Piles, medically called haemorrhoids, happen when the blood vessels and soft supporting tissues inside or around the anus become swollen.

There are naturally small blood-filled cushions inside the anal passage. They help the anus close properly and assist with controlling stool and gas. Normally, you do not feel them. However, when too much pressure is repeatedly placed on that area, these cushions can become enlarged and begin causing problems.

This pressure commonly occurs when someone frequently strains to pass hard stool, suffers from constipation, spends too long sitting on the toilet, repeatedly lifts heavy objects, or experiences pressure from pregnancy or excess body weight.

Think of it like repeatedly squeezing a soft water hose. As the pressure continues, the hose expands and becomes weaker. In a similar way, continuous pressure can make the blood vessels around the anus swell, while the tissues holding them in place gradually become weak.

With time, the swollen tissue may begin to move downward or come out through the anus while passing stool. This is called prolapse. It may return inside by itself, require gentle pushing back, or remain outside in more serious cases.

A person with piles may notice:

Bright-red blood after passing stool

Pain or a burning sensation around the anus

Itching and irritation

Swelling or a painful lump near the anus

Slimy discharge

Difficulty sitting comfortably

A feeling that the bowel has not emptied completely

A piece of tissue coming out during or after using the toilet

Internal piles develop inside the anal passage. They may not initially cause pain, but they can bleed or come outside.

External piles develop under the skin around the anus. They can be painful, especially when blood collects and forms a clot inside the swollen vein.

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