Piles: A Private Struggle We Cannot Afford to Ignore

In all the time I have been writing about health and wellness, I have noticed a peculiar trend. People will talk quite openly about their blood sugar levels, their recurring migraines, or even the invasive details of their latest colonoscopies. Yet, mentions of haemorrhoids, or “piles” as we more commonly call them, usually happen in […]

In all the time I have been writing about health and wellness, I have noticed a peculiar trend. People will talk quite openly about their blood sugar levels, their recurring migraines, or even the invasive details of their latest colonoscopies. Yet, mentions of haemorrhoids, or “piles” as we more commonly call them, usually happen in hushed whispers or through embarrassed euphemisms. This silence is doing us no good at all. Piles are not a dirty secret or a mark of poor hygiene; they are a mechanical reality of being human in a modern world.

Technically speaking, we all possess haemorrhoids. They are naturally occurring cushions of blood vessels located in the lower rectum and anus, designed by nature to help us maintain bowel control and protect the anal canal. The medical problem occurs when these vessels become abnormally swollen and inflamed. You might think of them as being very similar to varicose veins, only located in a much more inconvenient and sensitive place. They can be internal, tucked away where you cannot see or feel them until they begin to bleed, or they can be external, forming sensitive lumps around the anus that make their presence known with every single step you take or every time you attempt to sit down.

If you are currently sitting uncomfortably while reading this, you are far from alone in your struggle. Globally, it is estimated that about half of all adults will experience the uncomfortable symptoms of piles by the time they reach fifty years of age. In many Western countries, this is often attributed to a highly processed diet; however, in Nigeria, the numbers tell a more specific and evolving story.

While hard data can be difficult to come by because of significant underreporting, our hospitals and local clinics see a massive influx of cases linked to our rapidly changing lifestyles. We are a nation that traditionally loves our “swallow” and spicy delicacies. However, as our diets shift toward more refined white flours and our jobs become increasingly sedentary, our digestive systems start paying a huge price.

The truth is that piles are essentially a pressure problem. Anything that puts excessive, prolonged strain on the pelvic and rectal area can cause those delicate veins to bulge and lose their elasticity. And chronic constipation is the leading culprit in this regard. When we strain to pass hard stools, we are essentially forcing those vessels to swell under the weight of the effort. If your diet lacks the natural sweep of leafy greens and whole grains, your digestion slows down, and the internal pressure builds up over time.

We also have to contend with what is now being called “the sitting disease”. Whether it is a long-haul flight, a cross-country bus journey, or an eight-hour office stint, gravity and prolonged pressure on the seat are not your friends. Even the natural joy of pregnancy can bring them on, as the growing baby puts immense physical pressure on the pelvic floor and restricts blood flow in the lower body.

Now, spotting the signs of piles is usually straightforward, though it is often alarming for the person experiencing it. Bright red bleeding is typically the first indicator, often appearing as painless spotting on the toilet tissue or in the bowl during a bowel movement. This is frequently accompanied by a persistent itching and irritation because swollen veins can leak small amounts of mucus that bother the surrounding skin. You might feel a sensitive or painful bump that feels tender to the touch, or perhaps just a persistent, dull aching discomfort after sitting for long periods. While piles are the most common cause of this kind of bleeding, you should never simply assume it is just piles. Any rectal bleeding calls for an urgent conversation with a medical doctor to rule out more serious issues such as inflammatory bowel disease or colorectal cancer.

The truth is that most people treat piles as a minor nuisance, but if they are left unchecked, they can become a genuine medical crisis. Chronic, long-term bleeding can lead to anaemia, leaving you constantly exhausted, pale, and short of breath. More painfully, an external pile can develop a blood clot, known as a thrombosed haemorrhoid. This causes excruciating, sudden pain and a hard lump that often requires surgical drainage to resolve. There is also the risk of a “strangulated” haemorrhoid, where the blood supply to the tissue is completely cut off, leading to tissue death and infection. These are traumatic outcomes that no one should have to endure simply because they were too shy to speak up earlier.

The good news is that you have significantly more power over this condition than you might think. Managing piles is less about searching for “miracle” herbal cures and more about daily discipline and personal responsibility. It starts with a total fibre revolution. You need about twenty-five to thirty grams of fibre every single day to keep your system moving. Think of oats, beans, brown rice, and plenty of local fruit. In Nigeria, we are blessed with amazing local options like efo riro, garden eggs, and local pears. However, consuming fibre without drinking enough water is like trying to push a dry sponge through a narrow pipe—it just gets stuck and makes the problem worse. You must hydrate until your urine is consistently pale yellow to keep your stool soft and easy to pass.

You also have to learn to listen to your body’s natural timing. You should never ignore the urge to go, as delaying a bowel movement allows the colon to soak up more water, making the stool harder, drier, and much more difficult to evacuate later. Perhaps most importantly for the modern era, you must stop turning the toilet into a library or a social media hub. Sitting on that toilet seat for twenty minutes while scrolling through your phone is a recipe for disaster because the seated position itself puts the most physical strain on the rectal area. It is best to go in, do whatever you need to do, and leave that space without delay.

Now, if you are already in pain, simple home remedies such as sitz baths—soaking the area in plain, warm water for fifteen minutes—can provide temporary relief. For those who have moved beyond home care, modern medicine offers several non-invasive options. Doctors can perform rubber band ligation, where a tiny band is placed around the base of the pile to cut off its blood supply, or use laser treatments that shrink the vessels with very little downtime.

We tend to wait until we are in absolute agony before we seek help for piles, enduring the itching and the awkward sitting-on-one-hip discomfort because of a misplaced sense of embarrassment. But your health is your primary responsibility. You are the only person who truly knows what is happening with your body every morning. If you have been ignoring the signs or hoping they will just disappear on their own, let this be your wake-up call. Change what you put on your plate, increase your water intake, and if the pain or bleeding persists, please consult a doctor. Do not let a treatable, manageable condition rob you of your daily comfort or dignity.

Ojenagbon, a health communication expert and certified managementnt trainer, lives in Lagos