Piles, or haemorrhoids, are areas in the anal canal where the tissue, which contains lots of blood vessels, has become swollen. They can be internal, occurring inside the anus, or external, when they can be seen and felt on the outside of the anus. When visible they look like round pink swellings, the size of a pea or a grape. Piles are common in pregnant women, but are rare in children.

causes :

Straining to empty the bowels when constipated.
Chronic diarrhoea.
Pregnancy – the weight of the fetus on the abdomen and the increased blood flow, as well as the effect of hormones on the blood vessels.
Childbirth – pushing during childbirth increases the pressure in the veins.
Straining to pass urine, especially in men with prostate problems.
Cancer or growths in the pelvis or bowel, which may exert pressure in a similar way to a pregnancy. Family history – piles can run in families and are potentially hereditary, perhaps because of weak veins in the anal area.
Obesity.
Varicose veins – many people with these also develop piles, although piles are not varicose veins.

Diagnosing piles
The doctor will ask about your health and carry out a physical examination.

If there are external piles, these will be spotted on examination. A rectal examination, where a gloved finger is gently inserted into the anal canal, will be performed. Internal piles cannot normally be felt in this way, but the examination can reveal other problems such as an anal fissure - a painful tear of the lining of the anus. These other conditions need to be excluded before a diagnosis can be made.

Relieving symptoms
Regular warm baths may relieve the irritation; Ice packs may help reduce swelling,

Treatments
Piles can usually be treated at home. The most important element in encouraging existing piles to clear up is to avoid constipation. By having regular bowel movements, and avoiding straining, stools pass easily and do not put pressure on the blood vessels in the anal area.

Eating plenty of fibre-rich foods such as fruit, vegetables and wholegrain cereals (eg brown rice, wholemeal bread), and drinking plenty of fluids, especially water, should keep bowel movements soft.

Avoid rich and spicy food,non-vegtarian food,strict no to pickles

It may help to take a fibre supplement or mild laxatives which soften bowel motions.

Answered by Alok , an ibibo Master, at 12:56 PM on November 18, 2008

see http://hcd2.bupa.co.uk/fact_sheets/ html/Haemorrhoids.html

Although piles develop from inside the anal canal, they can hang down out of their normal place. Piles can be described as follows.

* First degree piles are swellings on the inside lining of the anal canal. They bleed but can't be seen from outside the anus.
* Second degree piles are larger and stick out (or prolapse) from the anus when you open your bowels, but return on their own afterwards.
* Third degree piles are similar, but hang out from the anus and only return inside when pushed back in.
* Fourth degree piles permanently hang down from the anus and you can't push them back inside. They may become extremely swollen and painful if the blood in them clots.

Swellings that develop from below the anal cushions are sometimes called external piles. They can be more painful than the other types of piles. Other causes of lumps around the anus can include a "sentinel pile", which is the painless skin tag that develops when a crack in the anus (an anal fissure) heals up. Also, a collection of blood under the skin, called a peri-anal haematoma, may also be referred to as a type of external pile. The treatment of these conditions is different from true piles.

Bright red blood from the anus is most likely to come from piles, rather than anything more serious. However, if you are unsure whether the bleeding is due to piles, you should visit your GP for advice.

The exact cause of piles isn't known. One theory is that it's due to weakness of the tissue that connects the anal cushions to the muscle layers underneath. Due to this weakness, the anal cushions slide out of their normal place and down the back passage.

You have an increased risk of getting piles if you:

* strain to empty your bowels (eg if you have constipation)
* eat a low-fibre diet
* have long-lasting (chronic) diarrhoea
* are pregnant - due to the effect of hormones on the blood vessels, plus the increasing weight of the baby within your abdomen
* have a family history of piles
* have cancer or growths in your pelvis or bowel, which may put pressure on your abdomen

To examine the walls of the anal canal, your doctor may use a proctoscope (also called an anoscope).
A similar examination, using a longer tube called a sigmoidoscope, allows your doctor to view the lower part of the large bowel and helps to rule out problems in the rectum.

At hospital, the whole of your large bowel can be viewed with a colonoscopy. A colonoscopy is a test that allows your doctor to look inside your large bowel using a narrow, flexible, tube-like telescope called a colonoscope. For more information, see Related topics.

If you have daily bowel movements that are solid but soft, and you don't need to strain, faeces will pass easily and will not put pressure on the blood vessels in your anal area.

To keep your bowel movements soft, you should:

* eat plenty of fibre-rich foods such as fruit, vegetables and wholegrain cereals (eg brown rice, wholemeal bread and wholemeal pasta)
* drink plenty of water

You shouldn't spend too much time on the toilet (reading, for example). Regular warm baths may relieve irritation and help to keep the area clean.

If you are still passing hard or infrequent faeces, you could try a fibre supplement such as ispaghula husk (eg Fybogel) or mild laxatives such as lactulose, which soften faeces. Don't use strong laxatives, such as the stimulant laxative senna, unless your doctor advises you to.
Medicines

There are a number of over-the-counter treatments that can help relieve the symptoms of piles, but won't cure them.

* Soothing creams, ointments and suppositories may ease pain and itchiness. There are many different products available without prescription. Some contain a local anaesthetic such as li

Answered by Vida Writer , an ibibo Master, at 7:45 PM on November 17, 2008

Hemorrhoidectomy is surgical removal of piles or hemorrhoids. Large or prolapsed piles can be very painful, and their definitive treatment is by surgery.

Hemorrhoids, or piles, are varicose veins that occur inside, on, or just, outside the anus. Full-scale surgery to remove piles (hemorrhoidectomy) is required only when the hemorrhoids are large, have become visible outside the anus, and are causing constant pain and itching. By this time they may also be bleeding and/or discharging mucus.
Many types of treatment for small uncomplicated piles can be performed on an outpatient basis within a surgeon's office. They can be treated in a number of conservative ways such as by:

a change of diet
soothing creams or suppositories
injection of an irritating (sclerosing) solution that causes the blood in the piles to clot solid and the piles subsequently to shrink
subjecting them to extreme cold (cryotherapy)
'banding', a rapid form of surgical treatment that causes them to wither away

Answered by SESHAN , an ibibo Master, at 2:25 PM on November 17, 2008