Piles Causes , Symptoms , Treatment , Advise - Dr. T V Ramesh

This article is a contribution by Dr. T V Ramesh research centre for Piles , Mysore , one of renowned Proctologist serving patients for decades in Mysore and Bangalore - discusses about Piles , causes for piles , its symptoms , treatment advise.


Life began on our planet millions of years ago in the form of a minute cell. Thereafter in an unhurried fashion, countless stages in evolution took place both in the planet and animal kingdom. in the animal world an exquisite form of life evolved -the human being During the course of human evolution -both at the physical and the intellectual levels, certain undesirable elements crept in. Piles one among them. It is often said that Piles is the price that man has to pay for his erect posture

It is surprising that people know so little about this very common health problem. Fear, doubt and shyness towards anything is most often due to inadequate or wrong understanding of a situation. Those who have piles suffer much because of misconceptions and inadequate understanding of a disease. Proper understanding of the situation will go a long way in relieving the suffering.



Piles, so common an ailment is not yet easily accepted of its presence, and often felt shy of. While most piles patients are silent sufferers, only a few dare to talk about it. Silent Sufferers of piles are those who refuse to reveal they have piles. People living along with patients who suffer Piles silently can find out changes in the behavior of such persons as well as changes in their day to day habits suggesting the probable presence of the dreaded disease in such persons.

Listen to what Mr. Bore Gowda, a healthy looking. 42 year old agricultural officer, says: "I used to enjoy chicken a great deal; but you know of late, it does not suit my health". Housewife Mrs. Geetha Narayana, 23years, also had same complaints. Mr. Shivaswamy, 64 years, retired Chartered Accountant, often, proudly proclaimed chuckling. "I consume not less then three bananas a day. 1 believe it is good for health

An active businessman, 69 years old Mr. Prakash Jain, whose staple diet has been chappathies made of wheat, since a few years has a complaint: "Chappathies and Purees! Presume, 1 am too old to enjoy them.

"Sitting at work for a long time is becoming uncomfortable these days, says Dr. Kamalamma, 38 years old scientist, who spends several hours a day sitting in the laboratory. She has been doing similar work for the last 16 years.

A few days back a lady came to my clinic with her 22 years old son and said Sir, my son after attending to his job for 2 to 3 days in the factory starts complaining of headache or stomach ache and takes rest in the house without going to the job for 3 to 4 days. Somehow I suspect something. Please examine him thoroughly and treat him" When I heard these words even though I was a bit surprised, I did a complete examination of her son and found to my surprise that he neither had a problem in the head nor in the stomach 1, but was suffering from PILES Due to severe bleeding of the Piles , he was feeling very weak to attend to his job. Also he was very shy to reveal this problem to his own mother . but the knowledge and wisdom of the mother, made her to bring her son to me. After a simple treatment in this hospital for his piles and after complete rest for few days in his house he is now back to his normal duty.

Well, these expressions of sorrow and feelings of the sufferers are glaring clues of the presence of piles in them. The problem of piles is nothing new, nor it is rare. It has been a pestering problem ever since man began to stand erect and is a penalty man has to pay for standing straight unlike animals which have horizontal posture. It is the downward pushing during the time of easing that results in piles. Medical statistics reveals that more than 30% of the population has piles, also 50% of the people of more than 50 years of age has piles. Of these, about 107% have symptoms.

Piles is not confined to any one set of race, religion or creed nor to males alone. it affects both men and women; however, it affects men twice as frequently as women. Although it is common in adults, sometimes teenagers also suffer from piles

Piles is an uncharacteristic disease which causes severe discomfort and unbelievable mental agony, irritation and depression. Continued silent suffering about the anal area takes away an individuals patience and concentration both at home and at work. Piles which occurs at such a sensitive area is very personal in nature. is it possible to discuss it with friends and relatives as one would about cold, cough and headache ?! Never. Yes: shyness prevents them from talking! So we must know the facts about piles


Many of us have learnt and heard about the word piles through discussion or conversation or by reading popular articles in books or papers. That might have given some vague idea that it is a disease of bleeding while defecating. But, how many of us know the complete and real meaning of piles?

Knowing the disease is equal to "knowing the enemy and gaining confidence to win the battle on piles. True, knowing what is piles helps one to overcome doubts and fears of the disease. It convinces one to undergo treatment for the same without hesitation.

Piles is just a mass of dilated and tortuous veins that occur in the anal canal-simple and surprising fact? Right .These dilated veins arise from under the mucous membrane in the lower rectum. They form a mass containing several branches of veins which descend down the anal canal giving rise to piles. Such piles may be external (present and visible at the anus) or internal (within the anus and required internal examination to confirm its presence) to the anal orifice.

The external type is covered by skin while the internal is covered by mucous membrane. Both of these may be present in the same individual. It is these dilated veins that cause bleeding., pain and other discomfort at the anus.


There are definite signs and symptoms that can highlight the presence of piles. However some symptoms are individualistic in nature, they are

Bleeding while passing motion Pain in the anus while passing motion Irritation, itching, Discomfort in the anal area Difficulty in passing motion Red masses of tissue coming out during defecation Swelling at anus Constipation

Though several symptoms are enumerated here, all these symptoms including bleeding may not appear in all the individuals. The symptoms keep changing as the disease advances. In some persons only one of the above symptoms may be present or predominant, while it is general contention that when prolapse occurs, it is an advanced stage of the disease. Such a symptom may be the first to appear in some persons!!

Though the clinical explanation of the disease appears simple the psychological and behavioral effects on the individual is mind-boggling

  • Mental irritation- leads often to quarreling or over reacting to ordinary situation in social and professional life. 
  • Loss of concentration - especially at work Loss of efficiency in profession 
  • Depression 
  • Isolation from friends and relatives 
  • Fear to sit for long duration or walk long distance.


Why should anyone be a victim of piles? Why does it happen to me and you ? It is our standing straight or erect posture that is the real cause of piles. Animals maintaining horizontal position almost never get piles. Unlike other passages in the body it is the anal passage that has to bear the greatest pressure and stress of the abdomen, lying as it is in the lowermost part of the abdominal cavity. A problem of this nature can never be eradicated, obviously-because of the vertical positioning of the human body. Apart from this natural cause, there are other causes also which results in piles.

  • Irregular bowel habits Passing of hard stools
  • Habitual sitting in toilet for long time
  • Excessive straining at bowel movement
  • Constipation
  • Poor hygiene Improper food habits

It is well recognized that members of the same family have more chances of developing the disease. Persons having prolonged, irregular bowel habits and those consuming food containing less of fibre are more prone to develop piles. The excessive straining at stools over a long period of time pushes the rectal and anal veins with its mucous covering towards the anal canal resulting in the formation of piles. Those persons who travel long distance frequently and also those who change their place of living frequently are likely to develop piles

It is an accepted fact that constipation causes piles, but it is also true that piles results in constipation! Thus it is a vicious circle of piles -constipation -piles
Frequent visits to toilets, excessive use of laxatives and when such measures fail use of fingers as a last resort are all signs of developing piles or its presence.

Complicated piles can produce difficulty in urination more so in middle aged and elderly men. It is not rare to find patients diagnosed to have enlarged prostate gland also having piles, which may truly be the cause of the disturbed urination. Major surgery of the prostate can be avoided by taking the simple treatment for piles.


Women are more susceptible to piles especially during pregnancy. Increased venous pressure in the pelvis due to enlarged uterus presses on the pelvic veins. which in turn dilate the rectal veins. But the natures boon is such, that this problem may resolve by itself completely s0on after delivery in most women. However, we should not forget that these women would develop piles in subsequent pregnancies also, alas! with increasing severity which may not resolve by itself. So, lesser the number of pregnancies, lesser in the chance of developing piles and women should restrict the pregnancies to one or two only. This along with preventing Piles also helps in promoting family planning which is so essential to our society. Pregnant women with piles suffer extreme pain. Out of fear of pain while passing motion, such women refuse to eat sufficient quantity of food, thereby causing poor growth and weight in the new born babies.


Is piles the only disease that causes pain and discomfort in the anal region or are there any other diseases that afflict that area ?

There are several conditions that cause pain and discomfort in the anal region and a person may easily be misled to believe it to be piles!

"Fissure- in - Ano" is a disorder when a fissure or ulcer occur on the anal verge. This causes excruciating pain and bleeding while passing motion.

"Fistula-in-ano" involving the rectum, the anal canal and the surrounding areas causes recurrent infection, discharge of pus, bleeding. pain, itching. fever etc.

"Polyp is a mass of outgrowth from within the rectum about the size of a small marble. It results in bleeding and mass coming out with motion. It is usually seen in young children. "Peri-anal abscess"is local infection leading on to abscess formation which unless treated with suitable surgical measures, can lead to Fistula-in - Ano.

Prolapse Rectum is when rectum comes out of the anus forming a large mass.

Cancer of the rectum and anus may occur at any age after the second decade. Bleeding, pain, constipation, discomfort, sometimes loose motion are some of the symptoms of the cancer of the anus. It should be well appreciated here that it will be very difficult to differentiate piles from cancer of rectum because of the very similar symptoms in both the conditions. Only proper internal examination by a specialist can confirm the absence of cancer.


The knowledge of the disease, particularly knowing the symptoms is good and builds confidence in the affected individuals. But as mentioned earlier there are other conditions which mimic the same symptoms as that of piles. So, one should not jump to the conclusion "1 have piles" and start self treatment. Such self treatment, or consulting and following treatment through personal column in popular magazines, the treatment by "Quacks", the advice of the relatives and friends who might have only "half-knowledge" of the disease-can all lead to complications.and further sufferings.

Remember, t is very important to consult a doctor who has specialized in the fieid of piles. He can clear all your doubts about the disease and can treat scientifically. Consult the doctor at the appearance of the first symptoms for an early diagnosis. Treatment at an early stage is simple and easy with minimum discomfort.


There is no known medication, be it a pil or tonic or applicant that would ensure complete cure of piles. Of course, there are some allopathic and ayurvedic medications which are Usually given. But these give temporary symptomatic relief only and they never tackle the root cause. One should remember that the disease continues to grow inside irrespective of the presence or absence of the symptoms Thus the use of medications and postponement of the treatment only results in the disease progressing inside. As such, the treatment of ples was being done so far by extensive surgical operation that required use of general anesthesia and hospitalization for one to three weeks or more and everyday dressings of the operated area and later rest at home till the wound healed Thanks to the development of medical technology. persistent research on safe and easy treatment of piles has now yielded a simple and effective treatment procedure. Such a treatment causes little discomfort; no hospitalization is usually done and no general anesthesia administered. Yes! you can return home the same day after this simple treatment! And in yet another day or two you can return to work! Now one should be able to begin a good morning with a good motion!., and ensure a happy day.


  • Never feel shy of discussing the disease with others. Talk and discuss piles without inhibitions.
  • Like heart, kidney, stomach etc., another part of the body is afflicted by piles! So why do you shy about it ?
  • Remember that longer the delay, bigger the problem.
  • Always consult the specialist
  • Although internal testing alone can confirm the disease
  • Mere oral consultation may gve wrong diagnosis.
  • Treatment of piles is now very simple and easy


Piles is a peculiar disease which afflicts a large part of the population. People of all ages except very young children are susceptible. Men and women both are affected though men are relatively more frequently than women. It affects an area which is very personal and highly sensitive. The most often asked question about piles is well-What is piles? It will be very surprising to know that the dilated and tortuous veins in the anus is piles.!

Bleeding, pain, prolapse, itching, discomfort, weakness, etc.,are some of the symptoms of piles. It also results in mental irritation, agony, isolation and depression. These in turn cause isolation in social life, loss in professional life and disharmony in personal life. Excessive bleeding may result in anemia and weakness.

Remember that bleeding with motion is not always due to piles, it could be due to other causes also including cancer! Also, piles does not always "bleed with motion". it may have other symptoms. It is only with a through internal examination that a correct diagnosis of piles can be made and cancer excluded.

It is strongly advised that you talk and freely discuss about piles. Do not feel shy about the disease. Do not fear piles. Consult the specialist Take the advise of the specialist. Remember treatment of piles is now very simple and safe. There is no known medication at present in the entire world, either oral or applicant that can cure the disease.

Control of symptoms like-stopping of bleeding, reduction of pain, decreased discomfort etc., is not cure of the disease. In fact the disease progresses inside and may reach an advanced stage! The disease shows up at the later date with further but increased severity of symptoms.

Persons with other diseases like high blood pressure, heart diseases, diabetes, stroke etc., can undergo the treatment very safely.

About the doctor



Life Member:
Association of Colo Rectal Surgeons of India Association of Surgeons of India.
Indian Medical Association.
Academy of Medical Specialties

Fellow of the International College of Surgeons

Hospital Address:

Dr.T V Ramesh Piles Hospital
Ramesh Research Centre for Piles
The Rayal Crown, No. 10-14, Ashoka Road, Chandragupta Junction, Opp. Clock Tower,
Mysore 570001 

Reception: 0821-4287023, Hospital: 4246269 
Working Hours : 9.30 a.m. to 5.30 p.m.  Closed on Sundays
Mobile: 9241723045

Bangalore Facilities

Dr.T V Ramesh Piles Hospital
1st main , Ganganagara
Bangalore 560032

Contacts numbers : 080-23336586, 41172700/ 9243117090
Working Hours: 10.30 a.m. to 5.30 p.m. Closed on Sundays

Dr.TV Ramesh usually visits Bangalore on Monday , Tuesday and Wednesdays and on other days at Mysore. Appointments may be booked at above hospitals.