Symptoms
- Bright red blood on the toilet paper or in the pan after passing stool.
- A lump or swelling at the anus that may come out during stool.
- Itching, discomfort or a feeling of incomplete emptying.
- Sudden severe pain with a hard blue lump (thrombosed external pile).
Grades of internal piles
| Grade | Description | Typical treatment |
|---|---|---|
| I | Bleed, but do not come out | Diet, fibre, medicines |
| II | Come out on straining, go back on their own | Banding, sclerotherapy, laser |
| III | Come out and need to be pushed back | Banding, laser, stapler or surgery |
| IV | Remain outside, cannot be pushed back | Haemorrhoidectomy |
Home care
- Eat 25–30 g of fibre a day (fruits, vegetables, whole grains, psyllium husk) and drink 2–3 litres of water.
- Do not strain or sit on the toilet for long – avoid reading or phones in the toilet.
- Warm sitz baths for 10–15 minutes, two or three times a day.
- Short courses of soothing creams and venotonic tablets as prescribed.
Procedures
Rubber band ligation
A small band is placed at the base of the pile in the clinic; the pile shrinks and falls off within a week. Quick, with no anaesthesia needed – often the first choice for grade II–III piles.
Laser haemorrhoidoplasty (LHP)
Laser energy shrinks the pile from within, with minimal cutting and usually less pain than conventional surgery. Suitable for grade II–III piles.
Stapled haemorrhoidopexy (MIPH)
A circular stapler lifts the piles back into position and reduces their blood supply. Less painful than open surgery, though recurrence is somewhat higher.
Haemorrhoidal artery ligation (DGHAL/THD)
Doppler guidance is used to tie off the arteries feeding the piles, with or without stitching the prolapse back up.
Open or closed haemorrhoidectomy
Surgical removal remains the most effective long-term treatment for large grade IV or mixed piles, at the cost of more post-operative pain and 2–3 weeks of recovery.
Frequently asked questions
Is laser piles surgery permanent?
Laser treatment works well for suitable grades, but piles can recur if constipation and straining continue. Diet and bowel habits are key to lasting results.
Can piles turn into cancer?
No. Piles do not become cancer, but cancer can cause similar bleeding, which is why examination is important.
How long is recovery?
Banding: same day. Laser or stapler: 2–5 days. Open haemorrhoidectomy: 2–3 weeks.
Last reviewed: October 2026. This page is general information and does not replace advice from your own doctor.