Haemorrhoids or piles are swollen veins in the rectum, similar to varicose veins. Haemorrhoids can also develop in the skin around the anus. They are common, and nearly 3 out of 4 adults will develop haemorrhoids in their lifetime. Haemorrhoids are the most common cause of rectal bleeding.

Signs and symptoms

Haemorrhoids are of 2 types – internal and external. Internal haemorrhoids are usually not visible and usually hurt less. You would notice blood in the stools though, and in case of prolapse, the prolapsed tissue could project out and cause major pain during bowel movements. External haemorrhoids occur under the skin around your anus and cause pain, itching, bleeding and swelling.

Causes and risk factors

Haemorrhoids can be caused due to straining during bowel movements, chronic diarrhoea or constipation, anal intercourse, a low fibre diet, and regular heavy lifting. Old age and pregnancy can also increase your risk of haemorrhoids.


Haemorrhoids could lead to anaemia or blood clots. In rare cases, the haemorrhoid could become strangulated, i.e. have its blood supply cut off, leading to severe pain.


External haemorrhoids can be diagnosed with a physical exam and a patient medical history and maybe a digital rectal exam. However, to diagnose internal haemorrhoids, the doctor may need additional tests such as an endoscopy, a colonoscopy and a sigmoidoscopy.

Treatment and Surgical Interventions

Basic lifestyle changes can help alleviate the symptoms of mild haemorrhoids. A fibre-full diet, adequate water and ice packs for the pain will help. The doctor will prescribe topical creams and ointments or oral painkillers for relief from itching, pain and swelling. However, for serious, chronic haemorrhoids, the doctor may choose to perform a non-invasive or surgical procedure for removal. Non-invasive procedure for removal, like a rubber-band ligation, sclerotherapy or coagulation with a laser or infrared radiation. Surgical procedures to treat haemorrhoids include haemorrhoidectomy and haemorrhoid stapling.


To prevent haemorrhoids, the stools need to be kept soft. Eating high fibre foods and drinking adequate water will help with this. It is also recommended to exercise and avoid long periods of sitting.


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