Hemorrhoids (US English) or haemorrhoids , are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become pathological or piles when swollen or inflamed. At this point the condition is technically known as hemorrhoidal disease. The signs and symptoms of hemorrhoids depend on the type present. Internal hemorrhoids usually present with painless rectal bleeding, while external hemorrhoids may produce few symptoms or if thrombosed significant pain and swelling in the area of the anus. Many people incorrectly refer to any symptom occurring around the anal-rectal area as “hemorrhoids” and serious causes of the symptoms should be ruled out. While the exact cause of hemorrhoids remains unknown, a number of factors which increase intra-abdominal pressure, in particular constipation, are believed to play a role in their development. Initial treatment for mild to moderate disease consists of increasing fiber intake, oral fluids to maintain hydration, NSAIDs to help with pain, and rest. A number of minor procedures may be performed if symptoms are severe or do not improve with conservative management. Surgery is reserved for those who fail to improve following these measures. Up to half of people may experience problems with hemorrhoids at some point in their lives. Outcomes are usually good.
