Piles (or haemorrhoids�which is another name for the same condition) can occur on the outside or inside of the muscle ring that forms the anus. In both situations they are caused by a dilated vein. The blood inside this vein may clot to cause a thrombosed pile. The pressure of the dilated vein or the clotted blood it contains on adjacent nerves causes pain. Twisting of the pile can also cause severe pain. The other main symptom apart from pain is bleeding, which occurs if the pile bursts. Piles are caused in the first place by excessive stress on the anus. This stress can be in the form of constipation, prolonged diarrhoea, or heavy lifting. Weight-lifters are notorious sufferers of piles. There is no evidence that they become cancerous, and I cannot see why alcohol in any form would cause them to develop. There is certainly a tendency for piles to develop within a family due to a congenital weakness in the area. Treatment involves creams or suppositories which contain medication to soothe the pile, anaesthetics and anti-inflammatory substances. Further treatment involves injecting, banding or excising the pile.

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