When hemorrhoids which act as cushions during normal conditions become pathological as piles when swollen is a major cause of distress. Technically called Hemorrhoidal disease, they are usually painless with rectal bleeding in internal conditions. External hemorrhoids produce significant pain and swelling of anus. Constipation however seems to play a leading role in development of this condition. Initial treatments can include increase of oral fluids, fiber intake to relieve constipation with medications to help with pain and rest.