Piles (Haemorrhoids)

Grade 1

Grade 1 piles are small swellings on the inside lining of the anal canal that cannot be seen or felt from the outside. They do not prolapse or protrude out of the anus. These are common and can be diagnosed using a proctoscope during a proctoscopy.

Grade 1 piles are usually treated with medications or topical suppositories.

Suppositories are a type of topical medicine meant to be inserted into the rectum, where they dissolve and are absorbed through the lining of the rectum. Your doctor may prescribe constipation medications to prevent your piles from recurring.

Due to the small size of Grade 1 piles, no surgical intervention is necessary.

Grade 2

Grade 2 haemorrhoids are internal haemorrhoids that prolapse but then go back inside the anal canal spontaneously without interference.

For Grade 2 haemorrhoids, doctors will often try conservative treatment therapies, such as painless in-office treatment procedures like rubber band ligation, injection sclerotherapy, or infrared coagulation. These treatments are performed on internal prolapsed haemorrhoids only, not external haemorrhoids. While these treatments for Grade 2 haemorrhoids usually last from six months to a year before they need to be repeated, results have shown that they can be effective on many patients and are done without anaesthesia and cause minimal discomfort.

Grades 3 and 4

Grade 3 – Haemorrhoid protrudes through the anus during straining or evacuation but needs to be manually returned to position.

Grade 4 – Hemorrhoid remains prolapsed outside of the anus and cannot be manually returned to position.

For treatment of Grade 3 and Grade 4 haemorrhoids, doctors will recommend surgical treatments. The most common surgical treatments are surgical haemorrhoid excision and surgical haemorrhoid stapling procedure.