Piles, or haemorrhoids, are lumps that develop in the rectum region, where blood vessels become inflamed.

Even though piles are mostly common with adults, children may also develop piles albeit not so frequently.

The condition can result in irritation, soreness and haemorrhage, and as such it is likely to be quite discomforting for the child and his or her attendants.

Wondering what are its causes? Looking for proper treatment for your child?

Mykare Health is here to help you. In this blog, we will discuss all about piles in children and the available treatment options.

What Are Piles?

Haemorrhoids are swollen blood vessels found in the lower rectum and the anus. When these vessels become enlarged and swollen, they are termed piles. There are two types of haemorrhoids

• Internal haemorrhoids: These are situated within the rectum and they are normally not tender. But they may lead to the bleeding effect during defecation.

• External haemorrhoids: These are occurrences that form under the skin around the anus lumps that may lead to pain, discomfort, and inflammation.

Childhood piles are rare but they may develop due to a number of factors. In young children with piles, some of the symptoms may be the same as those in older persons, including painful and bleeding stools.

Causes of Piles in Children

The causes of piles in children may not be the same as the causes in adult clients. In children, the primary factors contributing to piles include

• Chronic Constipation

Among the causes of piles in children, constipation is one of the common complaints among kids world over. Constipation in children is when a child struggles to pass stool and this may lead to the child exerting pressure in the rectum and anus thus putting pressure on the veins.

This process can cause straining and the veins become kind of swollen hence giving rise to haemorrhoids.

Several factors can contribute to constipation in children, such as

1. A diet low in fibre

2. Not drinking enough water

3. Lack of physical activity

4. Constipation due to fear or even embarrassment of passing stool.

5. Sitting for extended hours on the toilet

Children could sit for long hours on the toilet especially when they being forced to ease their bowels. Sitting on the toilet for long periods puts pressure on the veins in the rectal area leading to piles.

• Diarrhoea

Piles also come about due to diarrhoea with constipation being a very common cause of piles. Stressful high frequency defecation and rubbing or irritation of the rectal mucosa by diarrhoea leads to development of inflammation and subsequent swelling of the veins.

• Genetic Predisposition

For instance, children may be born with the genes that put them at risk of ever getting piles. Sometimes, children, especially when there is a family history of haemorrhoids, are more vulnerable to developing the problem because their vein walls in the rectal area are not as strong as in adults.

• Obesity

Child obesity can cause piles because pressure on the veins in the lower abdomen and rectum is heightened. Obesity is one of the terrible conditions that cause the veins to struggle to perform their tasks that results in haemorrhoids.

• Sedentary Lifestyle

Sedentary lifestyle is a major reason behind formation of piles. No physical exercise or activity , eating more junk foods etc can cause piles.

Symptoms of Piles in Children

The signs of piles in kids may be linked to the severity and type of haemorrhoids that a child develops. Some will have only mild manifestations while others will be very uncomfortable throughout the episode. Common symptoms include

1. Rectal Bleeding

The first thing people notice, and perhaps one of the most common signs of piles, is passing stools with blood. It usually looks like bright red blood on the toilet paper or floating in the water after a bowel movement. Nevertheless, the quantum of blood may be variable depending on the extent of the ailment.

2. Pain or Discomfort

For children with external haemorrhoids, they may develop pain, itching or discomfort around the anal region. This pain may feel sharp during or after defecation is experienced and the skin around the anus is sensitive.

3. Swelling Around the Anus

These piles may be felt as lumps or swelling outside the anal opening. These lumps may be tender and often these cause itching, discomfort when sitting or passing stool.

4. Prolapsed Hemorrhoids

At times internal haemorrhoids can get to a size that they will extend outside the rectum, this is termed strangulated haemorrhoids. This is called a prolapsed hemorrhoid.

Haemorrhoids that have prolapsed may produce pain and discomfort and may be an individual has to put them back into their original position.

5. Mucus Discharge

For children who have piles, there can be a secretion of a specialised kind of mucus that discharges from the anus and could cause redness and itching on the skin surrounding the anus.

6. Constipation or Refusal to Use the Washroom

The young children for instance might not describe the symptoms well but they may frown, cry or refrained from using the toilet because of the pain or the discomfort that they feel.

Diagnosis of Piles

Diagnosis of piles in children is done through physical examination of the child’s external rectal area, endoscopy, assessment of the symptoms, an X-ray and a digital rectal examination.

In case piles are thought of, it is advisable to visit a paediatrician or any health care consultant for confirmation. The doctor will review the child’s medical history, conduct a physical examination, and possibly order tests such as

• Digital Rectal Exam (DRE): The doctor will then carry out a physical examination involving touching the rectal area to feel for any enlargement, lumps or when touched, it will be sore.

• Anoscopy or Proctoscopy: All these procedures include using an endoscopic tube that has a light to examine the haemorrhoids from the rectum.

At times, the doctor may also suggest the rectal bleeding issue comes from other problems like infections or inflammatory bowel disease, where a stool sample test will be done as well.

Management of Piles in Children

In case of managing Piles in children, the primary aim is generally on treatment of the signs and causes.

1. Dietary Changes

One of the most effective ways to prevent and treat piles in children is through dietary changes. A diet high in fibre can soften stools, reduce constipation, and make bowel movements easier. Foods rich in fibre include

Fruits and vegetables (e.g., apples, pears, spinach, broccoli)

Whole grains (e.g., oats, brown rice, whole wheat bread)

Legumes (e.g., beans, lentils)

Encouraging children to drink plenty of water is also essential, as hydration helps soften stool and ease bowel movements.

2. Encouraging Regular Bowel Movements

Children should be encouraged to use the toilet when they feel the urge to have a bowel movement.

Delaying bowel movements can lead to constipation and worsen piles. Parents can help by creating a routine where the child uses the toilet at a regular time each day.

3. Warm Baths

Sitting in a warm bath, also known as a sitz bath, can help relieve pain and discomfort caused by piles. The warm water helps relax the muscles in the rectal area and reduces inflammation.

4. OvertheCounter Medications

For mild piles, over the counter creams and ointments may be recommended to relieve itching and pain.

These creams often contain ingredients like hydrocortisone to reduce inflammation or numbing agents to relieve discomfort.

However, it is important to consult a healthcare provider before using any medication on a child, as some products may not be suitable for young children.

5. Medical Procedures

In severe cases where home remedies and over the counter treatments are not effective, medical procedures may be necessary. These can include

• Rubber Band Ligation: A small rubber band is placed around the base of the hemorrhoid to cut off blood flow, causing the hemorrhoid to shrink and fall off.

• Sclerotherapy: A solution is injected into the hemorrhoid to shrink it.

• Hemorrhoidectomy: In rare cases, surgical removal of the hemorrhoid may be necessary.

Prevention of Piles in Children

Preventing piles in children largely revolves around promoting healthy bowel habits. Some strategies to prevent piles include

• Ensuring a high fibre diet

• Encouraging regular physical activity

• Teaching children to use the toilet when they feel the urge

• Avoiding prolonged sitting on the toilet