Piles, also known as hemorrhoids, are swollen veins in the rectal or anal area. There are two main types: internal piles and external piles, and they differ based on their location, symptoms, and treatment approaches.
Internal Piles
Internal piles occur within the rectum, situated above the dentate line, which serves as an internal demarcation in the anal canal.
Characteristics:
- May result in painless bleeding during bowel movements, often presenting as bright red blood.
- Typically painless due to the lower concentration of pain-sensitive nerves in the rectum.
- In more advanced cases, they may protrude from the anus (prolapse).
- Classified into four grades (I to IV) based on severity and the extent of prolapse.
Symptoms:
- A sensation of incomplete bowel evacuation.
- Mucus discharge.
- Bleeding following stool passage.
- A noticeable lump in more severe instances.
External Piles
External piles form outside the anus, beneath the skin surrounding the anal opening.
Characteristics:
- Can be painful, particularly if a blood clot (thrombosis) occurs.
- Easily identifiable as lumps or swelling around the anal area.
- More prone to causing itching, irritation, and discomfort.
Symptoms:
- Itching or a burning sensation.
- Pain and swelling in the anal region.
- Possible bleeding if the skin becomes irritated or ruptured.
- Firm lumps near the anal opening.
Key Difference between Internal and External Piles
| Feature | Internal Piles | External Piles |
| Location | Inside the rectum | Around the anus |
| Pain | Usually painless | Often painful |
| Bleeding | Bright red, painless | Less common unless ruptured |
| Visibility | Not visible unless prolapsed | Visible and can be felt as a lump |
Final Thoughts
Both internal piles and external piles can be managed effectively with lifestyle changes, medications, and natural remedies. Severe or persistent piles may need medical treatment or minor procedures.
