Internal piles are hemorrhoids that are located inside the anal cavity. The internal piles may protrude from the anus after a bowel movement, but are usually unseen. Most are painless unless they are pushed outside the anal cavity and prolapse. Treatment traditionally does not begin until the hemorrhoids cause discomfort over a period of time.
Most internal piles are caused by a variety of factors. Poor diet can cause the fecal matter to be hard, resulting in straining while trying to have a bowel movement. Straining puts pressure on the blood vessels in the rectum, causing the vessels to dilate and swell. Not drinking enough water can cause the stool to bulk up, resulting in constipation. Prolonged constipation may cause internal piles to form.
Rapid weight gain during pregnancy may increase the pressure on the blood vessels in the rectum, causing hemorrhoids to develop. Another cause of internal piles in pregnant women is the delivery of the baby. The straining involved in pushing the baby out of the birth canal may cause the blood vessels in the anal cavity to suddenly swell, becoming piles.
People that are overweight have a higher risk of developing piles. The additional weight causes the dilation of the blood vessels in the rectum. Straining during bowel movements can cause the swollen vessels to distend, resulting in discomfort when trying to pass a bowel movement. Some people have the sensation of an incomplete bowel movement because of the piles prolapsing past the anus.
Symptoms of internal piles are few. Most people first notice bright red blood in the toilet water or on the bathroom tissue after a bowel movement. A mucus-like discharge may be seen on the bathroom tissue when cleaning the anal area after a having a bowel movement. The mucus contains trace amounts of fecal matter, and can cause extreme itching around the anus.
Treatment of internal piles depends on the degree of discomfort experienced by the patient. Many doctors will advise against surgical intervention until the piles become painful. Most often, a physician will advise adding fiber and water to the diet to prevent the formation of additional piles. An exercise program may be recommended to promote the quick movement of fecal matter through the digestive system, resulting in less constipation that causes internal piles.
Surgical treatment may become necessary if the pile prolapses outside the anal cavity. The anal sphincter may contract around the piles, causing the piles to strangulate. A surgeon may put a small rubber band around the pile to cause it to fall off, cauterize the pile, or excise the tissue. Recovery from the hemorrhoidectomy is usually complete within three weeks.