Shiv Shakti Piles Clinic



Dr. SHRIVASTAV B. S. A. M. MUM, Dr.GUPTA B. Sc., B. A. M. S.



Piles (haemorrhoids) are swellings that can occur inside and around the back passage (anus) and the anal canal. The anal canal is the last part of the large intestine and is about 4 cm long. At the lower end of the anal canal is the opening to the outside (usually referred to as the anus), through which faeces ( poo ) pass. At the upper end, the anal canal connects with the rectum (also part of the large intestine).

There is a network of small veins (blood vessels) within the lining of the anal canal. These veins sometimes become wider and engorged with more blood than usual. The engorged veins and the overlying tissue may then form into one or more small swellings called piles.

Piles can be of various sizes and may be internal (inside the anus) or external ones (outside the anus). Typically, internal piles occur from 2 to 4cm above the opening of the anus. External piles (perianal hematoma) occur on the outside edge of the anus.

Internal piles (haemorrhoids) are those that form above a point 2-3 cm inside the back passage (anus) in the upper part of the anal canal. Internal piles are usually painless because the upper anal canal has no pain nerve fibres. External piles are those that form below that point, in the lower part of the anal canal. External piles may be painful because the lower part of the anal canal has lots of pain nerve fibres


1. Straining during bowel movements.

2. Sitting for long periods of time on the toilet.

3. Chronic diarrhea or constipation.

4. Obesity.

5. Pregnancy.

6. Anal intercourse.

7. Low-fiber diet.


1. After going to the toilet, a feeling that the bowels are still full.

2. Bright red blood after a bowel movement.

3. Itchiness around the anus.

4. Mucus discharge when emptying the bowels.

5. Pain while defecating.

6. The area around the anus may be red and sore..

What is sign?

1. Painless bleeding during bowel movements — you might notice small amounts of bright red blood on your toilet tissue or in the toilet bowl.

2. Itching or irritation in your anal region.

3. Pain or discomfort.

4. Swelling around your anus.


Treatment is according to stages as well as degree of piles.

Preventing an anal fissure

1. All people who are at risk need to take at least six to eight glasses of water daily to keep the stools lubricated.

2. Weight should be reduced since obesity and being overweight is a risk factor for piles.

3. Regular physical exercise is important since this helps in weight reduction and also helps in regular bowel movements and avoids constipation.

4. Do not scratch. For more information on dealing with itch, look at the section on anal itching.

5. Avoid constipation by eating lots of fresh fruit and vegetables and bran cereal. Aim for faeces ( Poo ) that are soft enough to change their shape as you push them out.

6. Drink plenty of fluids.

7. After you have passed the faeces, do not strain to finish.

8. People with piles often think there is more to come, but this is a false sensation caused by the swollen spongy pads in the piles themselves.

9. Do not read on the toilet and aim to be out of the toilet within a minute.

10. If you can feel a lump, try pushing it gently upwards; try to relax your anus as you do so.

  • Any significant rectal bleeding, sudden pain or recent changes in bowel movements should also be brought to the attention of your doctor.
  • Hemorrhoids do not require immediate medical attention. Bright red blood in the stool is a clear symptom of hemorrhoids and you can first try some home treatment. However should you experience dark colored blood or black stool contact your doctor straight away as this could be a sign of intestinal bleeding.
  • Topical creams and gels are for external use only. There are suppositories available if the burning or itching you feel is inside the anal canal.
  • Most lumps and swellings under the skin are harmless and can be left alone. However, see your GP if you develop a new lump or swelling so that the cause can be identified.

    Anal swellings or lumps are usually one of the following:

  • a haemorrhoid (pile) –a swollen blood vessel that can hang outside the anus 
  • a skin tag – a harmless growth that hangs off the skin and looks similar to a wart
  • an abscess – a painful collection of pus
  • a rectal prolapse – where part of the rectum (the end of the bowel) sticks out of the anus
  • genital warts – small, fleshy growths caused by a sexually transmitted infection (STI)
  • Color Variations