First degree piles are swellings on the inside lining of your anal canal. They may bleed but can't be seen from outside your anus.

 

Second degree piles are larger than first degree piles. They come out of your anus when you have a bowel movement, but go back inside on their own afterwards.

 

Third degree piles hang down from your anus and only go back inside when you push them in.

 

Fourth degree piles permanently hang down from your anus and you can't push them back in. They may become very swollen and painful if the blood inside them clots.

 

External piles are swellings that develop further down your anal canal, closer to your anus. They can be more painful than internal types of piles.

 

 

 

Common symptoms of piles include:

 

bleeding from your anus – you may only see this as bright, red blood on toilet paper

a lump in or around your anus

a slimy discharge of mucus

a feeling that your bowels haven't emptied completely

itchy skin around your anus

swelling around your anus

pain and discomfort after a bowel movement (if you have external piles)

These symptoms may be caused by problems other than piles. If you have any of these symptoms, see your doctor for advice.

 

 

 

Piles are often mild and get better with simple lifestyle changes. There are a number of things that you can do to help to relieve the symptoms.

 

 

Diet and lifestyle changes can often help to relieve your symptoms. For example, eating a high-fibre diet will make your stools softer and easier to pass. This is important for reducing the increased pressure on the veins in your anus caused by straining when you have a bowel movement. Drink enough fluids to keep hydrated and don’t have too much caffeine.

 

Try not to strain when you’re passing a bowel movement and gently clean around your anus with baby wipes afterwards. Regular warm baths may relieve any irritation and help to keep your anal area clean. 

 

 

 

There are a range of medicines that can help relieve the symptoms of piles.

 

If you're passing hard or infrequent faeces, a fibre supplement such as ispaghula husk (eg Fybogel) or mild laxatives such as lactulose, will soften your faeces. 

Over-the-counter painkillers, such as paracetamol or ibuprofen, may help to ease any pain you have.

Soothing creams, ointments and suppositories may ease any pain and itchiness. 

 

 

 

There are certain treatments that you will need to go into hospital for, but you won't have to stay overnight. These include the following.

 

Banding. This involves placing a small elastic band around the pile, which cuts off the blood supply and causes it to die and fall off after a few days. The area left behind will heal up naturally.

Sclerotherapy. This involves having your piles injected with an oily solution, which makes them shrivel up.

Infra red coagulation or laser treatment. This uses infra red light to seal the veins above the pile, which causes it to shrink.

Bipolar diathermy and direct current electrotherapy treatment. This uses an electrical current to burn off the pile.

 

 

 

Surgical treatments for piles are an option if you have severe piles and other treatments haven't worked. There are different types of surgery, including haemorrhoidectomy or stapled haemorrhoidopexy. The type that is recommended for you will depend on the size and number of piles you have.

 

Consult Dr. Gaurav Mittal for more information