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Piles is another term for hemorrhoids. Hemorrhoids are collections of inflamed tissue in the anal canal. They contain blood vessels, support tissue, muscle, and elastic fibers. Many people have piles, but the symptoms are not always obvious. Hemorrhoids cause noticeable symptoms for at least 50 percent of people in the United States (U.S.) before the age of 50 years.
Internal haemorrhoids lie inside the rectum and are difficult to see with naked eye or feel with hand. They don't usually hurt because there are less pain-sensing nerves in the rectum. Bleeding may be the only sign in many cases. Sometimes internal haemorrhoids prolapse or enlarge and protrude outside the anal sphincter. In that case it may be seen outside or felt with hand as moist, pink pads of skin that are pinker than the surrounding area. Prolapsed haemorrhoids may hurt because they become irritated by rubbing from clothing and sitting. They usually recede into the rectum on their own; it can be even gently pushed back into place.
External haemorrhoids lie within the anus and are often uncomfortable. If an external hemorrhoid prolapse to the outside (usually in the course of passing a stool), it can be seen or felt. Blood clots sometimes form within prolapsed external haemorrhoids, causing an extremely painful condition called a thrombosis. When the external hemorrhoid becomes thrombosed, it can look rather frightening, turning purple or blue, and could possibly bleed. Despite their appearance, thrombosed haemorrhoids are usually not serious and will resolve themselves in about a week. If the pain is unbearable, the thrombosed hemorrhoid can be removed with surgery, which stops the pain.