Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
MBBS, MS, FMAS, FISCP, DMAS
- 8 Yrs
- ASCRS Member
Piles (haemorrhoids): causes, grades and treatment
Medically reviewed by
Dr. Samhitha Reddy, MS, FISCPConsultant Proctologist & Laparoscopic Surgeon
Last reviewed · 9 min read
Piles are swollen vascular cushions in the anal canal. Everyone has these cushions; they only become a problem when raised pressure makes them enlarge, bleed or prolapse.
Grading matters because it drives treatment. A grade 1 pile and a grade 4 pile are the same condition at very different stages.
What causes piles
- Chronic constipation and straining
- Long periods seated on the toilet
- Pregnancy and childbirth
- Chronic cough or heavy lifting
- Age-related weakening of supporting tissue
The four grades
1
Grade 1 — bleeding without prolapse
The pile stays inside the anal canal. Bleeding is usually the only symptom, and diet plus habit changes are often enough.
2
Grade 2 — prolapse that reduces on its own
The pile comes down on straining and returns by itself. Outpatient treatments such as banding are commonly used.
3
Grade 3 — prolapse needing manual reduction
The pile comes down and has to be pushed back. A day-care procedure is usually discussed at this stage.
4
Grade 4 — permanently prolapsed
The pile stays outside and cannot be reduced. Surgical treatment is normally required.
Speak to the proctology team
Daycare procedures, cashless insurance, and consultations seven days a week at Gachibowli.
Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
MBBS, MS, FMAS, FISCP, DMAS
8 YrsASCRS Member
Book AppointmentView Profile →Treatment options
Treatment follows the grade, the symptoms and how much they interfere with daily life.
- Fibre, fluids and toilet-habit changes for early grades
- Topical treatment for short-term symptom relief
- Rubber band ligation as an outpatient procedure
- Laser or stapled procedures as day care
- Conventional haemorrhoidectomy for advanced disease
Frequently asked questions
Do piles come back after treatment?
They can, particularly if the original cause — usually straining and constipation — has not changed. Diet and toilet habits matter as much after treatment as before.
Is laser treatment better than surgery?
Laser procedures generally mean less post-operative pain and a faster return to work, but they are not suitable for every grade. Your surgeon will match the method to the findings.
How long is recovery?
Day-care procedures usually mean home the same day and back to desk work within a few days. Open surgery for advanced piles takes longer.
Still unsure what is causing your symptoms?
A short consultation with a Lux proctology specialist can tell you what you are dealing with — and what, if anything, needs treating.
Gachibowli, Hyderabad · Seven days a week · Cashless insurance accepted
Sources & references
Published · Last reviewed · Next review due March 2027
This article is published for general education. It is not a diagnosis and does not replace an in-person consultation. If you are worried about a symptom, please speak to a qualified doctor.
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