This is an interesting question that many people wonder about when dealing with piles or hemorrhoids. In the opening paragraphs, we’ll provide some quick answers and background information before diving into more detail.
The quick answers
In short, the size of hemorrhoids or piles can change over time. They may start small and become larger if not treated. Certain factors can cause piles to enlarge like straining during bowel movements, constipation, pregnancy, obesity, and more. Piles can also shrink and reduce in size with the right treatments and lifestyle changes.
What are piles?
Piles, also known as hemorrhoids, are swollen veins located in the lowest part of the rectum and anus. There is a network of small veins known as hemorrhoidal plexuses in this area that can become inflamed and engorged.
There are two types of piles:
- Internal piles occur inside the rectum and are usually painless.
- External piles occur under the skin around the anus and can be painful.
Piles are very common, especially as people get older. They affect nearly 1 in 20 Americans. Piles can cause symptoms like itching, discomfort, bleeding, and pain. Small piles may not cause any symptoms at all.
What causes piles to enlarge?
There are several factors that can lead to the enlargement and swelling of existing piles:
- Straining during bowel movements – Straining puts extra pressure on the veins in the lowest rectum and anus. This can cause hemorrhoids to swell and enlarge.
- Constipation and hard stools – Constipation causes people to strain more to pass hard, dry stools. This added pressure can inflame hemorrhoids.
- Pregnancy – Hormonal changes and extra pressure from the baby on the veins can cause hemorrhoids in pregnant women.
- Obesity – Being overweight or obese increases pressure in the lower rectum which can lead to enlarged hemorrhoids.
- Heavy lifting – Lifting heavy objects can cause straining and pressure in the anal area, inflaming hemorrhoids.
- Lack of fiber – A low-fiber diet can lead to constipation and extra straining, irritating piles.
- Chronic diarrhea – Frequent diarrhea can overstimulate the anal sphincter, causing enlarged hemorrhoids.
- Sitting for long periods – Sitting puts constant pressure on the anal area which can cause hemorrhoids to enlarge.
So in summary, anything that causes straining, pressure, and constipation in the rectal area can make existing piles become enlarged and swollen.
Can piles change size over time?
Yes, the size of piles can fluctuate and change over time. They may start out small and become larger if exacerbating factors like straining or constipation persist. An external pile that starts pea-sized could enlarge into the size of a grape over time.
Piles also often shrink and reduce in size when aggravating factors are removed. For example, adding more fiber to your diet, drinking more water, and avoiding straining during bowel movements may allow swollen piles to decrease and shrink back down.
Piles also tend to change in size during and after pregnancy. They frequently enlarge during the 3rd trimester when pressure on the veins is highest, and then often shrink back down post-partum.
| Time Period | Typical Size Change |
|---|---|
| Early stages | Start small |
| Without treatment | Enlarge over time |
| With lifestyle changes | Shrink and reduce |
| During pregnancy | Enlarge |
| After pregnancy | Shrink back down |
This table summarizes how piles commonly change size during different time periods.
How are enlarged piles treated?
There are several ways to treat enlarged hemorrhoids and shrink them back down, including:
- Improving bowel habits – Eating more fiber, drinking more fluids, and avoiding straining during bowel movements can allow piles to shrink back down.
- Over-the-counter treatments – OTC hemorrhoid creams, ointments, suppositories, and wipes can reduce swelling and irritation.
- Sitz baths – Sitting in warm water for 10-15 minutes 2-3 times per day can relieve swelling and discomfort.
- Ice packs – Applying an ice pack wrapped in cloth to the area can reduce swelling and shrink piles.
- Medications – Doctor-prescribed medications like steroid creams or stool softeners can help shrink piles.
- Procedures – Rubber band ligation, sclerotherapy injection, infrared coagulation, and hemorrhoidectomy surgery can remove enlarged hemorrhoids.
With consistent treatment, most enlarged piles can shrink back down to a smaller size and be better managed.
How to prevent piles from enlarging
Some tips to help prevent existing hemorrhoids from becoming enlarged include:
- Eat a high-fiber diet with fruits, vegetables, and whole grains.
- Drink plenty of water and fluids daily.
- Don’t strain or hold your breath during bowel movements.
- Go to the bathroom as soon as you feel the urge.
- Avoid sitting on the toilet for long periods.
- Exercise regularly to prevent constipation.
- Avoid heavy lifting and carrying.
- Lose weight if overweight or obese.
- Take over-the-counter fiber supplements or stool softeners if needed.
- Don’t sit for prolonged periods without getting up.
Making these lifestyle changes can prevent straining and pressure in the rectal veins, stopping existing hemorrhoids from becoming enlarged.
Lifestyle changes
Adopting habits like eating more fiber, drinking more water, exercising, and losing excess weight can help prevent hemorrhoid enlargement. Avoiding straining during bowel movements is also key.
Proper toilet habits
Going to the bathroom as soon as needed and avoiding sitting on the toilet for too long helps reduce pressure and straining that can inflame hemorrhoids.
Over-the-counter remedies
Using over-the-counter creams, ointments, or suppositories can shrink swelling, relieving pressure on hemorrhoid veins.
When to see a doctor
You should see a doctor if:
- Hemorrhoids don’t shrink with home treatments.
- Hemorrhoids continue to enlarge.
- Hemorrhoids bleed frequently or bleed a lot.
- Hemorrhoid pain or swelling worsens.
- You experience rectal bleeding for the first time.
A doctor can help identify the cause of hemorrhoid enlargement and provide prescription medications or procedures if needed.
Conclusion
In summary, piles can definitely change size over time. They often start small and may enlarge with straining, constipation, pregnancy, and other factors. Piles can frequently shrink back down with lifestyle changes, over-the-counter remedies, and medical treatments. Preventing constipation and straining is key to stopping hemorrhoids from becoming enlarged. See a doctor if home treatments aren’t working to reduce swelling. With proper care, the size of enlarged hemorrhoids can often be improved.