Hemorrhoids are one of the most common conditions experienced. It is considered non-life-threatening by professionals. Hemorrhoids are swollen veins that occur in the rectum or anus. They are also called piles.

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Hemorrhoids are genetic and can occur due to excessive pressure or strain in the lower rectum. There are two types of hemorrhoids: internal hemorrhoids and external hemorrhoids.

Internal hemorrhoids occur inside the rectum and cannot be seen with naked eyes. However, internal hemorrhoids can be pushed down during bowel movements and protrude through the anus. This condition is called prolapsed internal hemorrhoids.

External hemorrhoids are piles that grow around the anus and are visible through naked eyes.

Hemorrhoids Symptoms

Internal hemorrhoids are generally less painful as there are fewer pain nerves in the area. Here are the symptoms of internal hemorrhoids:

  • Bleeding on the stool
  • Generally painless

Prolapsed hemorrhoids have these symptoms:

  • The lump that can be felt when wiping the area
  • Pain during bowel movement
  • Bleeding during bowel movement
  • Severe itching
  • Irritation, discomfort, or pain when sitting down

External hemorrhoids, on the other hand, are more painful and have these symptoms:

  • The lump that can be felt and seen around the anus
  • Pain when straining
  • Bleeding during bowel movement
  • Severe itchiness

Diagnosing Internal Hemorrhoids

Diagnosis of internal hemorrhoids is done by medical professionals. A specialist will examine the rectum and anus to see if there are prolapsed and external hemorrhoids.

There are 4 grades of hemorrhoids depending on the severity:

Grade I: piles are prominent and bleeding may occur, but hemorrhoids do not protrude outside the anus

Grade II: Piles protrudes outside the canal due to straining, bleeding may occur. Piles normally retract back inside by itself

Grade III: Piles are prominent and protrude outside the anal canal and have to be pushed back in manually by yourself or by a doctor

Grade IV: Happens when prolapsed hemorrhoids cannot be pushed back in and require further medical procedures for treatment

During the examination, the doctor may insert a small tube with a camera to check for internal hemorrhoids. Because hemorrhoid symptoms are often mistaken as other serious medical conditions, the doctors might also check for colorectal cancer risk factors.


Generally, anal piles disappear on their own with an improved lifestyle. Mild hemorrhoids typically occur and disappear within one week. However, if symptoms persist despite over-the-counter medications, consult a specialist.

There are several home remedies for anal piles such as:

  • Fibre-foods: used to soften the stool, which eventually reduce straining during bowel movements
  • Topical treatments such as hemorrhoid cream that contains hydrocortisone
  • Regularly soaking in warm water to soothe the pain and itch

Aside from these remedies, if symptoms persist typically there are procedures to treat piles. The most common procedures are:

  • Rubber band ligation: During this procedure, the doctor will apply two or more rubber bands to the piles to cut off its circulation. With this procedure, the piles will then drop on their own during bowel movements. Rubber band ligation is only for internal piles
  • Sclerotherapy: the doctor will inject a chemical solution into the hemorrhoids to shrink it

When To See A Doctor?

If you have persistent symptoms or severe piles, visit a specialist to consider the best option to remove the hemorrhoids.

Go to Okadoc.com or download our mobile app, and choose your preferred method of meeting your Gastroenterologist.