Hemorrhoids, commonly known as piles refer to a condition in which the veins around the anus or rectum become swollen and inflamed. Many people suffer from hemorrhoids at some point in their life. Hemorrhoids are more common in individuals aged between 45 and 65 years and in pregnant women. External hemorrhoids occur on the skin around the anus whereas internal hemorrhoids develop in the rectum. Internal hemorrhoids tend to protrude out through the anus.

    Factors causing hemorrhoids include:

    • Chronic constipation and diarrhea
    • Excessive straining during bowel movement
    • Diet lacking in fibrous food
    • Aging (weak connective tissue in the rectum and anus)
    • Pregnancy (increased pressure in the abdomen)


    Internal hemorrhoids: The most common symptom is passage of bright red blood with the stools. If the hemorrhoids have prolapsed, it causes pain, discomfort and itching around the anus.

    External hemorrhoids: Blood clots may form in the swollen veins causing bleeding, painful swelling or a hard lump.


    Your doctor will perform a physical examination which involves a digital rectal exam with a gloved, lubricated finger and an anoscope. Additional diagnostic tests may be ordered to rule out other causes of bleeding.

    • Colonoscopy: Colonoscopy is a procedure in which a flexible lighted tube is passed through the anus into the rectum and the colon. The colonoscope helps to view the inside of the rectum and colon.
    • Sigmoidoscopy: This procedure uses a shorter tube called a sigmoidoscope to transmit images of the rectum and the sigmoid colon (the lower portion of the colon).
    • Barium enema X-ray: This procedure involves taking an X-ray after injecting a contrast material called barium into the colon.


    Lifestyle modifications and dietary changes are often helpful in reducing the symptoms of hemorrhoids. A diet high in fiber softens the stools and helps them pass easily which avoids straining. Fruits, vegetables and cereals serve as a good source of dietary fibers. Fiber supplements such as methylcellulose or stool softeners can be taken. Drinking plenty of water and adequate exercise helps prevent constipation. Over-the-counter creams and suppositories help relieve the pain and itching. However, these are short term remedies as long-term use can cause damage to the skin.

    Medical Treatment

    Outpatient treatments are provided for internal hemorrhoids and include the following:

    • Rubber band ligation: This procedure involves placement of a special rubber band around the base of the hemorrhoid. This band obstructs the blood circulation causing the hemorrhoid to shrink.
    • Surgical removal becomes necessary when the hemorrhoids are large enough and do not respond to conservative treatment.