Hemorrhoids (US English) or haemorrhoids are vascular structures in the anal canal which help with stool control. They become pathological or piles when swollen or inflamed. In their normal state, they act as a cushion composed of arterio-venous channels and connective tissue.
The symptoms of pathological hemorrhoids depend on the type present. Internal hemorrhoids usually present with painless rectal bleeding while external hemorrhoids may produce few symptoms or if thromboses 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 the 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 life. Outcomes are usually good.