Causes of piles

Piles (haemorrhoids) are swollen blood vessels in and around the anus and lower rectum. They are very common and are mostly linked with pressure and strain in the lower bowel.

Main causes

• Constipation and straining: hard stools and pushing hard raise pressure in the veins.
• Long sitting on the toilet, including using a phone there
• Chronic diarrhoea, which irritates and inflames the area
• Low-fibre diet and too little water
• Pregnancy: the growing womb presses on veins, and hormones relax vein walls. Constipation adds to this.
• Obesity and a sedentary lifestyle
• Heavy lifting and long standing or sitting
• Ageing: the supporting tissue weakens over time
• Family tendency
• Anal intercourse can irritate the area in some people

Internal and external piles

Internal piles form inside the rectum, and external piles form under the skin around the anus.

Other causes of similar symptoms

Anal fissures, polyps, infections and bowel cancer can also cause rectal bleeding, so bleeding should not simply be assumed to be piles.