Hemorrhoids are often referred to as piles, a term that is applied to a number of different conditions of the anal canal. Most commonly, however, it refers to hemorrhoids. It is also used to describe anal fissures or tears, clotted external hemorrhoids, and flaps of extra skin or skin tags on the anus.

The rectum is connected to the outside by a short tube called the anal canal which is the last part of the large intestine. The first part of this canal is lined with mucous membrane and the latter part is lined with skin which is very sensitive to pain. This canal is circled by a ring of muscle which is tightly contracted but relaxes to allow a bowel movement. This muscle is called the anal sphincter.

Hemorrhoids can be internal or external. Internal hemorrhoids are in the higher part of the anal canal. The veins swell and continue to increase in size over a period of years. They may be caused by prolonged straining to pass bowel motions and can be exacerbated by pregnancy. They are usually characterized by bright red bleeding that occurs at the end of passing a motion and they are usually relatively painless. If the hemorrhoids become bigger, they may come out of the anal canal and can be quite painful because of being strangulated or squeezed by a tight anal canal.

An anal fissure is a split in the anal canal, possibly caused by straining when constipated. This causes extreme pain when passing bowel motions and may be so bad that the person fears passing a motion. Often, these fissures heal of their own accord but sometimes a minor operation may be required.

External piles or hemorrhoids are caused when a blood vessel bursts just under the surface of the skin near the edge of the anal canal causing severe pain during and after the passing of a bowel motion. Sometime later, a painful lump appears that becomes red, sore, and inflamed. These are sometimes referred to as thrombosed piles.

Skin tags around the anal canal are not uncommon or painful but can cause problems with personal hygiene. They are often diagnosed and treated as external hemorrhoids but treatment is not really required.

Another condition that is sometimes wrongfully diagnosed as hemorrhoids is a condition known as anal fistula. The main symptom is a discharge of fluid, often like pus, but there is seldom much pain, bleeding or a lump. This condition usually appears as a result of an abscess in the lining of the anal canal, causing an abnormal connection between the outer skin of the anal canal and the inside of the canal. This causes secretions to leak out through the rectum. Treatment of internal hemorrhoids can take several different forms. They can be injected with a substance that makes them shrivel up if they are only small. Another method of treatment is by shrinking the hemorrhoids through a process of freezing, using a cryoprobe. Yet another method is to apply tiny rubber bands to cut off the supply of blood to the hemorrhoids.

There are some home treatments that are worth noting as they can be very helpful. These are taking a warm bath with a handful of salt dissolved in it if the hemorrhoids prolapse or appear externally as lumps. Alternatively, if the hemorrhoids become strangulated, you can apply a plastic bag of crushed ice to the enlarged hemorrhoids to ease the pain.

A diet high in fibre is very important to keep the gastrointestinal system working well and to avoid the discomfort of hemorrhoids as well as assisting in the general wellbeing of your body.