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Hemorrhoids, also known as piles, are cushions of blood vessels that line the anal passage. When these veins become swollen or enlarged, they can cause a range of symptoms, including anal bleeding, discomfort, and irritation.
Generally, external hemorrhoids, which develop under the skin outside of the anus, tend to heal on their own in a few days or weeks. Internal hemorrhoids, which form inside the anus or rectum, can persist for much longer, and they can get progressively worse. Internal hemorrhoids are categorized into four stages or grades. These stages reflect the severity of symptoms and what type of treatment will be effective.
Early-stage hemorrhoids are still inside the anal canal, so they aren’t visible. Symptoms may be minor or even unnoticeable, depending on how swollen the veins are.
Common symptoms of early stage 1 hemorrhoids include:
Early-stage hemorrhoids often go unnoticed without a medical exam. They also may respond well to at-home care and lifestyle changes, such as adding fiber to the diet, drinking more water, and being more physically active. If there is irritation or itching, over-the-counter hemorrhoid treatments can offer relief.
A stage 2 hemorrhoid is an internal hemorrhoid that prolapses (bulges out of the anal canal) during bowel movements but retracts on its own.
Symptoms of a stage 2 internal hemorrhoid include:
Mild prolapse indicates that the hemorrhoid is still manageable. However, it can progress without medical intervention.
A stage 3 hemorrhoid won’t automatically retract inside the anus because the connective tissue that holds the veins in place is too weak. Instead, the hemorrhoid has to be pushed back inside manually. Once repositioned, it will remain inside temporarily but may prolapse again after a bowel movement or straining.
Symptoms of stage 3 hemorrhoids include:
At this stage, there’s a higher risk of painful complications, such as blood clotting or tissue damage, because blood can’t flow through the vein due to inflammation.
Hemorrhoids that are permanently prolapsed are considered stage 4 hemorrhoids. This is the most advanced of all the hemorrhoid stages.
Symptoms of a stage 4 hemorrhoid include:
At this stage, at-home remedies like over-the-counter hemorrhoid creams and sitz baths won’t be effective. Medical treatment is necessary for resolution.
It’s important to seek treatment for internal hemorrhoids early on to avoid more severe symptoms and to prevent the hemorrhoid from progressing beyond the point where less invasive treatment options are effective.
Mild hemorrhoids (stage 1) usually respond well to at-home care. Moderate to severe hemorrhoids (stages 2 and 3) can be treated non-surgically. Very severe hemorrhoids (stage 4) might only respond to hemorrhoid removal surgery.
Understanding what to expect for the hemorrhoid stages can help determine when to seek treatment. At-home care and healthy lifestyle changes, such as eating more fiber, staying hydrated, and being physically active, can relieve early-stage hemorrhoids.
If symptoms persist or worsen despite conservative management, or if hemorrhoid symptoms impact your daily life, schedule a consultation with a hemorrhoid doctor near you. A specialist can help determine what stage of hemorrhoids you have and recommend a personalized treatment plan to help you get relief.
A hemorrhoid doctor can determine what hemorrhoid stage you have. Hemorrhoids range from stage 1 ( no prolapsed (bulge outside of the anus), stage 2 ( prolapsed but retract on their own, stage 3 (require manual repositioning, and stage 4 (hemorrhoid can’t be placed back inside the anus).
A stage 1 hemorrhoid can go away without medical treatment. Caring for the hemorrhoid at home can help it heal faster and alleviate symptoms. If the hemorrhoid persists and symptoms worsen, consider scheduling a consultation with a hemorrhoid doctor to get a personalized treatment plan.
Stage 4 hemorrhoids might require surgery. These hemorrhoids are usually very inflamed, and the connective tissue can no longer hold the hemorrhoid in place, so they are permanently prolapsed.
I am so glad to have gone to USA Hemorrhoid Centers. My experience has been amazing. The staff are all so friendly but professional. The doctor is wonderful and in his professional manner makes you very comfortable and explains anything you have questions about. So very happy.
USA Hemorrhoid Centers all staff were incredible. They communicated throughout and checked in frequently to ensure I was as comfortable as possible. I am happy I chose to get the treatments and look forward to the improvements.
I am so glad to have gone to USA Hemorrhoid Centers. My experience has been amazing. The staff are all so friendly but professional. The doctor is wonderful and in his professional manner makes you very comfortable and explains anything you have questions about. So very happy.
USA Hemorrhoid Centers all staff were incredible. They communicated throughout and checked in frequently to ensure I was as comfortable as possible. I am happy I chose to get the treatments and look forward to the improvements.
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USA Hemorrhoid Centers are accredited for providing high-quality outpatient care. Our doctors who perform Hemorrhoid artery embolization are experienced interventional radiologists with expertise in vascular anatomy.
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