By | June 14, 2019


Unhealthy eating habits, lack of physical exertion and prolonged seating jobs have been on rise lately. In addition to this sedentary lifestyle, obesity and chronic constipation due to lack of fibrous diet and inadequate intake of water have also become quite common these days. With such conditions come the risk of being infected by piles. Haemorrhoids or piles, also known as ‘bavasir’ in common Indian households, are the inflamed or swollen rectal or anal blood vessels. The primary cause behind development of piles is sustained intra-abdominal pressure. This pressure makes the blood vessels to become inflamed and enlarged. Haemorrhoids can create a huge amount of discomfort and pain to the infected person. Rectal or anal bleeding is quite frequent in this disease, while the person may even experience itching, redness and soreness around the anal region with pain. Formation of lumps and discharge of mucus is also pretty usual under this disease.

For deciding about the best possible treatment, firstly careful diagnosis is vital. The doctor would first figure out the stage or grade of piles that the person is infected with as different stages need to be medically treated differently. Having said that, now let us take a look at severity of haemorrhoids or piles.


Grades of Piles

Generally, piles are mainly classified into two types – internal and external haemorrhoids. Internal haemorrhoids occur deep inside the rectum or anal region and may not be visible to naked eye. This type of piles is normally not painful but characterised by blood mixed with stool. On the other hand, external haemorrhoids are present out of the anal canal, near the anal region, and create a lot of pain. They may even develop blood clots and create excruciating pain. It is feasible to have both the types of haemorrhoids simultaneously.

Due to irritability and discomfort that the piles generate, patients immediately look for some cure. Several options to heal piles are available depending upon the nature and severity of piles. Piles have been graded on the basis of extent to which they protrude out of the pectinate line, the line differentiating the upper and lower anal canal, into the anal region. Thus, various stages of internal haemorrhoids include –


  • Grade 1: The internal haemorrhoids at this stage are small inflammations and not visible to naked eye. They do not protrude out of or fall into the anal canal but just bulge into it. It causes anal cushion to bleed during the bowel movements and are lined across inside of the anus. They can be easily cured by use of medicines and some dietary changes like including rich fibrous diet, devoid of spicy food and plenty of water intake. A topical cream and sitz bath may also prove useful.
  • Grade 2: These are larger than initial stage of piles but like the first stage, remain inside the anal canal. However, they may be pushed out while passing stools and bleeding can be noticed. Haemorrhoids protrude past the anal verge due to the straining caused during bowel movements but would reduce on its own spontaneously when the straining subsides. Similar to grade 1 piles, they can be treated without surgery using topical ointments, home remedies and following various precautionary measures.
  • Grade 3: Also known as prolapsed haemorrhoids, the anal cushion prolapses out of the anal canal at this severity of piles. The patient might feel like something is hanging from their rectum but can be manually or physically re-inserted into the anal canal. While use of medicines and dietary changes may mitigate the symptoms of piles and provide relief to the infected person, they may require surgical intervention to get completely cured.
  • Grade 4: This is the last stage of piles and the most severe one. At this final grade, haemorrhoids stay out of the canal all the times and cannot be manually pushed back in. They are comparatively larger and remain out of the anus, causing a huge amount of pain and discomfort. They can only be treated through surgical procedure.


On the contrary to internal haemorrhoids, external haemorrhoids might require surgical intervention promptly. Even ice packs and haemorrhoids creams might be prescribed by the doctor to provide relief. The surgery can be conducted in varied ways such as their removal through open surgery and use of laser to burn tissues affected by haemorrhoids. Sometimes, they might clot blood inside of them and this can be an immensely grievous situation.



Piles are even curable at last stage. While the first two stages can be easily cured through self-care, the last stages may require medical procedures. Nevertheless, the risk rate of piles can be reduced by following some basic precautionary steps. These include diet high in fibre, adequate intake of water, regular exercise and avoiding chronic constipation and obesity.


Also Read: Know about Laser Surgical Treatment for hemorrhoids (Piles)

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