Piles, or hemorrhoids, are a common health concern that affects millions of people worldwide. Though often dismissed as a minor inconvenience, piles can cause significant discomfort and disrupt daily life. To properly manage and treat them, it’s essential to understand that there are two main types: internal and external piles.
While both are caused by swollen blood vessels in the rectal area, their symptoms, severity, and treatment approaches can vary. This blog will walk you through the key differences between internal and external piles, their causes, and how to find relief, including the role of natural remedies like Him Arogya PILEXA.
What Are Piles?
Piles, or hemorrhoids, are swollen veins in the lower part of the rectum and anus. They occur when pressure builds up in this area, causing the veins to stretch, swell, and sometimes bulge outward. Hemorrhoids can be either internal (inside the rectum) or external (under the skin around the anus).
Internal Piles
Internal piles are located inside the rectum and are usually not visible. Because the rectum has fewer pain-sensitive nerves, internal piles typically cause painless rectal bleeding. You might notice bright red blood on toilet paper or in the toilet bowl after a bowel movement.
However, internal piles can also prolapse, meaning they push out through the anus. Prolapsed piles may cause discomfort or irritation, especially if they do not retract on their own.
Common symptoms of internal piles include:
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Bright red bleeding during or after bowel movements
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A feeling of incomplete evacuation
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Prolapsed tissue coming out of the anus
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Mild discomfort or irritation if the piles protrude
Internal piles are often classified into four grades based on their severity:
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Grade I: No prolapse; slight swelling
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Grade II: Prolapse during straining, but retracts on its own
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Grade III: Prolapsed and requires manual repositioning
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Grade IV: Permanently prolapsed and may need surgery
External Piles
External piles develop under the skin around the anus and are more likely to cause pain and discomfort. These piles are usually visible or can be felt as lumps near the anal opening.
Since the skin in this area contains more nerve endings, external hemorrhoids can be painful, itchy, or swollen. If a blood clot forms in one of these piles (a condition known as a thrombosed external hemorrhoid), the pain can be severe and sudden.
Common symptoms of external piles include:
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Pain or discomfort when sitting or during bowel movements
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Itching or irritation around the anus
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Swelling or a hard lump near the anal opening
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Bleeding, although less common than with internal piles
What Causes Piles?
Internal and external piles share the same underlying causes. These include:
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Chronic constipation or diarrhea
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Straining during bowel movements
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Sitting for long periods, especially on the toilet
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Low-fiber diets
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Obesity
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Aging, which weakens rectal tissues
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Pregnancy, which increases abdominal pressure
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Lack of physical activity
These factors increase pressure in the rectal veins, which can lead to swelling, irritation, and ultimately the formation of piles.
Diagnosis and When to See a Doctor
If you’re experiencing symptoms like rectal bleeding, persistent pain, or lumps near the anus, it’s important to see a healthcare provider. Proper diagnosis will confirm whether the issue is internal or external piles—or another condition like an anal fissure, infection, or colorectal disease.
Diagnosis may include:
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A visual examination (for external piles)
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A digital rectal exam
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Anoscopy or sigmoidoscopy (to inspect internal piles)
Timely diagnosis helps determine the best treatment approach and prevents complications.
Treatment Options
1. Lifestyle Changes
The first step in treating both types of piles is addressing the root causes through lifestyle:
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Eat a high-fiber diet with fruits, vegetables, and whole grains
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Drink plenty of water to prevent hard stools
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Exercise regularly to stimulate digestion
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Avoid straining or sitting too long on the toilet
2. Home Remedies
For mild cases, home care may be sufficient:
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Warm sitz baths to reduce inflammation and soothe discomfort
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Cold compresses to alleviate swelling
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Topical creams to relieve itching and pain
3. Herbal Support
Natural remedies are gaining popularity for their gentle, non-invasive approach. Him Arogya PILEXA, a trusted herbal formulation, is designed to support relief from piles through a blend of Ayurvedic ingredients. It helps reduce inflammation, ease bowel movements, and support rectal health without harsh chemicals or side effects.
4. Medical Procedures
For more severe cases or persistent symptoms, medical treatment may include:
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Rubber band ligation (for internal piles)
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Sclerotherapy (injection to shrink the hemorrhoid)
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Infrared coagulation
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Hemorrhoidectomy (surgical removal, for Grade IV piles or thrombosed external piles)
Final Thoughts
Understanding the difference between internal and external piles is essential for effective treatment and long-term relief. Internal piles often cause painless bleeding, while external piles are more associated with pain, irritation, and visible swelling. Despite their differences, both types can often be managed with the right diet, healthy habits, and early intervention.
If you're looking for a natural solution to support your recovery, Him Arogya PILEXA offers a trusted, plant-based approach to hemorrhoid care. Whether you're dealing with discomfort, inflammation, or digestive imbalance, PILEXA helps restore comfort and improve bowel health, without the side effects of chemical medications.
With awareness, timely care, and the right treatment, piles don't have to control your life. Take the first step toward relief and lasting wellness today.
