Recognizing the Signs of
Piles (Hemorrhoids)

Early diagnosis leads to easier treatment. In India, many patients ignore painless bleeding until the condition worsens. Knowing what to look for can save you from surgery.

Medically Reviewed by Dr. Jaya Maheshwari
Last Updated: January 2025

Common Symptoms

01

Painless Bleeding

The most common sign. You may notice drops of bright red blood or a 'splash' in the toilet bowl during bowel movements. It is usually not painful.

02

Protruding Lumps (Massee)

Fleshy lumps that come out of the anus during defecation. In early stages, they go back in automatically; later, they may need to be pushed in manually.

03

Itching & Irritation

Persistent itching around the anal region (Pruritus Ani) caused by mucus discharge or moisture from the prolapsed hemorrhoids.

04

Discomfort or Dull Ache

While internal piles are often painless, you may feel heaviness or a sense that the bowel hasn't completely emptied.

05

Mucus Discharge

A slimy, sticky discharge often accompanies larger hemorrhoids, which can stain undergarments and cause hygiene issues.

06

Pain (In Specific Cases)

Pain usually occurs if the blood inside the pile clots (Thrombosed Piles) or if there is an associated Fissure.

Director's Interview

Is it Piles or Something Else?

Understanding Symptoms

"Pain is actually NOT the primary symptom of Piles. If there is severe pain, it is often a Fissure. Piles usually present with painless bleeding."

Dr. Jaya Maheshwari explains the difference between Piles bleeding and Fissure pain, and why you shouldn't ignore 'minor' symptoms.

Vice President IAGES (2020–2022)
Trained in Germany & USA
Pioneer of Laser Proctology
Now Watching: Dr. Jaya on Advanced Treatments

Internal vs. External Piles

Internal Piles

  • Located inside the rectum.
  • Usually painless.
  • Main symptom: Bright red blood.
  • May protrude (prolapse) when straining.

External Piles

  • Located under the skin around the anus.
  • Can be itchy or painful.
  • Can be felt as lumps/swelling.
  • Bleeding may occur if ruptured.

When to see a Doctor?

  • Bleeding continues for > 1 week
  • Blood is dark or black in color
  • Severe pain or fever occurs
  • Lightheadedness or dizziness
  • Sudden change in bowel habits

Don't ignore bleeding

Early detection prevents complications. Consult Dr. Jaya Maheshwari today.

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