What are Piles?

If you are experiencing pain, discomfort, and itchiness in the region near your anal opening, there is a possibility you are suffering from piles. Piles are enlarged, swollen lumps seen in the area of your anal opening and rectum. Piles are commonly referred to as haemorrhoids and can occur in males and females, commonly noticed between the ages of 45 to 65 years. Males are affected more than females as activities such as weight lifting and other strenuous activities contribute to the development of piles in males.¹

Based on the location, piles can be internal or external. Internal haemorrhoids are seen inside the rectum and are not visible to the naked eye. External haemorrhoids often are noticed near the anal opening.

The commonly asked questions include: Why do piles occur in males? What causes piles in males? Piles commonly occur in males due to increased pressure in the lower rectum. Piles can occur at any age but are more prevalent in elderly individuals. If you suspect you have piles, seek medical care and get treatment immediately. Untreated piles can lead to complications that can be avoided with urgent care.

Symptoms

Around 40% of haemorrhoids are painless and asymptomatic. On the other hand, the early symptoms of piles in male patients are:

• Inflammation and swelling in the anal region
• Slight discomfort and mild pain in the anal region
• Small amounts of blood were noticed in the stool.

The early symptoms of piles in males are mild and cause little discomfort. As it progresses, the symptoms of piles in males noticed are: ²

• Pain and itchiness in the region of your anal opening
• Bright red blood after passing stool
• Mucous discharge is seen in the underwear
• Swelling and lumps in the anal region

There are 4 grades of haemorrhoids (based on severity): ¹

• Type 1: These haemorrhoids are located inside the anal opening. Usually, these are small and painless and a small amount of blood discharge is noticed after stool.
• Type 2: Larger swelling and the region of the anal opening are also affected. The lump may protrude outside during bowel movements, but they usually return to its place later.
• Type 3: Swelling protrudes outside the anal opening, and a lump will be noticed by the individual. These can be physically pushed back with the fingertips (Prolapsed haemorrhoids)
• Type 4: The swelling bulges outward and falls out even if forced back into the rectum. Bleeding may or may not be present. Pain may be present if a clot form or if the haemorrhoids are strangled by the anal opening.

It is important for patients to seek medical consultation in cases of rectal bleeding, especially in middle and older-aged individuals, as the risk of malignancy is higher in these groups. It should not be automatically assumed that Rectal bleeding is piles.

Dr. M.G. Kartheeka, MBBS, MD

Causes

Reason for piles in males include: ^3,4

• Straining during bowel movements
• Weight lifting
• Obesity
• Advancing age
• Chronic constipation or diarrhoea
• Low-fibre diet and low fluid intake
• High pressure or strain

Complications

Piles, if left untreated, could lead to various complications. These include:⁵

• Bleeding from the anal region and rectum
• Anaemia
• Swollen tissues around the anal opening
• Formation of a blood clot inside the haemorrhoid
• Gangrene of tissues surrounding the anal opening
• Excruciating pain
• Drop in blood pressure leading to dizziness

Also Read: How to Stop Itchy Anus at Night: Effective, Research-Backed Solutions

Diagnosis

Medical History:⁶

The doctor will ask you about your main complaint and the symptoms you have been experiencing. Any relevant past and present family and medical histories should be discussed, as this is essential while treating piles. The doctor will also inquire about your eating habits, bathroom routines, use of enema and laxatives, and any current medications. 

Physical Examination:⁶

The region of your anal opening and the lower rectum will be examined for:

• Swelling or lumps
• Tears in the anal region
• Mucous discharge
• Stool leakage
• Skin tags
• Skin inflammation in the region of your anal opening

Read More: 8 Best Home Remedies For Piles

Treatment

Haemorrhoids are usually treated by proctologists. Based on the severity of your condition, the doctor may recommend diet and lifestyle modifications, medications, and surgical or non-surgical options for your treatment. 

1. Diet and Lifestyle Modifications:⁶

• Avoid straining while using the bathroom
• Regular exercise
• High-fibre diet
• Increase in fluid intake
• Avoiding medications causing constipation and diarrhoea

2. Medications:⁶

Medication help reduces the severity of symptoms of piles in males.

• Many over-the-counter and prescription drugs may be prescribed for the treatment of piles.
• These are available in the form of pills, suppositories, lotions, and wipes. 

3. Non-Surgical Management:⁶

The doctor may prescribe a non-surgical line of treatment for low-grade piles. These procedures include:

• Rubber band ligation
• Injection sclerotherapy
• Infrared coagulation

4. Surgical Management:⁶

The surgical management of piles includes the following procedures:

• Haemorrhoidectomy
• Laser Haemorrhoid Procedure (LHP)
• Stapled haemorrhoidopexy
• Doppler-guided haemorrhoidal artery ligation

Consult a healthcare professional to figure out the best course of action for the treatment of haemorrhoids.

Read more: What is the Cost of Piles Surgery in India? 

Frequently Asked Questions (FAQs):

Disclaimer: The information included on this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.

References

1. Haemorrhoids | National Health Portal of India [Internet]. www.nhp.gov.in.
   Available from: https://www.nhp.gov.in/haemorrhoids_mtl
2. NHS Choices. Piles (hemorrhoids). NHS Choices. 2020. Available from: https://www.nhs.uk/conditions/piles-haemorrhoids/
3. Piles in Men – Causes & Symptoms | Germoloids. Germoloids UK. Available from: https://www.germoloids.co.uk/tips-advice/piles-in-men
4. Piles (hemorrhoids) | Health Information | Bupa UK. Available from: https://www.bupa.co.uk/health-information/digestive-gut-health/haemorrhoids
5. Slauf P, Antoš F, Marx J. [Complications of hemorrhoids]. Rozhledy V Chirurgii: Mesicnik Ceskoslovenske Chirurgicke Spolecnosti [Internet]. 2014 Apr 1;93(4):223–5. Available from: https://pubmed.ncbi.nlm.nih.gov/24881480/
6. National Institute of Diabetes and Digestive and Kidney Diseases. Diagnosis of Hemorrhoids | NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. 2019.  Available from: https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/diagnosis
7. Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist’s view. World Journal of Gastroenterology. 2015;21(31):9245.Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541377/