What are the symptoms?
When piles flare up, they can cause itching, burning, pain, swelling and bleeding. They may seriously impair quality of life, as they become worse.
There are the typical symptoms for internal hemorrhoids:
- bright red blood during and after bowel movement and on toilet paper
- prolapse when internal hemorrhoids go or stay outside the anus
- un-painful swelling from anal canal
- an itching or burning sensation in the anal region, especially
while sitting and during the night
There are the typical symptoms for external hemorrhoids:
- permanent pain, increasing when sitting
- painful margin swelling
- un-painful swelling from anal margin
It is important to know that very frequent bleeding may also lead to anemia, i.e. a deficiency of red blood cells.But anemia associated with hemorrhoids is rare and needs systematic intestinal explorations.
First degree: Symptoms may occur
Hemorrhoids bleed, but do not prolapse. They are only seen at proctoscopy.
Second degree: Symptoms increase
Hemorrhoids protrude beyond the edge of the anal orifice during straining at stool and show spontaneous reposition when straining ceases. (Symptoms at this stage may consist of bleeding, itching, burning, and weeping.)
Third degree: Hemorrhoids do not retract on their own
Hemorrhoids protrude on straining and require manual reposition. Typical symptoms, such as bleeding, weeping and secretion of mucous material, become stronger.
Fourth degree: Permanent prolaps
Hemorrhoids are permanently prolapsed and partially fixed outside the anocutaneous line, no reposition possible. A typical symptom is anal itching caused by impaired continence.
It’s itching and burning:
View our cartoon episode 1.
Hemorrhoidal disease at stage I
First-degree piles (1) project into the anal canal, but do not prolapse.
Hemorrhoidal disease at stage II-IV
Second-degree piles temporarily protrude beyond the edge of the anal orifice
and show spontaneous reposition, third-degree piles are permanently prolapsed
and require manual reposition (1),
fourth-degree piles Hemorrhoids are
permanently prolapsed; no reposition possible (2).