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a "pile up" is when u take a monster shit, and when da shit gets piled up on da otha shit.
omg man, afta i ate dat spicy ass taco bell, i had such a big ass pile up it was starting 2 overflow in da toilet.
pile up by pimp daddy dollars September 6, 2004
As bottles for drinking, cooking and bathing pile up, residents finally embrace recycling.
Pile up by Toa Pohatu April 27, 2017
Term used for putting a good amount of money together creating a "pile up"

Usually a term used by drug dealers
"Everything i make today going to the pile up, stash need to get bigger"
Pile Up by Maconstreetlip June 27, 2025
A once-common game played mainly by boys in their first year of secondary school at Inverkeithing High School in Fife, Scotland. When on a crowded double-decker bus, one must stand at the bottom of the stairs between the two decks and not move. Others will stand behind you, and as many people will try to cram themselves into that tiny little space as possible. Some will get a bit too excited, attacking people and jumping off the top deck, inevitably leading to a riot.
"I heard Chris and John got into trouble yesterday by playing Pile-Up."
pile-up by SmileyDudette July 8, 2009

two car pile up 

Accidental anal entry during sex that causes the female to shoot forward and head butt a third participant
I pulled back too far and rammed it in Jill's ass she jumped fowatd so fast she and Jen caused a two car pile up.
two car pile up by Deeznuts617 April 27, 2016

Seven Car Pile-Up 

According to Dr. Jon Dorian, this is a dynamite name for a band.
Eliott: "He died in a seven car pile-up"
J.D.: "That would be a great name for a band"
Elliott: "Yeah you said that at the funeral"