Piles (Bawaseer): Why You Should Not Suffer in Silence
Piles — known in Urdu as bawaseer and to doctors as haemorrhoids — are one of the most common problems people are too embarrassed to talk about. Yet they are extremely common, they are not dangerous in themselves, and today they can be treated quickly and almost painlessly with modern laser techniques. This guide explains what piles are, the warning signs, why bleeding should always be checked, and the safe, advanced treatment available in Lahore.
What Are Piles?
Inside the back passage (anal canal) there are soft, cushion-like pads of tissue rich in tiny blood vessels. These “anal cushions” are completely normal — they help seal the passage and keep you continent. Piles develop when these cushions become swollen, enlarged and slip downwards, usually after years of straining. When they swell, they can bleed, itch, and sometimes come out of the back passage.
What Causes Piles?
Piles are mainly caused by anything that raises pressure in the lower tummy and back passage over time:
- Chronic constipation and straining on the toilet — the biggest cause
- A low-fibre diet and not drinking enough water
- Pregnancy and childbirth
- Sitting for long periods, and a sedentary lifestyle
- Ageing, which naturally weakens the supporting tissues
- Spending too long on the toilet (for example, using a phone)
Symptoms & Warning Signs
- Bright red bleeding during or after passing stool — seen on the tissue or as a splash in the toilet. This is the earliest and most common sign, and it is usually painless.
- Itching, irritation or a mucus discharge around the back passage
- A feeling of a lump coming down when you pass stool
- A sense that the bowel has not fully emptied
Important: piles are usually painless. If you have significant pain, it often points to another condition such as an anal fissure or a thrombosed (clotted) pile, which needs a proper examination.
Never Assume Bleeding Is “Just Piles”
This is the single most important message of this article. Bleeding from the back passage is very often due to piles — but it can also be the first sign of more serious conditions, including colorectal (bowel) cancer. Many patients delay seeing a doctor for months because they assume it is only piles. Any rectal bleeding should be examined by a surgeon to confirm the cause — especially if you are over 40, the bleeding is dark, mixed in with the stool, or comes with a change in bowel habit, weight loss, or a family history of bowel cancer. Getting checked brings peace of mind, and if it is something more, catching it early saves lives.
The Four Grades of Piles
- Grade 1: bleed only — do not come outside
- Grade 2: come out when passing stool but go back on their own
- Grade 3: come out and have to be pushed back by hand
- Grade 4: stay outside permanently
Knowing the grade helps decide the best treatment — early grades often respond to simple measures, while higher grades benefit from a procedure.
Treatment: From Simple Measures to Painless Laser
1. Lifestyle and diet (first step for everyone). Many early piles settle with a high-fibre diet, plenty of water, avoiding straining, and not sitting too long on the toilet. Stool softeners, along with certain creams and suppositories, help relieve symptoms.
2. Clinic (out-patient) procedures. For piles that keep bleeding or coming down, quick office treatments such as rubber-band ligation or injection can be very effective for early grades — no cutting and no hospital stay.
3. Painless laser treatment (modern option). For suitable patients, laser treatment of piles is a major advance over traditional cutting surgery. A thin laser fibre gently shrinks and seals the swollen piles from the inside. The benefits are significant:
- Little or no cutting, and minimal pain
- Usually a day-case — go home the same day
- Fast recovery and a quick return to work
- Less bleeding and a lower chance of complications than open surgery
4. Surgery (for advanced piles). Large, permanently prolapsed (grade 4) or “mixed” piles may still need a formal operation (haemorrhoidectomy). In experienced hands this is safe and gives a lasting cure.
How to Prevent Piles
- Eat plenty of fibre — vegetables, fruit, whole grains and salads
- Drink 6–8 glasses of water a day
- Do not strain or sit for long periods on the toilet
- Stay physically active and avoid long hours of sitting
- Go to the toilet as soon as you feel the urge — do not hold it
When to See a Surgeon in Lahore
See a surgeon if you have ongoing bleeding, a lump that keeps coming out, itching and discomfort that will not settle, or any pain — and importantly, to have bleeding properly checked. Prof. Dr. Zahid Mahmood is a General, Laparoscopic & Laser Surgeon in Lahore with over 30 years of experience in the modern, painless treatment of piles and other anorectal conditions, in complete privacy and comfort.
👉 Book a confidential consultation today to discuss your symptoms, or call 0300-4130159.
Frequently Asked Questions About Piles
Are piles dangerous?
Piles themselves are not dangerous and are very common. The real danger is assuming that bleeding is piles when it could be something more serious. That is why any bleeding should be checked by a surgeon.
Is laser treatment for piles painful?
No. Laser treatment is done under anaesthesia so you feel nothing during it, and because there is little or no cutting, discomfort afterwards is usually mild and settles quickly.
How soon can I return to work after laser piles treatment?
Most patients go home the same day and return to normal activities and work within a few days, much faster than after traditional surgery.
Can piles be cured without surgery?
Early piles often improve with a high-fibre diet, more water, and avoiding straining, sometimes with simple clinic procedures. More advanced piles are best treated with laser or surgery for a lasting cure.
Will piles come back after treatment?
Proper treatment gives long-lasting results, but piles can return if the habits that caused them continue. Keeping a high-fibre diet and avoiding straining greatly reduces the chance of recurrence.
Medically reviewed by Prof. Dr. Zahid Mahmood (MBBS, FCPS), General, Laparoscopic & Laser Surgeon, Lahore. This article is for general public awareness and education. It is not a substitute for a personal medical consultation. Please see a qualified surgeon for advice about your own condition.