Piles (Hemorrhoids): Stages, Symptoms & Treatment
A concise patient-friendly overview to help you understand symptoms, severity, and what to do at each stage.
What are piles?
Piles (hemorrhoids) are swollen veins in the rectum or anus. They can be internal (inside the rectum) or external (under the skin around the anus). They are common and often linked to constipation, straining, low-fiber diets, pregnancy, and prolonged sitting.
General symptoms patients notice
- Itching or irritation around the anus
- Mild pain or discomfort, especially while sitting
- Bright red bleeding during or after bowel movements
- Swelling or a tender lump near the anus (more common in external piles)
- Mucus discharge after passing stool
- A feeling of incomplete evacuation
How symptom severity progresses
Stages & what to do
Stage 1: Mild hemorrhoids
Symptoms: Occasional bleeding, itching, mild discomfort.
What to do: High-fiber diet (fruits, vegetables, whole grains), drink plenty of water, avoid straining, consider sitz baths (warm water for 10–15 min), and over-the-counter creams/suppositories as advised by a clinician.
Stage 2: Protruding but self-reducing
Symptoms: Protrude during bowel movements but go back in spontaneously; bleeding/irritation more frequent.
What to do: Continue diet/hydration changes; topical relief for pain/swelling; consult a doctor if persistent—rubber band ligation or sclerotherapy are common minimally invasive options.
Stage 3: Prolapse needs manual reduction
Symptoms: Hemorrhoids come out and need to be gently pushed back.
What to do: Seek medical care. Office procedures like rubber band ligation or infrared coagulation may help; surgery may be considered if conservative measures fail.
Stage 4: Permanently prolapsed
Symptoms: Remain outside permanently; severe pain/bleeding; higher risk of thrombosis and infection.
What to do: Surgery is usually required—hemorrhoidectomy or stapled hemorrhoidopexy. Continue lifestyle measures to prevent recurrence.
Prevention tips
- Eat 25–35g fiber daily (fruits, vegetables, legumes, whole grains)
- Drink enough water throughout the day
- Exercise regularly; avoid prolonged sitting
- Don’t delay the urge to pass stool and avoid straining
- Limit time on the toilet (no phones/reading)
- Maintain good anal hygiene; consider warm sitz baths for comfort
When should you see a doctor?
- Bleeding that is heavy, recurrent, or accompanied by dizziness/weakness
- Severe pain, a hard/tender lump (possible clot), or fever
- Symptoms persist beyond 1–2 weeks despite home care
- If you are over 40 or have risk factors—rule out other causes of bleeding
FAQs
Can piles go away on their own?
Mild cases often improve with diet, hydration, and avoiding strain. Persistent or advanced cases need medical treatment.
Which doctor should I consult?
Start with a general surgeon, colorectal surgeon, or a gastroenterologist for evaluation and treatment options.
Are home remedies enough?
They help in early stages. If symptoms persist or worsen (Stage 2–4), seek medical care.