Piles (or haemorrhoids) are vascular tissue or ‘cushions’ located in the anal canal. They form part of the normal human anatomy, and function to help prevent leakage of stool or gas. Piles become problematic (haemorrhoidal disease) when they swell up and/or bleed during defaecation.
Piles can be classified into four grades:
- First degree. Internal piles that bleed, but do not prolapse past the anus (or ‘pop out’).
- Second degree. Piles that prolapse past the anus during bowel movement but reduce spontaneously.
- Third degree. Piles that are prolapsed and must be manually reduced.
- Fourth degree. Piles that are permanently prolapsed and cannot be reduced, or piles with painful blood clots.