Piles are enlarged veins in the lower anus and rectum.Piles can cause localised tissue overgrowth and inflammation of the surrounding tissues. Hemorrhoids is another name to piles.

Piles can be of two types:

Internal piles which develop within the rectum and are typically invisible to the naked eye.

External pile (Prolapsed haemorrhoid) which develops from the anus. 

Sometimes, internal and external piles can occur at the same time. Internal piles are rated by medical specialists on a four-point scale as: 

Grade I: Asymptomatic and the growth does not rotrude out of the anus.

Grade II: The piles might prolapse from the anus but return inside on their own.

Grade III: The piles prolapse and only reverts back into the anus with manual intervention.

Grade IV: The piles prolapse out of anus and patient cannot push them back.

Symptoms of piles:

  • Bright red blood in the stools
  • Itching in the anus
  • Mucus and lumps around the anus
  • Pain around anus

How long do piles last?

Piles usually occurs in flare-ups and get better on their own after a few days. Sometimes large external piles may take longer to heal and may require medical management.

Diagnosis: A doctor can diagnose piles after doing a physical examination


Medical management: Many medication choices are available to help manage the symptoms of piles like painkillers, stool softeners and corticosteroids. 

Surgical management 

Banding: The surgeon wraps an elastic band around the pile’s base to stop the pile’s blood supply. Usually, the piles will disappear after a week.

Sclerotherapy: This procedure involves a doctor injecting a medication into the piles to cause it to contract and eventually shrivel up. This works well as an alternative to bands for grade II and III haemorrhoids.

Infrared coagulation: Using an infrared light source, a surgeon will burn the haemorrhoid tissue during the infrared coagulation technique.

Hemorrhoidectomy: In this procedure, all hemorrhagic tissue is removed. 

Haemorrhoid stapling: In this surgery, a surgeon uses staples to stop the blood supply to the area that has the haemorrhage.

Doctor would carefully evaluate the clinical condition of the patient to decide whether the patient needs a medical management or surgical management. 

Dr. Giridhar Reddy
Consultant Gastroenterologist

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