Piles are the result of swollen veins in the lower anus and rectum. They can cause tissue growths in and around the anus and can lead to significant discomfort. These growths can vary in size and location.

Internal vs. external

Internal piles occur within the rectum and are usually not visible during an external examination. However, in some cases, an external pile may grow to protrude outside of the anus. The medical term for this is prolapsed hemorrhoid.

Medical professionals grade internal piles on a four-point scale.

• Grade I: The growth does not cause symptoms and does not protrude out of the anus.
• Grade II: The piles may prolapse from the anus but return inside independently.
• Grade III: The piles prolapse and only recede within the anus with manual intervention.
• Grade IV: The piles prolapse outside of the anus and a person cannot push them back in.

External piles form small lumps on the outside edge of the anus. They are very itchy and can become painful if a blood clot develops because the clot can block blood flow. Thrombosed external piles, or hemorrhoids that have clotted, require immediate medical treatment.

In most cases, the symptoms of piles are not serious and resolve on their own.

An individual with piles may experience the following symptoms:

• painful lumps in and around the anus
• itching and discomfort around the anus
• discomfort during and after passing stools
• bloody stools

Piles can escalate into a more severe condition. These include:

• excessive anal bleeding, possibly leading to anemia
• infection
• fecal incontinence
• anal fistula
• strangulated hemorrhoid, in which anal muscles cut off blood supply to the hemorrhoid