Piles are small outpouchings of the mucosa of the anal canal with an inner buffer of blood vessels. They are seen in relation to the branches of the underlying arteries. When small, they do not cause any discomfort to the patient but as they increase in size, they may cause some problems. Depending on the site, they may be internal or external, to the anal orifice. Majority of piles are asymptomatic. Some may cause symptoms but are actually due to some other primary conditions.