Haemorrhoids (Piles): Symptoms, Grades and Treatment Options

Haemorrhoids are swollen blood vessels in and around the back passage. They're extremely common and, while uncomfortable, usually very treatable.

Symptoms

Typical symptoms include bright red bleeding, itching, a feeling of a lump, discomfort, and sometimes a prolapse — where internal piles come down through the anus.

How they're graded

Internal haemorrhoids are graded by how far they prolapse:

• Grade I — don't prolapse; may bleed.
• Grade II — prolapse on straining but return on their own.
• Grade III — prolapse and need pushing back manually.
• Grade IV — remain prolapsed.

External haemorrhoids form under the skin at the anal opening and can be painful, especially if a clot forms (a thrombosed pile).

Treatment options

Treatment is tailored to grade and symptoms:

• Lifestyle: more fibre and fluids to soften stools and reduce straining — often enough for mild cases.
• Topical treatments to ease symptoms.
• Rubber band ligation: a quick outpatient procedure for many internal piles.
• Other office procedures such as injection (sclerotherapy).
• Surgery (haemorrhoidectomy or related procedures) for larger or persistent piles.

The takeaway

Most piles settle with simple measures or minor procedures; surgery is reserved for those that don't. A proper assessment matches the treatment to the problem.

This article provides general information and is not a substitute for individual medical advice. Please consult a qualified clinician about your own circumstances.