Stages of Piles and Their Symptoms

Piles, also known as hemorrhoids, are swollen veins in the rectum or anus that cause discomfort, pain, and bleeding. They are a common problem affecting people of all ages, often due to factors like constipation, straining during bowel movements, pregnancy, or prolonged sitting. Understanding the stages of piles and their symptoms helps in seeking timely treatment and preventing complications. This article explains the four stages of piles in detail.



What Are Piles?

Piles occur when the veins around the anus or lower rectum become inflamed and swollen. They can be internal, occurring inside the rectum, or external, forming under the skin around the anus. Internal piles are further classified into four stages based on their severity and symptoms.

Stage 1 Piles

Description

Stage 1 piles are the earliest and mildest form of internal piles. In this stage, the swollen veins remain inside the rectum and do not protrude out of the anus.

Symptoms

  • Small painless bleeding during or after passing stools

  • Blood may appear bright red on toilet paper or in the toilet bowl

  • Itching or slight discomfort inside the anus

  • Often no visible lump is seen

At this stage, piles can be managed effectively with lifestyle changes such as increasing water intake, consuming a high-fibre diet, and avoiding straining during bowel movements.

Stage 2 Piles

Description

In stage 2, the piles become larger and may come out of the anus while passing stools but return inside on their own after the bowel movement.

Symptoms

  • Painless bleeding similar to stage 1

  • A feeling of incomplete evacuation after passing stools

  • Mild swelling or a lump that protrudes during bowel movements but goes back inside on its own

  • Itching and irritation around the anus due to mucus discharge

Stage 2 piles can also be managed with dietary changes, medications, and minimally invasive procedures if symptoms worsen or persist.

Stage 3 Piles

Description

Stage 3 piles are more severe. In this stage, the piles prolapse out of the anus during bowel movements or physical activity and do not go back inside on their own. They need to be pushed back manually.

Symptoms

  • Bleeding during and after passing stools

  • A visible lump outside the anus that needs manual reduction

  • Pain, discomfort, and swelling around the anal area

  • Increased itching and irritation due to mucus leakage

  • Feeling of heaviness or a mass near the anus

At this stage, medical intervention is often required. Procedures like rubber band ligation, sclerotherapy, or laser treatment are recommended to treat stage 3 piles effectively.

Stage 4 Piles

Description

Stage 4 is the most advanced and severe stage of internal piles. In this stage, the piles remain permanently prolapsed outside the anus and cannot be pushed back inside.

Symptoms

  • Constant pain and discomfort

  • Continuous bleeding, which may lead to anemia if untreated

  • Large lump or mass outside the anus that stays protruded

  • Difficulty cleaning the area, leading to hygiene issues

  • Severe itching, irritation, and possible infection due to mucus discharge and constant exposure

Stage 4 piles often require surgical treatment, such as hemorrhoidectomy or stapler surgery, to remove the piles completely and relieve symptoms.

External Piles

While internal piles have four stages, external piles develop under the skin around the anus and are visible from the beginning. Symptoms of external piles include:

  • Pain or discomfort around the anus, especially while sitting

  • Swelling or lump formation

  • Itching and irritation

  • Bleeding in some cases

If a blood clot forms inside external piles, it leads to a painful condition called thrombosed hemorrhoid, which requires prompt medical treatment.

Conclusion

Understanding the stages of piles and their symptoms helps in identifying the severity of the condition and seeking timely treatment. Early stages can be managed with simple lifestyle changes and medications, while advanced stages may require medical or surgical intervention. If you experience persistent bleeding, pain, or discomfort, it is important to consult a doctor to get proper diagnosis and treatment to prevent complications and improve your quality of life. 


Location: Kochi, Kerala, India

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