Piles, also called hemorrhoids, are swollen veins in or around the lower rectum and anus. Rectal bleeding is common with piles, but it should not automatically be assumed to be piles.
When to seek emergency care: See a doctor promptly for any rectal bleeding, black stool, dizziness, worsening pain, fever, pus, unexplained weight loss, a persistent change in bowel habits, or symptoms that do not improve after about a week of sensible self-care.
Internal and external piles
Internal hemorrhoids develop inside the rectum. They may cause bright red blood on toilet paper, stool or in the toilet bowl and can sometimes protrude through the anus. External hemorrhoids develop under the skin around the anus and may cause itching, tenderness, pain or a hard lump.
Not every anal symptom is caused by hemorrhoids. Fissures, infections, inflammatory bowel disease and cancers of the colon or rectum can cause overlapping symptoms. That is why new or unexplained bleeding needs a medical review.
Why piles develop
Pressure on veins around the anus can increase with straining, chronic constipation or diarrhea, prolonged sitting on the toilet, pregnancy, repeated heavy lifting and lower-fibre eating patterns. Supporting tissues also weaken with age.
What may help mild symptoms
- Increase fibre gradually through vegetables, fruit, daal, beans and whole-grain foods.
- Drink enough water unless a clinician has restricted your fluids.
- Avoid straining and do not sit on the toilet scrolling for long periods.
- Respond to the urge to pass stool rather than repeatedly delaying.
- A warm bath may ease discomfort.
- Ask a pharmacist or doctor before using creams, suppositories or laxatives, especially during pregnancy.
How doctors treat piles
Treatment depends on whether piles are internal or external, the severity of bleeding or prolapse, and whether another cause must be excluded. Mild cases may improve with bowel-habit changes and short-term symptom relief. Persistent internal hemorrhoids may be treated with office procedures such as banding or other techniques; severe, recurrent or prolapsed cases sometimes need surgery.
Which doctor should you see?
A general physician can assess initial symptoms. A gastroenterologist evaluates digestive and bleeding concerns. A general or colorectal surgeon may treat prolapse, thrombosed external hemorrhoids or cases requiring a procedure.
Which specialist to see
SehatGPT connects rectal-bleeding cases to a physician or gastroenterologist first, and routes procedure-related cases to an appropriate surgeon.
Frequently asked questions
Are piles and bawaseer the same?
Yes. "Piles," "hemorrhoids" and bawaseer commonly refer to the same condition.
Can piles turn into cancer?
Hemorrhoids do not turn into cancer, but the symptoms can overlap. Bleeding should be assessed so another cause is not missed.
Does spicy food cause piles?
Spicy food does not directly create hemorrhoids, though it may worsen burning or digestive discomfort in some people. Constipation and straining are more relevant.