Hemorrhoids, which are often called piles, are inflamed and swollen veins in the lower rectum and anus. They can have various causes; for example, the result of strained bowel movements, or the pressure which is placed on the bowel during pregnancy. Hemorrhoids can be internal or external, depending on the veins affected. They are quite common and are not life threatening. Hemorrhoids which are not prolapsed are often painless. Prolapsed hemorrhoids are usually painful, uncomfortable and itchy. Creams, ointments and gels should be applied in a thin layer around the area of the anus if that is the affected area. For internal piles your finger or a pile pipe should be used. After lubrication it should be inserted into the anus and the hemorrhoid treatment product applied. The most efficient pile pipes have holes on both the sides and end.