Piles

What are haemorrhoids?

Haemorrhoids (piles) are enlarged blood vessels inside or around the opening of your bottom (anus). Your anus is lined with spongy tissue and blood vessels called the anal cushions. These help your anus to close. If the blood vessels in this area become enlarged, you might experience symptoms of piles.

How do I know if I have haemorrhoids (piles) – what do they look like?

Piles don’t always cause pain or other symptoms. But sometimes you might see blood on the toilet paper, drips in the toilet, or on the surface of your poo. You might be able to feel piles on your anus or hanging down from your anal canal too.

Are skin tags the same as piles?

No, skin tags aren’t the same as piles. But you may get them if you have external piles (swellings that develop on the outside edge of your anus). Blood clots can sometimes form in external piles and this will stretch your skin over the area. As the pile heals, it will gradually shrink and leave behind a small tag of extra skin. You can also get skin tags without having piles or a blood clot.

Types of piles

The following are two main types of piles.

Internal piles

Internal piles start inside your anal canal (the short, muscular tube connecting your rectum with your anus). Internal piles can also hang down and come out your anus. They’re graded into four categories:

- First degree piles: these may bleed but don’t come out of your anus.

- Second degree piles: these come out of your anus when you have a poo, but go back inside afterwards.

- Third degree piles: these come out of your anus and only go back inside if you push them back in.

- Fourth degree piles: these always hang down from your anus and you can’t push them back in. They can become very swollen and painful if the blood inside them clots.

External piles

External piles are swellings that develop further down your anal canal, closer to your anus. They can be really painful, especially if they have a blood clot in them.

It’s possible to have both internal and external piles at the same time.

Causes of piles

Piles develop when the veins in your anal canal become swollen, which may happen for a number of reasons. These include if you:

- strain when you go to the toilet, for example if you have constipation

- anal canal weakens with age

- have a persistent cough

- lift heavy objects

Piles are also common during pregnancy. They may develop due to the higher pressure in your tummy (abdomen) when you’re pregnant. They usually get better after you give birth.