Piles, also known as hemorrhoids, are swollen and inflamed veins in the lower rectum and anus. They are a very common condition and can affect people of any age, though adults between 30–60 years are most often affected. Piles develop when the pressure increases in the rectal veins, causing them to stretch, swell, and sometimes bleed.

There are two main types of piles: internal piles, which form inside the rectum and are usually painless but may cause bleeding; and external piles, which occur under the skin around the anus and can be painful, itchy, or swollen. Depending on severity, piles can range from mild discomfort to severe pain and difficulty in passing stool.

Common symptoms of piles include bleeding during bowel movements, itching or irritation around the anus, swelling or lumps near the anal opening, pain while sitting, and mucus discharge. In severe cases, piles may prolapse, meaning they protrude outside the anus during bowel movements and may need to be pushed back inside.

Several factors contribute to the development of piles. These include chronic constipation, long-term diarrhea, straining during bowel movements, low-fiber diet, prolonged sitting, obesity, pregnancy, heavy lifting, and a sedentary lifestyle. Genetic factors and aging also play a role in weakening the vein walls, making piles more likely.

Diagnosis is generally made by physical examination. In some cases, doctors may recommend procedures like proctoscopy or sigmoidoscopy to assess the condition more clearly.

Treatment depends on the severity of the symptoms. Mild piles can often be managed with lifestyle changes such as increasing fiber intake, drinking plenty of water, avoiding straining, and using warm sitz baths to reduce discomfort. Over-the-counter creams, ointments, and pain relievers can also provide relief. For persistent or severe piles, medical procedures may be necessary, including rubber band ligation, sclerotherapy, infrared coagulation, or surgical removal (hemorrhoidectomy).