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Haemorrhoids or piles are dilated blood vessels in and about the anus and lower rectum. This is common in pregnancy, and after labour. It’s likely that extreme abdominal pressure causes the veins to swell and become susceptible to irritation. The pressure can be caused by obesity, pregnancy, standing or sitting for long periods, straining on the toilet, coughing, sneezing, vomiting, and holding your breath while straining to do physical labour.


1. External (outside) hemorrhoids develop near the anus and are covered by skin which is sensitive. Generally painless.
If a blood clot (thrombosis) develops in an external hemorrhoid, it becomes a painful and a hard lump is formed. It may bleed if the external piles ruptures.
2 .Internal (inside) hemorrhoids develop within the anus. Common symptom is protrusion and painless bleeding during the bowel movement. An internal hemorrhoid can cause severe pain if it is completely “prolapsed” – protrudes from the anal opening and cannot be pushed back inside.

*There are four grades-

1. First degree piles – small swellings on inside lining of the anus. They cannot be seen or felt outside the anus. It may itch because of poor anal hygiene.
2. Second degree piles – partially pushed out ( prolapse), they are usually painless and spontaneously return to the anal canal following defecation.
3. Third degree piles – prolapse from the anus and are felt as one or more small soft lumps outside the anus. They can be pushed back inside the anus with a finger. They cause constant discomfort and prolapse in response to any increase in intra-abdominal pressure.
4. Fourth degree piles – Permanently present outside the anus and cannot be pushed back inside. They are sometimes become quite large.


1. Bleeding of bright red blood from the anus. Blood may streak the bowel movement or the toilet paper.
2. Soreness, pain, itching in the anal region.
3. Painful swelling or a lump near the anus.
4. If there is constant loss of blood per rectum, may lead to anemia.

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