Piles: Symptoms, causes, and treatments

Piles is another term for hemorrhoids. Hemorrhoids are collections of inflamed tissue in the anal canal. They contain blood vessels, support tissue, muscle, and elastic fibers.

Many people have piles, but the symptoms are not always obvious. Hemorrhoids cause noticeable symptoms for at least 50 percent of people in the United States (U.S.) before the age of 50 years.

This article will explore piles, their causes, how to diagnose, grade, and treat them, and what effects they might have on the body.

Fast facts on piles:

Here are some key points about piles. More detail and supporting information is in the main article.

Piles are collections of tissue and vein that become inflamed and swollen.

The size of piles can vary, and they are found inside or outside the anus.

Piles occur due to chronic constipation, chronic diarrhea, lifting heavy weights, pregnancy, or straining when passing a stool.

A doctor can usually diagnose piles on examination.

Hemorrhoids are graded on a scale from I to IV. At grades III or IV, surgery may be necessary.

What are piles?

Hemorrhoids and piles demonstrated in diagram or rectum. Image credit: Mikael Häggström, (2012, September 17)
Internal piles occur more frequently than external piles.
Image credit: Mikael Häggström, 2012, own work

Piles are inflamed and swollen collections of tissue in the anal area.

They can have a range of sizes, and they may be internal or external.

Internal piles are normally located between 2 and 4 centimeters (cm) above the opening of the anus, and they are the more common type. External piles occur on the outside edge of the anus.

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Pregnant woman in doctors office.
Pregnancy may increase the risk of developing piles, as it causes increased pressure in the body.

Piles are caused by increased pressure in the lower rectum.

The blood vessels around the anus and in the rectum will stretch under pressure and may swell or bulge, forming piles. This may be due to:

chronic constipation

chronic diarrhea

lifting heavy weights


straining when passing a stool

The tendency to develop piless may also be inherited and increases with age.

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