Piles, medically known as hemorrhoids, are swollen veins in the anus and lower rectum, similar to varicose veins. They are a common condition that can cause discomfort, pain, and sometimes bleeding. While many people experience piles at some point, recognizing the symptoms and understanding how they are diagnosed is crucial for timely and effective treatment.
Understanding the Types of Piles
Piles are generally categorized into two main types based on their location:
- Internal Piles: These develop inside the rectum and are usually not visible or felt from the outside. They often don’t cause pain because the inner lining of the rectum has few pain-sensing nerves. The most common symptom is painless bleeding during bowel movements. In some cases, internal piles can prolapse (protrude) through the anus, which may cause pain and irritation.
- External Piles: These form under the skin around the anus, where there are many pain-sensing nerves. They are typically visible or can be felt as lumps. External piles are often more painful, especially when sitting or during bowel movements. They can also itch, swell, and bleed. A thrombosed external hemorrhoid occurs when a blood clot forms within it, leading to severe pain, swelling, and a hard, bluish lump.
Common Symptoms of Piles
Recognizing the signs and symptoms is the first step in detecting piles. While symptoms can vary in severity, common indicators include:
- Rectal Bleeding: This is one of the most common signs. You might notice bright red blood on toilet paper after wiping, in the toilet bowl, or on the surface of your stool. This bleeding is typically painless.
- Itching or Irritation: A persistent itch or irritation around the anal region is a frequent symptom, often caused by mucus discharge or difficulty cleaning the area.
- Pain or Discomfort: This is more common with external piles or thrombosed hemorrhoids. The pain can range from a mild ache to severe discomfort, especially during or after bowel movements, or when sitting.
- Lumps or Swelling: You may feel or see tender lumps around the anus, particularly after a bowel movement. These can be external piles or prolapsed internal piles.
- Mucus Discharge: A slimy discharge of mucus from the anus can occur, which may stain underwear and contribute to itching and irritation.
- Feeling of Incomplete Evacuation: Some individuals report feeling as though their bowels haven’t completely emptied even after a bowel movement.
- Soreness: The skin around the anus may feel sore or tender.
How Piles Are Diagnosed
If you suspect you have piles, it’s important to consult a healthcare professional. They will typically diagnose hemorrhoids based on your medical history and a physical examination.
- Medical History: Your doctor will ask about your symptoms, bowel habits, diet, and any other relevant medical conditions.
- Physical Examination:
- Visual Inspection: For external piles or prolapsed internal piles, the doctor may be able to see them by visually examining the area around your anus. They will look for swelling, lumps, or irritation.
- Digital Rectal Examination (DRE): The doctor will insert a gloved, lubricated finger into your rectum to feel for any abnormalities, including internal hemorrhoids or tenderness. Internal hemorrhoids are often too soft to be felt during this exam unless they are significantly enlarged.
- Internal Examinations (if necessary): If internal piles are suspected or if there’s a need to rule out other conditions, your doctor may use specialized instruments:
- Anoscopy: A short, rigid tube with a light (anoscope) is inserted to view the lining of your anus and lower rectum. This allows for a clear view of internal hemorrhoids and helps assess their size and location.
- Proctoscopy/Sigmoidoscopy: Similar to anoscopy, a proctoscope or sigmoidoscope (a longer, flexible tube with a camera) can be used to view the lining of the rectum and lower colon.
- Colonoscopy: In some cases, especially if there’s significant bleeding, changes in bowel habits, or risk factors for colorectal cancer, a colonoscopy may be recommended to examine the entire colon and rule out more serious conditions.
When to See a Doctor
While mild symptoms of piles can often be managed with home remedies, it’s crucial to seek medical attention if:
- You experience persistent rectal bleeding.
- Your symptoms worsen or don’t improve after a week of home care.
- You have severe pain or discomfort.
- You notice a hard, painful lump near your anus (which could indicate a thrombosed hemorrhoid).
- You experience changes in bowel habits or your stools change in color or consistency.
- You have signs of infection (fever, chills, pus leaking from piles).
- You experience lightheadedness, dizziness, or faintness along with rectal bleeding (which could indicate significant blood loss).
Ignoring symptoms can lead to complications such as anemia, strangulated hemorrhoids (where blood supply is cut off), or infection. Prompt diagnosis ensures appropriate treatment and can prevent complications.
