Piles are swellings on the inside of the anal canal, the short, muscular tube that connects the rectum (back passage) with the anus, in areas known as the anal cushions. They are round swellings that can reach the size of a grape. Piles are varicose veins.
Types of piles
Although piles develop from inside the anal canal, they can hang down out of their normal place.
Piles can be described as follows.
- First degree piles are swellings on the inside lining of the anal canal (dental line). They bleed but can’t be seen from outside the anus.
- Second degree piles are larger and can stick out (or prolapse) from the anus when someone open his/her bowels, but return on their own afterwards.
- Third degree piles are similar, but hang out from the anus and only return inside when pushed back in.
- Fourth degree piles permanently hang down from the anus and can’t push them back inside. They may become extremely swollen and painful if the blood in them clots.
Some inguinal hernias have no apparent cause. But many occur as a result of increased pressure within the abdomen, a pre-existing weak spot in the abdominal wall or a combination of the two. In men, the weak spot usually occurs along the inguinal canal. This is the area where the spermatic cord, which contains the vas deferens, the tube that carries sperm, enters the scrotum. In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes occur where connective tissue from the uterus attaches to tissue surrounding the pubic bone.
More common in men
Men are more likely to have an inherent weakness along the inguinal canal than women are because of the way males develop in the womb. In the male fetus, the testicles form within the abdomen and then move down the inguinal canal into the scrotum. Shortly after birth, the inguinal canal closes almost completely, leaving just enough room for the spermatic cord to pass through, but not large enough to allow the testicles to move back into the abdomen. Sometimes, however, the canal doesn’t close properly, leaving a weakened area. There’s less chance that the inguinal canal won’t close after birth in female babies. In fact, women are more likely to develop hernias in the femoral canal, an opening near the inguinal canal where the femoral artery, vein and nerve pass through.
Weaknesses can also occur in the abdominal wall later in life, especially after an injury or certain operations in the abdominal cavity. Whether or not you have a pre-existing weakness, extra pressure in your abdomen can cause a hernia. This pressure may result from straining during bowel movements or urination, from heavy lifting, from fluid in the abdomen (ascites), and from pregnancy or excess weight. Even chronic coughing or sneezing can cause abdominal muscles to tear.