daily. Herbal teas and clear broths also contribute to hydration.
Why: Processed and refined foods can lead to hard stools and constipation, worsening haemorrhoid symptoms.
What to Limit:
White bread and refined grains
Sugary snacks
Fast food and packaged meals
Why: Good fats help lubricate the digestive tract and support regular bowel movements.
Sources:
Avocados
Olive oil
Fatty fish (salmon, sardines)
Nuts and seeds
Why: Probiotics maintain a healthy gut microbiome, aiding in regular and smooth digestion.
Probiotic-Rich Foods:
Yogurt
Kefir
Kimchi
Sauerkraut
Why: These beverages can dehydrate your body and harden stools, increasing the risk of constipation.
Tip: Reduce intake and drink extra water if consuming alcohol or caffeinated drinks.
Why: Too much salt can cause water retention and swelling, potentially worsening haemorrhoids.
Avoid: Salty snacks, processed meats, and canned soups with high sodium content.
Why: Physical activity improves blood flow and supports regular bowel movements.
How: Aim for at least 30 minutes of moderate exercise (e.g., walking, swimming, yoga) on most days.
Why: Sitting for long periods—especially on the toilet—increases pressure on the anal veins.
Tip: Take short breaks every 30–60 minutes if your work involves sitting. Avoid lingering on the toilet.
Why: Proper bowel habits reduce strain and irritation.
Best Practices:
Respond promptly to the urge to defecate
Avoid straining or sitting too long
Use a footstool to elevate your feet and improve toilet posture
Why: Soaking the anal area in warm water helps reduce pain, itching, and inflammation.
How: Sit in a warm bath for 10–15 minutes, especially after bowel movements. Repeat 2–3 times daily.
Why: Cleanliness prevents further irritation and infection.
Tips:
Use unscented, hypoallergenic wipes instead of dry toilet paper
Gently pat the area dry after washing
Avoid harsh soaps and scented products
Why: Cold therapy can reduce swelling and numb the discomfort.
How: Use a clean ice pack wrapped in cloth and apply to the affected area for short intervals.
Why: Over-the-counter creams can provide quick relief from itching, burning, and swelling.
Options: Hemorrhoid creams or ointments with hydrocortisone or witch hazel (as directed).
Why: Lifting heavy objects increases intra-abdominal pressure, aggravating haemorrhoids.
How: Avoid unnecessary lifting, and always use proper form when needed.
Benefits: Opens the hips, stretches the lower back, and improves bowel movement.
How to do:
Squat with your feet flat on the floor.
Bring your palms together in a prayer position at your chest.
Use your elbows to gently press your knees apart.
Hold for 30 seconds to 1 minute.
Benefits: Relieves gas and bloating, improves digestion, and supports intestinal health.
How to do:
Lie on your back, bring one or both knees toward your chest.
Hold your shins and gently pull the knees in.
Keep the head on the floor or raise it toward the knees.
Hold for 20–30 seconds and repeat.
Benefits: Enhances blood circulation, reduces pressure in the rectal area, and promotes relaxation.
How to do:
Lie on your back with your legs extended vertically up against a wall.
Relax your arms at your sides.
Hold the pose for 5–10 minutes.
Benefits: Relieves stress and tension, gently stretches the lower back and digestive organs.
How to do:
Sit on your heels, bend forward, and stretch your arms in front.
Rest your forehead on the mat.
Hold for 1–2 minutes while breathing deeply.
Benefits: Stimulates abdominal organs, improves digestion, and eases constipation.
How to do:
Lie on your stomach, place your hands under your shoulders.
Inhale and lift your chest gently while keeping your elbows slightly bent.
Hold for 15–30 seconds.
Benefits: Improves blood circulation and helps relieve constipation.
Note: Should be done under supervision if you are a beginner or have high blood pressure.
How to do:
Lie on your back and lift your legs upward, supporting your hips with your hands.
Keep your legs and body straight.
Hold for 30 seconds to 1 minute.
Benefits: Tones the pelvic floor muscles and improves blood flow to the anal region.
How to do:
Sit in a meditative posture.
Contract and relax the anal sphincter muscles repeatedly.
Do 10–15 repetitions
Homeopathy is a gentle, natural system of healing that focuses on treating the root cause of illness, not just the symptoms. It works in harmony with your body’s innate ability to heal itself—without causing side effects. Safe for all ages and tailored to each individual, homeopathy supports long-term health and well-being.
Whether you’re managing a chronic condition or seeking relief from acute symptoms, homeopathy offers a holistic, personalized path to recovery.
At Spiritual Homeopathy, we are deeply committed to helping you achieve true wellness—physically, emotionally, and spiritually. Our mission is to provide compassionate, individualized care using time-tested homeopathic principles and modern clinical insight.
We don’t just treat symptoms; we focus on identifying and resolving the underlying imbalances that cause illness, so you can enjoy lasting health and vitality.
At the heart of our practice is a unique approach that blends classical homeopathy with a deep respect for the spiritual and emotional dimensions of healing. Here’s what sets us apart:
✅ Root-Cause Healing: We look beyond surface symptoms to identify and treat the root cause.
✅ Personalized Treatment: Every remedy and plan is uniquely tailored to your body, lifestyle, and emotional needs.
✅ Experienced Team: Our skilled and empathetic homeopathy doctors in Hyderabad offer both in-clinic and online consultations for your convenience.
✅ Safe & Non-Toxic: Our remedies are gentle, non-addictive, and free from harmful chemicals.
✅ Spiritual Care: We understand the mind-body-spirit connection and integrate it into every treatment.
We take time to listen—really listen. During your initial session, our experts assess your health history, lifestyle, emotional state, and current symptoms to develop a treatment plan that’s customized just for you.
We offer a wide range of homeopathic medicines, carefully selected to suit your individual condition—whether you’re dealing with an acute illness like bronchitis or a long-standing issue like digestive problems, skin disorders, or allergies.
Healing is a journey, and we’re with you every step of the way. Regular follow-ups help us monitor your progress, fine-tune your treatment, and ensure you’re getting the best possible outcome.
At Spiritual Homeopathy, your well-being is our highest priority. Whether you’re seeking relief from specific health issues or aiming to boost your overall vitality, we’re here to guide you with care, empathy, and clinical excellence.
Ready to experience the power of natural, root-cause healing?
Book your consultation with Spiritual Homeopathy now — in person or online — and take the first step toward balanced, vibrant health.
Answer: Piles, or haemorrhoids, are swollen blood vessels in the rectum or anus. They can be internal (inside the rectum) or external (under the skin around the anus), and often cause discomfort, itching, bleeding, or pain during bowel movements.
Answer: Common causes include chronic constipation, straining during bowel movements, a low-fiber diet, prolonged sitting, obesity, pregnancy, and ageing. Poor toilet habits can also contribute.
Answer: Symptoms may include:
Bright red rectal bleeding
Pain or discomfort during bowel movements
Itching or irritation near the anus
Swelling or lumps around the anus
Mucous discharge
Prolapse (lumps that come out of the anus during straining)
Answer: While piles are usually not life-threatening, they can cause significant discomfort and may lead to complications like thrombosis, bleeding, or infection if left untreated. Rarely, severe bleeding may cause anaemia.
Answer: Mild haemorrhoids can often resolve on their own with dietary and lifestyle changes. However, persistent or severe cases may require medical treatment or procedures.
Answer: Doctors may diagnose piles through:
Physical examination (for external piles)
Digital rectal exam
Anoscopy, proctoscopy, or sigmoidoscopy (for internal piles)
Answer: Treatments vary depending on severity and may include:
High-fiber diet and hydration
Topical creams or suppositories
Sitz baths
Rubber band ligation
Sclerotherapy
Laser or surgical removal (hemorrhoidectomy) for advanced cases
Answer: Yes. A diet high in fiber (fruits, vegetables, whole grains, legumes) and plenty of water helps prevent constipation and straining, reducing the risk and symptoms of piles.
Answer: No. Although symptoms may overlap, they are different conditions:
Piles are swollen veins.
Fissures are small tears in the anal lining.
Fistulas are abnormal tunnels between the rectum and skin near the anus.
Answer: See a doctor if:
Bleeding is frequent or heavy
You experience severe pain or swelling
Over-the-counter treatments don’t help
You notice a lump that doesn’t go away
There’s leakage or signs of infection
Reference
[1]Harrisons_Principles_of_Internal_Medicine_19th_Edition-_2_Volume_Set
[2] Therapeutics from Zomeo Ultimate LAN
[3] Bailey_and_Love_s_Short_Practice_of_Surgery
Happy Clients. True Testimonials.
