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Piles or hemorrhoids, hernia, and varicose veins are common surgical conditions encountered in primary health care. Their causes may be related to increased pressure, weakness of supporting tissues, obstruction of blood flow, or other local and systemic factors. Piles and hemorrhoids are swollen and enlarged veins in the lower rectum and anus. They may be internal or external. The main cause is increased pressure in the veins of the anorectal region. Chronic constipation and repeated straining during defecation are important causes because they increase pressure ________ _____ _________ _________ ________ _______ _______ _________ ______ ________ ___ ____.
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