What are the Causes of Piles? Main Reasons and Factors!

Piles are a common condition among people of various age groups and probably more than half the population do suffer from piles at some point in their lives, the main causes being bad eating habits, poor lifestyle, and other factors that show the negligence on the part of the individual. The disease is painful with lots of discomfort and embarrassment, as felt by the person, and should be treated as soon as the patient experiences the symptoms.

Re-thinking what we know about piles!

Piles or Hemorrhoids are swollen, inflamed veins entangled around the anal area or in the lower part of the rectum i.e. the last part of the large intestine leading to the anus which is the opening at the end of the digestive tract where the bowel contents leave the body. The cause of hemorrhoids or piles is usually clinically explained as when excess pressure is applied on blood vessels in and around the anus, just like in conditions like long term constipation or straining hard to pass the stools, which leads to their swelling and inflammation.

A detailed description of the causes of having piles is summarised as follows:

Dietetic Factors

 Adding more fiber to the diet from food, fiber supplement helps soften stools and makes them easier to pass, reducing pressure on hemorrhoids and hence helping decrease hemorrhoidal bleeding, inflammation, and also reducing irritation from small bits of stool that are trapped around the blood.

1. Low fiber diet: Low-fiber diets with < 20-30 grams of fiber per day, significantly increases the risk of constipation. Diet low in fiber like oil cakes, germinated corn & some pulses, cheese, chips, fast food ice-cream, prepared or frozen food items, freshly harvested corn & cereals that can cause constipation, should be avoided.
2. Unwholesome diet: Excessive consumption of alcohol, cigarette smoking during bowel movements, non-vegetarian diet or uncooked or too spicy food adds up to the list.

Lifestyle Habits

Aspects of a modern materialistic lifestyle that are leading to hemorrhoids by increased consumption of processed foods, a sedentary lifestyle, and use of cell phones while defecating, which translates to much more time spent on the toilet.

There are certain lifestyle factors that can increase a person’s risk both directly and indirectly, some are;

1. Suppression of natural urges: Suppression of natural urges like passing flatus leads to the weakening of veins surrounding the anus. Hence, go to the bathroom immediately whenever there is an urge to pass stools and don’t wait until a more convenient time. The stool can back up, leading to increased pressure and straining.
2. Poor hydration: Drinking less than 8 glasses of water per day contributes to constipation and, therefore, the development of piles. 
3. Lack of regular activity: Lack of adequate physical activity, no exercise, day sleeping, and excessive vehicle riding cause a general loss of muscle tone and lead to hemorrhoids.
4. Excessive straining: Tight laced clothes and excessive straining while passing stools to have a bowel movement lead to piles.
5. Sitting posture: The posture during defecation is another factor responsible for piles as squatting is a more natural position for defecation, and one is less likely to contribute to constipation and hemorrhoids.
6. Anal sex: Excessive sexual indulgence or receptive anal sex intercourse also leads to hemorrhoids.
7. Chronic constipation: In the long history of chronic constipation, excess pressure is applied to the rectum making the veins push against the wall of anus, resulting in feeble and weak anus muscles. This ruptures the hemorrhoids which bleed making stools even tougher to eject and is often accompanied by pain and sensitivity. 
8. Diarrhea: Recurrent & constant diarrhea leads to a hypovolemic state in which loss of ions has the ability to create flaccidity in the muscles

Genetic & Age Factor

A family history of hemorrhoids puts one at a higher risk of whether family members suffer from hemorrhoids in order to identify a genetic tendency. The risk of hemorrhoids increases with age as children and young adults do experience hemorrhoids, they are most common in adults 45-65 years old.

As a Symptom Of Other Conditions or Disease

Rectal bleeding or blood in the stool is never normal and, it can be relatively due to hemorrhoids, but can also be the result of more serious causes that can be life-threatening such as bleeding from ulcers, diverticulitis, inflammatory bowel disease, and tumors.

1. Trauma and age factor: In the case of aging, the tissues present across the lining area of the anal region get less supportive and affect the hemorrhoid veins.
2. Pregnancy: Increased intra-abdominal pressure due to the weight of carrying a baby put increased pressure on the pelvic area.
3. Varicose veins or the swollen veins around the anus and lower rectum lead to the formation of piles.
4. Obesity: Bodyweight with high BMI or obesity contributes to the risk of hemorrhoids as heavier weight causes additional strain on the body and contributes to a more sedentary lifestyle.
5. Inflammatory bowel diseases: Crohn’s disease and ulcerative colitis are inflammatory bowel diseases that can affect any part of the intestine and may result in symptoms like digestive discomfort
6. Add on pathology: Secondary pathologies may lead to hemorrhoids like liver cirrhosis, portal hypertension, spinal cord injuries.

A well-said phrase, “An ounce of prevention is worth a pound of cure,” marks the importance of having proactive lifestyle choices to prevent occurring and reoccurring of piles as they are one such lifestyle-related disease that can be effectively treated with over-the-counter medications, good fluid intake and by following a diet rich in fiber. 

The best ways to treat Internal & external hemorrhoids are through conservative measures like adopting lifestyle changes along with ayurvedic medications. Certain preventive measures to prevent piles are;

1. A sitz bath provides relief by soaking the rectal area in warm water for 15 minutes three or four times per day.
2. No phone in the bathroom as this habit is blamed for increasing the time on the toilet and leading to increased pressure on the anal region and straining during defecation.
3. Limit the time spent sitting on the toilet to reduce pressure on the rectal area.
4. More fiber-containing diet as fiber helps to draw water into the lumen of the colon, thus increasing the water content in the stool making it softer to evacuate easily.
5. Maintain hygiene by cleaning the peri-anal area after passing stools preferably with water and then wiping out it with toilet paper.