Hemorrhoids

Haemorrhoids (piles) are swollen blood vessels in and around the anus. They are extremely common — most Indian adults have some degree at some point. They cause discomfort but are rarely dangerous. Most respond to simple measures; some need a procedure.

Types

• Internal — inside the rectum; usually painless, may bleed with stool.
• External — under the skin around the anus; painful, itchy, may form a tender clot.
• Prolapsed — internal piles that have come out and may go back in by themselves or need to be pushed back.

Symptoms

• Bright red blood on toilet paper or coating the stool.
• Itching, discomfort, or a lump around the anus.
• Pain — particularly with a thrombosed external pile (a clot).
• Mucus leak or a feeling of incomplete emptying.

Red flags — see a Health Expert

• Blood that is dark, mixed in, or with clots.
• Change in bowel habit over 40, or family history of bowel cancer — bleeding may not be "just piles."
• Severe pain.
• Weight loss, tiredness, or anaemia.
• Bleeding in someone over 40 should always be evaluated, not assumed to be piles.

Self-care that works for most

• Treat constipation — fibre (dals, vegetables, fruit, whole grains), water, movement.
• Don't strain or sit long on the toilet.
• Warm sitz baths — sit in a tub of warm water 10-15 minutes, 2-3 times a day.
• Topical creams for short-term relief.
• A small cushion during long sitting helps.

When self-care isn't enough

• Office procedures — rubber band ligation, sclerotherapy, infrared coagulation.
• Surgery — for large, prolapsed, or recurring piles.
• Stapled or laser procedures in selected cases.
• These are all widely available in Indian cities and towns; day-care is typical.