Internal Piles (Hemorrhoids) - Causes & Treatment

Internal piles are found inside the rectum and are not visible from the outside. You can get the best treatment for internal piles at Pristyn Care using advanced surgery, post-surgery care, multiple payment options, etc. Book a consultation today for proper guidance and safe surgery for internal piles.

Internal piles are found inside the rectum and are not visible from the ... outside. You can get the best treatment for internal piles at Pristyn Care using advanced surgery, post-surgery care, multiple payment options, etc. Book a consultation today for proper guidance and safe surgery for internal piles. Read More

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Dr. Vipin Nagpal

MBBS, MS-General Surgery

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Pristyn Care Elantis Hospital, Lajpat Nagar, Delhi

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What Are Internal Piles?

Piles (hemorrhoids) are enlarged blood vessels inside or around your anus (the opening of the bottom). It is normal to have blood vessels in your anus, as they play an essential role in continence. But piles can evolve if these blood vessels become enlarged, which can cause certain symptoms like blood in stools, swelling or painful lumps near the anus, etc. Also, piles can develop because of multiple reasons, including older age, constipation, and pregnancy.

Internal piles are found inside the rectum and are not visible from the outside. They are generally minimal pain and rectal bleeding is the first sign of internal piles. Piles can also be external as well.

An internal pile protruding through the anus is called a prolapsed pile. This medical condition can be due to the wearing out of the muscles around the anus and can be extremely painful. Medical experts grade internal piles from 1 to 4, depending on the degree of prolapse:

Grade 1 piles remain in the rectum without protruding out of the anus.
Grade 2 piles prolapse when someone passes stool, then return inside on their own.
Grade 3 piles are prolapsed and should be pushed back in.
Grade 4 piles are prolapsed and cannot be pushed back in.

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Symptoms Of Internal Piles

Usually, internal piles are not a serious medical condition, and they do not readily show signs and symptoms. However, specific symptoms of internal hemorrhoids include:

Blood on the poop, on toilet paper, after you wipe, or in the toilet bowl
Pain and discomfort during defecation (bowel movement)
Feeling of constipation
Tissue that bulges outside the anal opening. This may be painful and can hurt when you poop. You might be able to see prolapsed piles as moist bumps that are pinker than the surrounding area.

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Causes Of Internal Piles

Internal piles occur when there is excess pressure on the veins around the anus. Possible causes and risk factors of internal piles include:

Pregnancy: At the time of pregnancy, tissues in the rectum get weaker, and hormones cause veins to swell and relax. Internal piles may emerge in up to 35% of pregnant women.
Aging: Internal piles are most common among adults over the age of 50 years. However, young people and children can also have piles.
Diarrhea: Internal piles can occur after cases of chronic diarrhea.
Chronic constipation: Straining to move stool puts extra pressure on the walls of the blood vessels, which can lead to internal piles.
Sitting for too long: Sitting in a seated position, particularly on the toilet, can also result in internal piles.
Diet: Eating low-fiber foods may contribute to internal piles.
Heavy lifting: Frequently lifting hefty objects can lead to internal piles.
Anal intercourse: Anal intercourse can cause new piles or worsen existing ones.
Weight: Research has linked being overweight to an increased risk of internal piles. It may result from increased pressure within the abdomen.
Genetics: There are people who inherit a tendency to develop internal piles.

Diagnosis And Treatment Of Internal Piles

Diagnosis

An experienced proctologist can quickly diagnose and treat internal piles. Your proctologist will ask about your medical history and symptoms to diagnose internal piles. They can also suggest the below mentioned examinations for a better diagnosis:

Physical exam- The proctologist will examine your anus and rectum to check for swelling, lumps, irritation, or other concerns.
Digital rectal exam- Your doctor will wear gloves, apply lubrication, and insert a finger into the rectum to inspect muscle tone and feel for lumps, tenderness, or other problems.
Anoscopy- In an anoscopy, the doctor uses an anoscope to see the lining of the anus and rectum. The doctor will examine the tissues or blood vessels lining the anus and rectum to look for lower digestive tract problems and bowel disease.
Sigmoidoscopy- In sigmoidoscopy, the doctor looks into the lower colon with a flexible tube called a sigmoidoscope. They can also use the tube to take some tissues for tests.
Colonoscopy– In a colonoscopy, the doctor looks at your large intestines with a flexible colonoscopy tube. They can also take tissue samples or treat other issues they find.

Treatment

The doctor’s treatment plan for internal piles depends on the severity of the symptoms. Some of the ways to treat internal piles include:

Home remedies – Lifestyle changes can reduce internal piles symptoms within 2 to 8 days. Some lifestyle changes can include adding fiber to the diet with over-the-counter supplements and foods like fruit, vegetables, and grains. Also, avoid straining during bowel movements and drink more water. However, to prevent piles from recurring, surgery is considered the most effective method to treat them.
Nonsurgical treatments – Over-the-counter creams and other medications can help ease pain, itching, and swelling.
Surgical treatments – Piles Laser surgery is one of the most successful and effective treatment methods for internal piles. Laser surgery is a surgical procedure in which a laser beam ablates the piles. It is also known as the hemorrhoidal laser procedure or laser hemorrhoidectomy. Alternatively, your surgeon may staple a prolapsed pile back into place in the anus. It is known as stapler surgery or stapled hemorrhoidectomy that uses a stapling device to remove piles tissues. Doctors advise this treatment procedure for patients whose piles have prolapsed or become abnormally large.

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Benefits for Internal Piles Surgery

Benefits Of Laser Surgery For Internal Piles

Laser surgery for internal piles has the following benefits:

No necessity for general anesthesia
Lesser pain than any other surgical procedure
No requirement for a hospital stay
Safer treatment option
Lesser bleeding during the procedure
Quicker healing
Shorter recovery period
No open wounds, cuts, or sutures
Quicker return to everyday activities
Shorter duration to complete the procedure
Better success rate
Fewer follow-up visits
No or less risk of post-surgical infections
Lower risk of recurrence of internal piles

Benefits Of Stapler Surgery For Internal Piles

Stapler surgery for piles is an advanced surgical process, and it has many advantages such as:

Lesser pain
Lesser bleeding
Faster recovery
Shorter hospital stay
Smaller incisions
High accuracy

How to Prevent Internal Piles?

Internal piles can be prevented by practicing certain healthy lifestyle habits. Below are some ways to prevent internal piles. They are as follows:

Avoid sitting too long: Sitting too long, mainly on the toilet, can raise the pressure on the veins in the anus, which can worsen your internal pile’s condition.
Eat high-fiber foods- Eat more vegetables, fruits, and whole grains. Eating high-fiber foods can soften the stool and improve its bulk, which will help avoid the straining that can result in internal piles. Furthermore, add fiber to the diet slowly to avoid problems with gas.
Drink plenty of fluids- To prevent internal piles, drink at least six to eight glasses of water and other liquids daily to help keep stools soft.
Consider fiber supplements- Most people don’t get sufficient fiber, i.e., 20 to 30 grams daily in their diet. Research has shown that over-the-counter fiber supplements like psyllium can improve overall symptoms and bleeding from piles. If you use fiber supplements, drink at least six to eight glasses of water daily because the supplements can cause or worsen constipation.
Don’t strain- Straining when trying to pass a stool puts greater pressure on the veins in the lower rectum. Added pressure on the veins of the rectum is a huge reason contributing to internal piles.
Exercise- Stay active to help prevent constipation and to relieve pressure on veins, which can happen with long periods of sitting or standing. Regular exercise can also help you lose weight which might contribute to your internal piles.

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Common FAQs Around Internal Piles

Do internal piles go away on their own?

In many cases, internal piles, including prolapsed hemorrhoids, can go away on their own within some days. If it does not go away independently, it is suggested to seek immediate treatment from an experienced proctologist.

Are internal piles serious?

Internal piles become serious only when they prolapse. When internal piles prolapse, they become strangulated, and patients experience acute pain and may have urinary retention. Urgent treatment through laser or stapler surgery is recommended in case of prolapsed piles.

Are internal piles common?

Internal piles are very common in both women and men. About half of all people will have internal piles by age 50. In addition, many women get internal piles during pregnancy and childbirth.

Is walking good for internal piles?

Yes, according to research, walking is good for internal piles. Regular brisk walking can enhance bowel health and lower the risk of internal piles.

Are internal piles cancerous?

No, internal piles are not cancerous and do not lead to cancer.

Which food items should be avoided during internal piles?

The food items to avoid during internal piles are fast food, spicy food, processed food, dairy products, red meat, caffeinated drinks, and alcohol.

Medically Reviewed By

Dr. Vipin Nagpal

MBBS, MS-General Surgery

31+ Years Experience Overall

Last Updated : October 25, 2026

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12 Oct, 2026

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Dr. Digvijay is an excellent surgeon for piles and hemorrhoid treatment. He is very kind-hearted, caring, and professional. I am truly grateful to him for his exceptional care, support, and dedication throughout my treatment. My treatment was successful, and I sincerely appreciate his efforts. Thank you so much, Dr. Digvijay Sir, for everything. I highly recommend him to anyone seeking treatment for piles and hemorrhoids. 🙏❤️ He is a very kind-hearted and wonderful person. I am truly grateful to him for his care, support, and dedication in making my treatment successful. Thank you so much, sir, for everything. 🙏❤️

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