PILES
these are group/clumps of enlarged veins tissues(generally hypertrophy of veins of anus/rectum)  developing either internally or externally in rectum or anus characterized by persistent painful elimination of feces


Hemorrhoid:
hemorrhoid /hem·or·rhoid/ (hem´ah-roid) prolapse of an anal cushion, resulting in bleeding and painful swelling in the anal canal. the hemorrhoids become larger, they protrude with any exertion or may actually stay outside the rectum all of the time.
The blood from hemorrhoids is usually bright red and not mixed with the bowel movement. It may vary in amount from streaks on the toilet tissue to quantities sufficient to make the water in the toilet bowl red. Protracted bleeding may result in anemia(reference http://zerohemorrhoids.blogspot.com/)

External hemorrhoid
                           one in a vein of the inferior rectal plexus,
                below the pectinate line and covered with modified anal skin. 
Prolapsed hemorrhoid:
                           an internal hemorrhoid that has descended
               below the pectinate line and protruded outside the anal sphincter.
Strangulated hemorrhoid
                            a prolapsed hemorrhoid whose blood supply
                 has become occluded by constriction of the anal sphincter.

Thrombosed hemorrhoid 
                           one containing clotted blood.
(Reference: http://medical-dictionary.thefreedictionary.com/internal+hemorrhoid)

Common Causes of Piles
Generally piles develops due to the increased pressure on walls of rectum so to overcome that pressure veins of rectum increased in size in a way that progresses to formation of thrombus that uncommonly comes along the feces with irritating pain. Pressure increase due to :

· Low fiber diet

· Pregnancy

· Aging

· Hereditary

· Chronic constipation

· Anal intercourse

· Bad eating habits and poor diet which does not contain adequate quantities of fiber from fruits and vegetables

· Insufficient fluid intake

· lack of exercise and general physical inactivity

· Long stay in a standing or sitting positions

· Work requiring high muscular effort

· Prolonged and frequent constipation (increased effort during straining at stools)

· childbirth

· Advanced age (that decreases the elasticity of the anal layer )

· Some lesions, such as the presence of large tumors in the abdomen and pelvis, liver cirrhosis (in 30% of cases)

· Diarrhea

· Frequent vomiting

· Heart failure

· Hypertension (high blood pressure)

· Rectal cancer



· Congenital weakness of the anal sphincter muscles
Internal haemorrhoids:

These form in the back passage about 2-4 cm above the rim (opening) of the anus. Their severity and size are classified into grades 1 to 4:
Grade 1 are small swellings on the inside lining of the back passage. They cannot be seen or felt from outside the anus. Grade 1 haemorrhoids are common. In some people they enlarge further to grade 2 or more.
Grade 2 are larger. They may be partly pushed out (prolapse) from the anus when you go to the toilet, but quickly spring back inside again.
Grade 3 hang out (prolapse) from the anus. You may feel one or more as small, soft lumps that hang from the anus. However, you can push them back inside the anus with a finger.
Grade 4 permanently hang down from within the anus, and you cannot push them back inside. They sometimes become quite large.



Symptoms can vary. Small haemorrhoids are usually painless. The most common symptom is bleeding after going to the toilet. Larger haemorrhoids may cause a mucous discharge, some pain, irritation, and itch. The discharge may irritate the skin around the anus.
External haemorrhoid (sometimes called a perianal haematoma)

This is less common than internal hemorrhoids. An external hemorrhoid is a small lump that develops on the outside edge of the anus. Many do not cause symptoms. However, if a blood clot forms in the hemorrhoid (a thrombosed external hemorrhoid) it can suddenly become very painful and need urgent treatment. The pain due to a thrombosed external hemorrhoid usually peaks after 48-72 hours, and then gradually goes away over 7-10 days. A thrombosed external hemorrhoids may bleed a little for a few days. It then gradually shrinks to become a small skin-tag.

Some people develop internal and external hemorrhoids at the same time.



Treatment of piles:

Keep the faeces (sometimes called stools or motions) soft, and don't strain on the toilet. You can do this by the following:
Eat plenty of fibre such as fruit, vegetables, cereals, wholemeal bread, etc.
Have lots to drink. Adults should aim to drink at least two litres (10-12 cups) per day. You will pass much of the fluid as urine, but some is passed out in the gut and softens faeces. Most sorts of drink will do, but alcoholic drinks can be dehydrating and may not be so good.
Fibre supplements. If a high-fibre diet is not helping you can take fibre supplements (bulking agents) such as ispaghula, methylcellulose, bran or sterculia.. Methylcellulose also helps to soften faeces directly which makes them easier to pass.
Avoid painkillers that contain codeine such as co-codamol, as they are a common cause of constipation.
Toileting. Go to the toilet as soon as possible after feeling the need. Some people suppress this feeling and plan to go to the toilet later. This may result in bigger and harder faeces forming which are then more difficult to pass. Do not strain on the toilet. Haemorrhoids may cause a feeling of fullness in the rectum and it is tempting to strain at the end to try to empty the rectum further. Resist this. Do not spend too long on the toilet, which may encourage you to strain. (For example, do not read whilst on the toilet.)



                    Home Remedies for Piles
Tip 1:
Take 1 tbsp black cumin seeds (shah jeera), roast and mix with 1 tbsp of unroasted black cumin seeds and powder both
together. Take 1/2 a tsp with a glass of water once a day.

Tip 2:
Radish juice taken in the morning and night. Start with 1/4 a cup and increase to 1/2 a cup gradually over a period of 1 month.

Tip 3:
Wash 3-4 figs. Soak in a glass of water over night. Eat them first thing in the morning. Again repeat in the night.

Tip 4:
Boil 1 ripe banana in 1 cup of milk, mash well. Take 3-4 times a day.

Tip 5:
Crush bitter gourd leaves and extract the juice. Mix 3 tsp in 1 glass of buttermilk, and drink on an empty stomach every morning, for a month.

Tip 6:
Drink a glass of buttermilk with 1/4 tsp carom seed powder (ajwain) and a pinch of salt

Reference: http://www.medindia.net/homeremedies/piles.asp
                        Types

• Internal haemorrhoid
• External haemorrhoid

Internal haemorrhoid
These form in the back passage about 2-4 cm above the rim (opening) of the anus. Their severity and size are classified into grades 1 to 4:
Grade 1 are small swellings on the inside lining of the back passage. They cannot be seen or felt from outside the anus. Grade 1 haemorrhoids are common. In some people they enlarge further to grade 2 or more.
Grade 2 are larger. They may be partly pushed out (prolapse) from the anus when you go to the toilet, but quickly spring back inside again.
Grade 3 hang out (prolapse) from the anus. You may feel one or more as small, soft lumps that hang from the anus. However, you can push them back inside the anus with a finger.
Grade 4 permanently hang down from within the anus, and you cannot push them back inside. They sometimes become quite large. 

                Symptoms can vary. Small haemorrhoids are usually painless. The most common symptom is bleeding after going to the toilet. Larger haemorrhoids may cause a mucous discharge, some pain, irritation, and itch. The discharge may irritate the skin around the anus.

External haemorrhoid (sometimes called a perianal haematoma)

This is less common than internal hemorrhoids. An external hemorrhoid is a small lump that develops on the outside edge of the anus. Many do not cause symptoms. However, if a blood clot forms in the hemorrhoid (a thrombosed external hemorrhoid) it can suddenly become very painful and need urgent treatment. The pain due to a thrombosed external hemorrhoid usually peaks after 48-72 hours, and then gradually goes away over 7-10 days. A thrombosed external hemorrhoids may bleed a little for a few days. It then gradually shrinks to become a small skin-tag.

Some people develop internal and external hemorrhoids at the same time.

Treatment of piles:

• Keep the faeces (sometimes called stools or motions) soft, and don't strain on the toilet. You can do this by the following:
• Eat plenty of fibre such as fruit, vegetables, cereals, wholemeal bread, etc.
• Have lots to drink. Adults should aim to drink at least two litres (10-12 cups) per day. You will pass much of the fluid as urine, but some is passed out in the gut and softens faeces. 
• Most sorts of drink will do, but alcoholic drinks can be dehydrating and may not be so good.
  Fibre supplements. If a high-fibre diet is not helping you can take fibre supplements (bulking agents) such as ispaghula, methylcellulose, bran or sterculia.. Methylcellulose also helps to soften faeces directly which makes them easier to pass.
  Avoid painkillers that contain codeine such as co-codamol, as they are a common cause of constipation.
  Toileting. 
• Go to the toilet as soon as possible after feeling the need. Some people suppress this feeling and plan to go to the toilet later. This may result in bigger and harder faeces forming which are then more difficult to pass. Do not strain on the toilet. 
• Haemorrhoids may cause a feeling of fullness in the rectum and it is tempting to strain at the end to try to empty the rectum further. Resist this.
•  Do not spend too long on the toilet, which may encourage you to strain. (For example, do not read whilst on the toilet.)

                         Home Remedies for Piles

Tip 1:Take 1 tbsp black cumin seeds (shah jeera), roast and mix with 1 tbsp of unroasted black cumin seeds and powder bothtogether. Take 1/2 a tsp with a glass of water once a day.
Tip 2:
Radish juice taken in the morning and night. Start with 1/4 a cup and increase to 1/2 a cup gradually over a period of 1 month.
Tip 3:
Wash 3-4 figs. Soak in a glass of water over night. Eat them first thing in the morning. Again repeat in the night.
Tip 4:
Boil 1 ripe banana in 1 cup of milk, mash well. Take 3-4 times a day.
Tip 5:
Crush bitter gourd leaves and extract the juice. Mix 3 tsp in 1 glass of buttermilk, and drink on an empty stomach every morning, for a month.
Tip 6:
Drink a glass of buttermilk with 1/4 tsp carom seed powder (ajwain) and a pinch of salt

Reference: http://www.medindia.net/homeremedies/piles.asp