Piles are classified into 4 grades based on severity and prolapse (how much they come out). Identifying the correct grade is crucial because Grade 1 & 2 can often be treated without surgery, while Grade 3 & 4 usually require Laser or Surgical intervention.
Doctors decide the treatment method primarily based on the grade. For example, Laser Treatment is highly effective for Grade 2 and early Grade 3, whereas advanced Grade 4 might need a combination of therapies.
Internal hemorrhoids are small swellings inside the lining of the anus. They cannot be seen or felt from outside.
The hemorrhoids are larger. They may come out (prolapse) when you go to the toilet but go back in on their own afterward.
Prolapsed hemorrhoids that hang out and do not go back in on their own. You have to push them back in with your fingers.
The hemorrhoids are permanently hanging out and cannot be pushed back in. They may become swollen and very painful.
Expert Explanation
"Patients often confuse Grade 2 and 3. The key difference is whether the lump goes back inside automatically or if you have to push it."
Dr. Jaya Maheshwari demonstrates the differences between grades using diagrams and explains which grade requires surgery and which can be treated with medicine.
Grade 1 & 2
Diet, Medication & Laser Treatment (MIVL)
Grade 3
Laser Hemorrhoidoplasty (LHP)
Grade 4
Stapler Surgery or Combination Therapy
Treating piles at Grade 1 or 2 is much easier and painless compared to Grade 4.
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