Symptoms and causes of hemorrhoids (piles)

Symptoms and causes of hemorrhoids (piles)

Hemorrhoids (piles) are warty swellings formed in the inside of the anus, which are the most common type of hemorrhoids. There are internal hemorrhoids formed above the dentate line at the border between the rectum and the skin area of the anus and external hemorrhoids formed in the anal epithelium below the dentate line.

2 types of hemorrhoids you should know.

2 types of hemorrhoids you should know.


Internal hemorrhoids

Usually, bleeding occurs at the time of a bowel movement but you do not feel pain. Hemorrhoids may come out of the anus depending on the degree.

*Some internal hemorrhoids are accompanied by severe pain.

External hemorrhoids

You feel pain. If it gets worse, a blood clot will be formed and cause severe pain.


Internal hemorrhoids, external hemorrhoids

It is mainly caused by the burden on the cushion part of the anus due to straining at the time of a bowel movement, constipation, or diarrhea, and other stress. Also blood circulation in the anal region becomes poor, and symptoms are exacerbated by congestion and swelling.

Internal hemorrhoids are classified into Grade I to IV according to the degree of prolapse.

  • Grade I Initial stage: There is no prolapse of hemorrhoids and no pain. Bleeding occurs while having a bowel movement.
  • Grade II A hemorrhoid prolapses at the time of a bowel movement but returns into the anus spontaneously.
  • Grade III It prolapses and does not return without pushing it back with the fingers.
  • Grade IV It does not return into the anus even if it is pushed back with the fingers. Mucus often oozes. Pain and bleeding disappear. Always have itching or discomfort.
This article is supervised by:
Dr. Junichi Iwadare
Dr. Akio Kurokawa
Dr. Rikisaburo Sahara
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