Piles, commonly known as hemorrhoids, are a prevalent medical condition that affects a large portion of the population. While many people may experience discomfort or pain associated with piles, not everyone is familiar with the different types – internal and external. In this blog post, we will delve into the intricacies of these two variations, exploring their causes, symptoms, and potential treatment options.


Internal Piles:

Internal piles are hemorrhoids that develop inside the rectum or anal canal, making them less visible than their external counterparts. There are four stages of internal piles, ranging from mild to severe:

1. **First Degree:**
– These are piles that bleed but do not prolapse, meaning they do not extend outside the anal opening.
– Symptoms may include bright red blood during bowel movements and a feeling of discomfort.

2. **Second Degree:**
– Piles at this stage may prolapse during a bowel movement but retract on their own.
– Patients may experience bleeding and a sensation of fullness or discomfort.

3. **Third Degree:**
– Prolapsed piles that need to be pushed back in manually.
– Bleeding, discomfort, and a feeling of incomplete evacuation may be present.

4. **Fourth Degree:**
– Piles that consistently prolapse and cannot be pushed back in.
– Severe bleeding, pain, and difficulty with hygiene are common symptoms.

External Piles:

External piles are located outside the anal opening and are generally more visible than internal piles. Unlike internal piles, external piles are covered with skin and can be felt or seen. Key characteristics include:

1. **Appearance:**
– External piles often appear as soft lumps around the anus.
– They can be accompanied by swelling, itching, and irritation.

2. **Thrombosis:**
– External piles can become thrombosed, meaning a blood clot forms within the hemorrhoid.
– This can lead to severe pain, swelling, and inflammation.

Symptoms Common to Both Types:

1. **Bleeding:**
– One of the most common symptoms associated with both internal and external piles is bleeding during bowel movements.

2. **Discomfort and Pain:**
– Discomfort, itching, and pain are prevalent symptoms, especially during bowel movements.

3. **Hygiene Challenges:**
– Maintaining proper hygiene can be challenging, leading to further irritation and discomfort.

Treatment Options:

1. **Lifestyle Changes:**
– Dietary modifications, including increased fiber intake and adequate hydration, can alleviate symptoms.

2. **Topical Medications:**
– Over-the-counter creams and ointments may provide relief from itching and inflammation.

3. **Sitz Baths:**
– Soaking the affected area in warm water can reduce swelling and promote healing.

4. **Medical Procedures:**
– In severe cases, medical procedures such as rubber band ligation, sclerotherapy, or surgical removal may be recommended.


Understanding the differences between internal and external piles is crucial for proper diagnosis and treatment. While milder cases can often be managed with lifestyle changes and conservative measures, consulting with a healthcare professional is essential for more severe or persistent symptoms. Remember, early intervention and proactive management can significantly improve the quality of life for those dealing with piles.