Internal & External Piles Causes: Hemorrhoids Symptoms & Remedies

Question: What is the best treatment for piles, medication, laser or surgery?

Answer: Piles or hemorrhoids are swollen and inflamed veins of the rectum and anus. They are classified into external and internal piles; external piles are the piles bulging out of the anal opening, where as internal piles are situated inside the rectum about 2 to 3 cm above the anal opening.

Men and women both are equally susceptible to this condition. Piles are common in the age group of 40 to 60 years and in pregnant women. Majority of patients improve with conservative treatment which consists of adequate intake of fluids and diet rich in fibers.

In severe cases, piles may need surgical intervention or laser cauterization.

Causes Of Internal And External Hemorrhoids

Piles may develop due to various reasons. Majority of these reasons are preventable with lifestyle changes and eating habits. The main underlying reason for development of piles is intense and recurrent pressure on the rectal and anal veins. As a result the veins are stretched excessively. They inflame and enlarge in size. Following are the triggering factors.

  • Constipation: A person suffering from chronic constipation is susceptible for development of piles. Prolonged straining puts extra pressure on the rectal veins and they stretch beyond limit.
    Repeated stretching makes the veins weak and they enlarge permanently.
  • Anal intercourse often exerts pressure and irritation on the anal sphincter and on the walls of veins, if anus is not well lubricated. This may cause damage to the rectal tissue as well. Though not always, the risk of piles among people practicing anal intercourse is high than those who do not.
  • Obese persons are at greater risk of suffering from piles.
  • Sedentary life causes irregular bowel movements. The whole system becomes lax and so does the bowel movement. It leads to strain and stress with each bowel movement. Such persons are usually constipated.
  • Pregnancy: During pregnancy and especially during labor the blood vessels of rectum are stretched. In some women the walls of rectal vein become weak and they bulge.
  • Overuse of laxative and enema exert pressure on the rectal veins.
  • In some cases there is inherited tendency for piles.

Symptoms Of Piles Disease

  • Piles usually develop as a result of constipation. Often the stool is hard.
  • Bleeding along with stool is an important clinical feature of piles. Drops of blood fall before defecation.
  • External piles are painful.
  • External piles feel like a lump coming out of anus after defecation.
  • Itching and irritation around the anus.
  • Discharge of mucus along with passage of stool.
  • Internal piles may come out of anus while passing stool but return back after defecation.
  • Internal piles when prolapsed appear outside the anus. They can be pushed inside with fingers.
  • Anemia due to blood loss. Patient feels weak and lethargic.

Home Remedies For Piles Or Hemorrhoids

Prolapsed piles are easy to diagnose by external examination. Internal piles are diagnosed by proctoscopy. Usually piles are treated conservatively.

  • Changing life style is important part of treatment. Patient is advised to increase consumption of fiber rich food. This will prevent constipation and make the stool soft. Eat vegetables, fruits and cereals as they are rich in fiber content.
  • Drink plenty of water to prevent constipation. Exercise regularly as it will improve the motility of intestine and prevent constipation. If the patient is obese he should reduce his body weight.
  • Avoid straining while passing stool. Use moisturized toilet paper instead of dry tissue paper to wipe. Avoid scratching even if it is itching as this will damage the delicate walls of rectal veins.
  • Sitz bath is effective home treatment in curing the disease. Sit in a tub half filled with warm water for 15 minutes. Warm water will help to reduce pain and also shrink the dilated veins of rectum (piles).
  • Dab witch hazel on the external piles. It is effective for bleeding piles. Witch hazel has quality to shrink piles.
  • Laser cauterization is also effective way to treat piles.
  • Surgery is the last option that is considered when all other means of treatment fail.


  1. Richard said:

    Thanks a lot for putting this information online. Am so grateful to know what the problem I have is called (hemorrhoids/piles); it’s causes, home and medical treatment.

    I am 34years and I have had this hemorrhoids problem since teenage on and off but now its bad!

    I’ve been/and am inserting medicine to heal but stil no much improvement.

    Should this be operated upon?

    What are advantages and diasdvantages of surgery for hemorrhoids.

    September 29, 2010
    • PUP said:

      It depends what is the grade of hemorrhoids, whether bleeding, whether prolapsed, painful etc. Your surgeon will be the right person to advise after examining you.
      Advantages of surgery for hemorrhoids is complete cure after surgery, reoccurrence is rare.
      Disadvantage of surgery is pain, loss of working hours. They are less significant compared to the advantages.

      October 1, 2010
  2. Celes said:

    Thanks very much for telling me that I have being suffering from hemorrhoids over four years now and it is on the third stage now. Please tell me what to do for it now? I have taken many herbs, drugs etc but all proved ineffective. But this time it must be cured because I believe in you.

    June 21, 2012
    • PUP said:

      Third stage is prolapsed hemorrhoids. They do not return inside the anus on their own and they require to be pushed in manually. This stage of piles is very painful and requires to be treated without delay or else they can get strangulated. If all the conservative options are exhausted, you can opt for surgery. It may be painful and time consuming but there will be permanent relief from the condition.

      July 3, 2012

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