Piles or Haemorrhoids can occur at any age. Many experts believe that they are caused by continuous high pressure in the veins of the body, which occurs because humans stand upright. The causes of haemorrhoids include constipation and excessive straining during bowel movements. Persistent diarrhoea and loose stool movements are also causes of haemorrhoids, and some people inherit a family tendency to develop piles. Women are more susceptible to haemorrhoids during pregnancy, as pressure from the growing uterus restricts blood flow in the pelvic area. Lifestyle factors can also contribute to haemorrhoid development.
Itching and irritation probably occur because the lumpy piles stop acting as soft pads to keep the mucus in; instead, a little mucus leaks out and irritates the area around the anus. Pain and discomfort comes from swelling around the pile, and from scratching of the lining of the anal canal by faeces as they pass over the lumpy area. The scratching also causes bleeding, which is a fresh bright red colour and may be seen on faeces or toilet paper or dripping in the pan. A pile that has been pushed down (a second- or third-degree pile) may be felt as a lump at the anus. Internal haemorrhoids cannot cause cutaneous pain, but they can bleed and prolapse. Prolapse of internal haemorrhoids can cause perianal pain by causing a spasm of the sphincter complex. This spasm results in discomfort while the prolapsed haemorrhoids are exposed. The discomfort is relieved with reduction. Internal haemorrhoids can also cause acute pain when incarcerated and strangulated. Again, the pain is related to the sphincter complex spasm.
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