Internal & External

PILES  is loss of elasticity of veins in the anal canal & lowermost part of rectum. It in seen in both the sexes. The chances of occurance increase with the age. Piles are classified as

  1.  Internal piles ( arising in the upper two-thirds of anal canal )
  2. External piles ( it is skin covered lower one-third of the canal or at anal opening) Intenal piles occurs due to obstruction in venous return from that part. Causes can be Hereditary, anatomical , physiological factors,constipation, diarrhea straining at stool, Inadequate fibre diet etc.

Grade 1

Painless Bleeding
Anal Discomfort

Pile may protrude while straining but not prolapsing

Grade 2

Painless Bleeding
Discharge, Itching

Prolapse visible at straining but spontaneously return to normal place when straining ends.

Grade 3

Painless Bleeding
Discharge, Itching

Prolapse has to be reduced manually.

Grade 4

Bleeding pain
Discharge, Itching

The piles always remain prolapsed.