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Different types of piles(Hemorrhoids) : Causes & Treatment



Piles, also known as hemorrhoids, are swollen and inflamed veins in the rectum or anus. They can be either internal or external, and can cause discomfort and pain. Piles are a common condition, affecting both men and women. They can range from mild to severe and can be treated with simple lifestyle changes or medical intervention. Understanding the causes, types, signs and symptoms, diagnosis and treatment of piles can help in preventing and managing the condition.

Causes of Piles (Haemorrhoids)

Piles are caused by increased pressure in the veins in the rectum or anus. This pressure can be due to a number of factors, including constipation, diarrhea, prolonged sitting or standing, obesity, pregnancy, and lifting heavy objects. Constipation and diarrhea can cause straining during bowel movements, which can lead to increased pressure on the veins in the rectum or anus. Prolonged sitting or standing can also cause increased pressure on the veins, as well as obesity and pregnancy, which can put extra pressure on the pelvic area.

Types of Piles (Haemorrhoids)

Internal Haemorrhoids: These are located inside the rectum and are not visible from the outside. They can cause painless bleeding during bowel movements. Internal hemorrhoids are classified based on their degree of prolapse, with grade 1 being the least severe and grade 4 being the most severe. 

Prolapsed Haemorrhoids: These are internal hemorrhoids that have become so enlarged that they protrude outside the anus. They can cause discomfort and pain.

External Haemorrhoids: These are located outside the anus and are visible. They can cause pain, itching, and bleeding.

Thrombosed Haemorrhoids: These are external hemorrhoids that have developed a blood clot, causing severe pain and swelling.

Common signs and symptoms

Common signs and symptoms of piles include painless bleeding during bowel movements, itching, discomfort, and pain in the rectal area. Prolapsed hemorrhoids may also cause a lump or bulge to be felt outside the anus. Other symptoms may include difficulty in bowel movements, feeling of fullness in the rectum, and a mucous discharge from the anus.

Diagnosis & Treatment

Piles are usually diagnosed through a physical examination and by looking at the patient’s medical history. A physical examination will involve a visual inspection of the anus, and digital rectal examination. If there is any suspicion of a more serious condition, such as colorectal cancer, further tests such as colonoscopy may be recommended.

Treatment options include lifestyle changes such as increasing fiber and water intake, over-the-counter creams and ointments, and in some cases, surgery. Eating a high-fiber diet and drinking plenty of water can help to prevent constipation and diarrhea, which can help to reduce the pressure on the veins in the rectum and anus. Over-the-counter creams and ointments can help to relieve symptoms such as itching and pain. In severe cases, surgery may be recommended to remove the hemorrhoids.

When to see a doctor

If you suspect you have piles, it is important to see a doctor. In some cases, piles can be a symptom of a more serious condition, such as colorectal cancer, so it is important to have them properly diagnosed and treated. If you experience symptoms such as severe pain, bleeding, or difficulty in bowel movements, it is important to see a doctor as soon as possible. Additionally, if over-the-counter treatments do not provide relief or if symptoms worsen over time, it is important to seek medical attention.

Prevention of Piles (Haemorrhoids)

Preventing piles can be done by maintaining a healthy diet with plenty of fiber, drinking plenty of water, and avoiding prolonged sitting or standing. Regular exercise can also help to prevent piles by promoting regular bowel movements and keeping the body weight in check. Avoiding straining during bowel movements, avoiding heavy lifting and avoiding prolonged sitting on the toilet can also help in preventing piles.


Piles, or hemorrhoids, are a common condition that can cause discomfort and pain. They are caused by increased pressure in the rectal veins and can be treated through lifestyle changes and medication. If you suspect you have piles, it is important to see a doctor for proper diagnosis and treatment. By understanding the causes, types, signs and symptoms, diagnosis and treatment of piles, individuals can prevent and manage the condition. Maintaining a healthy diet and lifestyle, regular exercise, avoiding prolonged sitting or standing, avoiding straining during bowel movements, and avoiding heavy lifting can help in preventing piles.


What is the 4th stage of piles?

  • The fourth stage of piles, also known as hemorrhoids, is characterized by the prolapse of hemorrhoids outside the anus, often accompanied by pain and difficulty in pushing them back inside. They can also become strangulated, meaning the blood supply is cut off, leading to further complications.

Which type of piles is painful?

  • Internal piles are usually painless, but external piles can be painful, especially when they become thrombosed, meaning a blood clot has formed within them.

What does serious piles look like?

  • Serious piles can appear as large, swollen, and painful lumps around the anus, which may be accompanied by bleeding during bowel movements. They can also prolapse outside the anus and may become strangulated. It’s important to consult a doctor if you suspect you have serious piles.

Which is the most common type of piles?

  • Internal piles are the most common type of hemorrhoids, they are often painless and can occur within the rectum. These can cause bleeding during bowel movements and it can be seen on the toilet paper or in the toilet bowl.

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About the Author

Dr goel
Dr. S. Goel
MBBS PGDCM FID MBAHHM at Ayu Health | Website | + posts

Dr. S. Goel  is a renowned Internal Medicine Specialist currently practicing at Ayu Health, Bangalore.  He is a Specialist in Internal Medicine, Diabetes HTN, Paediatric Care, and Family Medicine.

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