Stages of Hemorrhoids

Hemorrhoids are inflammation or dilation of clusters of veins in the rectum or the anal region. Due to the swelling of the veins, there is a pooling of blood thus causing them to push outward into the membranes in these regions. This can cause tremendous irritation, discomfort and pain. Hemorrhoids may not be visible always. However, when they expand they may appear reddish in colour or be seen as discoloured lumps. Hemorrhoids are commonly known as piles.


Hemorrhoids may swell when the veins enlarge and their walls are stretched and irritated by the passing stool. They are broadly classified as internal and external hemorrhoids based on their origin:
  1. Internal Hemorrhoids originate in the rectum and tend to be less painful. Symptoms include blood in the stools and prolapsed or bulged tissue outside the anal opening.  Prolapsed hemorrhoids are a more severe and painful form of this type.
  2. External Hemorrhoids are under the skin in the anal region and are more likely to be painful. The symptoms experienced in this case include bleeding, pain, itching sensation and swelling. Thrombosed hemorrhoids are external ones that have formed a blood clot and may cause intense itching and burning.

Causes of Hemorrhoids
  • Overweight and obesity
  • Pregnancy
  • Intensive coughing and sneezing
  • Consumption of low-fibre diet
  • Acute constipation and diarrhoea
  • Vomiting
  • Sitting or standing for prolonged periods

Stages of Hemorrhoids
  1. First Degree – Here, the hemorrhoids are slightly enlarged but do not protrude and are not prolapsed. They may cause bleeding though.
  2. Second Degree - The hemorrhoids in this stage prolapse and retract on their own with or without bleeding. They are likely to come out during the passage of stools but go back inside the body later.
  3. Third Degree - In this stage, the hemorrhoids prolapse and need to be pushed back using the fingers.
  4. Fourth Degree - The hemorrhoids here are prolapsed and cannot be pushed back easily. Most thrombosed hemorrhoids are in this stage. Other fourth-degree hemorrhoids include those that pull the rectum lining through the anus.

Hemorrhoid Treatment
  • Home Remedies - The following tips may be useful for treating hemorrhoids at home when there are mild symptoms:
  • Consuming healthy food that is rich in fibre content.
  • Using stool softeners and fibre supplements.
  • Being well-hydrated by drinking water and other fluids.
  • Using over the counter medications for pain relief, creams and suppositories.
  • Not getting strained during bowel movements.
  • Taking sitz bath by sitting in a warm tub of water for getting relief from pain.
  • Using cold compress using an ice pack for pain relief and reduction of inflammation.

  • Medical Intervention – Hemorrhoids Treatment Doctor may recommend procedures for removal when there is extreme pain and also to avoid complications. These interventions may be done in outpatient clinics or hospitals.
  • Rubber band litigation where the doctor places a special rubber band at the hemorrhoid base to cut off the blood circulation so that it falls off.
  • Sclerotherapy in which a solution is injected to create a scar tissue to shrink the hemorrhoid.
  • Photocoagulation where infrared light is directed on an internal hemorrhoid to create scar tissue and shrink it.
  • Electrocoagulation that uses a guided tool that passes current to shrink the hemorrhoid.
  • Stapling method, a surgery that involves a special stapling tool to remove the internal hemorrhoid tissue. The prolapsed part is subsequently pulled back to the anus by the surgeon.
  • Hemorrhoidectomy, a surgical process that is used to remove big external hemorrhoids and prolapsing internal types that have not responded to other forms of treatments earlier.

Prevention of Hemorrhoids
  • Eat foods endowed with high-fibre content to prevent constipation.
  • Avoid lifting heavy objects on a regular basis.
  • Drink lots of water and other healthy beverages daily to avoid dehydration.
  • Do not strain yourself while passing stools.
  • Avoid sitting in the toilet for long time intervals.

For more information on hemorrhoids or piles and their effective treatment, please consult this piles specialist clinic.


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