piles
People sometimes think that piles (haemorrhoids) are like varicose veins of the legs (i.e. a single vein that has become swollen). This is not the case. A pile is one of the soft pads that has slipped downwards slightly, because the surrounding tissue is not holding it in place properly (British Medical Journal 2008;336:380–3). When this happens, the small blood vessels within the cushion become engorged with blood, so the cushion swells up. When faeces are passed, the pile may be pushed further down the anal canal to the outside, and this is called a prolapsed pile. Doctors classify piles into four types.
Grade 1 piles are swollen cushions that always remain within the anal canal; these are painless and the usual symptom is that of bleeding, although in most people they are symptom-free.
Grade 2 piles are pushed down (prolapsed) when faeces are passed, but spontaneously return to their starting position afterwards.
Grade 3 piles are pushed down (prolapsed) when faeces are passed, or come down at other times. They do not go back by themselves after faeces have been passed but can be pushed back in.
Cystine stones. are the same but cannot be pushed back in.
