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Constipation and piles (hemorrhoids) are interconnected due to the increased pressure exerted on the veins in the rectal area. Constipation involves difficulty in passing stools or infrequent bowel movements, which often leads to straining during defecation. Straining while passing hard stools during constipation puts excessive pressure on the veins in the rectum and anus. This prolonged straining can weaken and enlarge the veins, leading to the development or worsening of piles. The increased pressure on these veins causes them to become swollen, inflamed, and susceptible to forming hemorrhoids. Additionally, constipation can exacerbate existing piles or increase the risk of developing new hemorrhoids. The continuous strain during bowel movements aggravates the condition, causing discomfort, pain, and sometimes bleeding associated with piles. Managing constipation through dietary changes, increased fibre intake, adequate hydration, and adopting healthy bowel habits can help alleviate pressure on the rectal area and reduce the risk of developing or worsening piles. In this video, Dr Arvind Kolekar, HOD of Surgery department at Shatabdi Hospital, Mumbai and Chief surgeon and consultant at Kolekar Hospital and ICCU, Mumbai, explores the intricate relationship between piles (hemorrhoids) and constipation. This video aims to raise patient awareness and understand how these two conditions are interconnected.