Piles is generally not a serious medical condition and can be treated with lifestyle changes and home remedies, like increasing fiber intake, drinking plenty of water, practicing good hygiene, using over-the-counter creams or ointments, and avoiding straining during bowel movements. However, in more severe cases, surgical procedures may be required.

Piles can be classified into the following based on their location and characteristics:

Internal Piles Internal piles develop inside the rectum above the dentate line. They are not visible from the outside and are categorized into different grades based on their severity and prolapse.

• Grade 1: Grade 1 piles are the mildest form of internal piles. They are small and found in the lining of the rectum. They do not protrude out of the anus and usually do not cause any symptoms. Treatment for Grade 1 piles often begins with conservative measures, like lifestyle modifications, sitz baths, topical creams or ointments, etc.
• Grade 2: Grade 2 piles are larger than Grade 1 and may protrude during bowel movements. They protrude from the anus but spontaneously retract back into the rectum after the bowel movement. Treatment options for Grade 2 piles may include non-surgical interventions like rubber band ligation, infrared coagulation, and sclerotherapy.
• Grade 3: Grade 3 piles also prolapse during bowel movements but do not retract independently. They need to be manually pushed back into the rectum. They may cause significant discomfort, pain, itching, bleeding, and difficulty maintaining proper hygiene. Treatment options for Grade 3 piles may include rubber band ligation, infrared coagulation, and sclerotherapy.
• Grade 4: Grade 4 piles are the most severe and advanced stage. They remain prolapsed and cannot be manually repositioned. These piles are large, inflamed, and highly sensitive. Grade 4 piles can cause intense pain, bleeding, and hygiene difficulties. In addition, they may also be associated with complications such as thrombosis (blood clots) or strangulation. Surgical intervention may be necessary for Grade 4 piles, and options may include laser surgery and stapled hemorrhoidectomy.