Hemorrhoids, commonly known as piles, are swollen veins in the rectum and anus that can cause discomfort, itching, and bleeding. They are a prevalent condition affecting millions of people worldwide, especially those with chronic constipation, prolonged sitting habits, or pregnancy-related pressure.
Many people experience hemorrhoids at some point in their lives, but not all hemorrhoids are the same. They can be classified into different types and stages, each requiring specific treatment approaches.
In this comprehensive guide, we will discuss:
✅ Types of hemorrhoids – Internal, external, thrombosed, and prolapsed.
✅ Stages of hemorrhoids – Grading system of internal hemorrhoids.
✅ Symptoms, causes, and treatment options for each type.
By the end of this article, you’ll have a thorough understanding of hemorrhoids and how to manage them effectively.
What Are Hemorrhoids?
Hemorrhoids are swollen blood vessels located in the lower rectum and anal region. They develop due to increased pressure on the veins, leading to inflammation, swelling, and discomfort.
Common Causes of Hemorrhoids
🔹 Straining during bowel movements (due to constipation).
🔹 Sitting for long hours, especially on hard surfaces.
🔹 Obesity (increased abdominal pressure).
🔹 Pregnancy and childbirth.
🔹 Chronic diarrhea.
🔹 Aging (weakening of anal tissues).
🔹 Low-fiber diet (leading to hard stools).
Types of Hemorrhoids
Hemorrhoids are mainly classified into four types:
1. Internal Hemorrhoids
🔹 Located inside the rectum and are usually painless.
🔹 Often discovered only when they cause bleeding during bowel movements.
🔹 Can protrude (prolapse) out of the anus in severe cases.
🔹 Common Symptoms:
✅ Painless rectal bleeding (bright red blood on toilet paper).
✅ Mucus discharge.
✅ Feeling of incomplete bowel evacuation.
2. External Hemorrhoids
🔹 Found under the skin around the anus.
🔹 More painful than internal hemorrhoids due to nerve endings in the area.
🔹 Can cause itching, discomfort, and swelling.
🔹 Common Symptoms:
✅ Pain and irritation near the anal opening.
✅ Swelling and lumps around the anus.
✅ Itching and discomfort.
3. Thrombosed Hemorrhoids (Severe External Hemorrhoids)
🔹 Develop when blood pools inside an external hemorrhoid, forming a painful clot (thrombus).
🔹 Can cause intense pain, swelling, and bluish discoloration.
🔹 Common Symptoms:
✅ Sudden severe pain in the anal area.
✅ Hard, swollen lump near the anus.
✅ Dark blue or purple coloration due to clot formation.
✅ Bleeding after rupture of the clot.
4. Prolapsed Hemorrhoids (Advanced Internal Hemorrhoids)
🔹 Occur when internal hemorrhoids protrude out of the anus.
🔹 Can be pushed back inside manually in early stages but may require surgery if severe.
🔹 Common Symptoms:
✅ Bulging hemorrhoid outside the anus (may retract on its own or need manual adjustment).
✅ Pain and discomfort while sitting or during bowel movements.
✅ Mucus discharge and skin irritation.
Stages of Internal Hemorrhoids (Grading System)
Internal hemorrhoids are classified into four grades based on severity:
Grade 1:
🔹 Small, internal hemorrhoids that do not protrude outside.
🔹 Mild bleeding may occur but no pain.
🔹 Can be managed with dietary changes and home remedies.
Grade 2:
🔹 Hemorrhoids that prolapse outside during bowel movements but retract on their own.
🔹 May cause mild discomfort but can be treated with lifestyle modifications and medications.
Grade 3:
🔹 Prolapsed hemorrhoids that do not retract on their own and need to be manually pushed back inside.
🔹 Increased pain, irritation, and bleeding.
🔹 Treatment: Minimally invasive procedures like rubber band ligation or sclerotherapy.
Grade 4:
🔹 Severely prolapsed hemorrhoids that remain outside permanently.
🔹 Severe pain, irritation, bleeding, and risk of infection.
🔹 Surgical treatment (hemorrhoidectomy or stapling) is often required.
Treatment Options for Hemorrhoids
Treatment depends on the type and severity of hemorrhoids.
1. Home Remedies for Mild Hemorrhoids (Grade 1 & 2)
✅ Increase fiber intake (eat fruits, vegetables, whole grains).
✅ Drink plenty of water (prevents constipation).
✅ Use Sitz baths (soaking in warm water for 15-20 minutes).
✅ Avoid straining during bowel movements.
✅ Apply topical creams (hydrocortisone, witch hazel).
2. Medical Treatments for Moderate to Severe Hemorrhoids (Grade 3 & 4)
✔ Rubber Band Ligation – A band is placed around the hemorrhoid to cut off blood supply.
✔ Sclerotherapy – A chemical solution is injected to shrink hemorrhoids.
✔ Infrared Coagulation – Uses heat to shrink hemorrhoids.
✔ Laser Therapy – A minimally invasive procedure using laser energy to shrink and seal hemorrhoids with less pain and faster recovery.
✔ Hemorrhoidectomy – Surgical removal for severe cases.
✔ Stapled Hemorrhoidopexy – A less painful surgical option to reposition hemorrhoids.
Preventing Hemorrhoids
✔ Eat high-fiber foods to prevent constipation.
✔ Stay hydrated – Drink at least 8-10 glasses of water daily.
✔ Exercise regularly to promote bowel movements.
✔ Avoid prolonged sitting – Take breaks if you have a desk job.
✔ Use proper toilet habits – Avoid straining and do not delay bowel movements.
Hemorrhoids are a common yet treatable condition that can cause discomfort and pain if not managed properly. Understanding the types, stages, symptoms, and treatment options can help you take the right steps toward relief.
If you experience persistent hemorrhoid symptoms, consult a proctologist or colorectal specialist for the best treatment plan.
FAQs
1. Do hemorrhoids go away on their own?
Mild hemorrhoids (Grade 1 & 2) often resolve with home remedies, but severe cases (Grade 3 & 4) may require medical treatment or surgery.
2. How long do hemorrhoids last?
Mild hemorrhoids may heal within a few days to a week, while severe or prolapsed hemorrhoids may persist longer and require medical intervention.
3. When should I see a doctor for hemorrhoids?
See a doctor if you experience severe pain, persistent bleeding, or prolapsed hemorrhoids that do not retract.
