How to Know If You Have Internal or External Piles
Most people realise they have piles when they notice bleeding, pain, itching, or a lump near the anus. But very few know whether their piles are internal or external. This matters because both types behave differently, show different symptoms, and require different treatment methods. Internal piles often bleed but are painless, while external piles usually hurt and form visible lumps.
At Thrissur Piles Clinic, senior Proctologist in Thrissur, Kerala — Dr. Raviram S, helps patients quickly identify the type of piles they have through simple examination and advanced diagnostic tools. Correct identification ensures faster relief, proper treatment, and prevention of complications.
What Are Internal and External Piles?
Piles (hemorrhoids) are swollen veins in the rectum and anus. These swollen veins can occur inside the anal canal or outside the anus.
What Are Internal Piles?
Internal piles form inside the rectum. They are located in an area with very few pain nerves.
This means:
- They often do not cause pain.
- They cause bright red bleeding during bowel movements.
- They may prolapse (come out) when they become bigger.
Internal piles are classified into Grade 1 to Grade 4, depending on whether they come out and whether they go back inside by themselves.
What Are External Piles?
External piles develop under the skin around the anus. This area is rich in pain nerves, so external piles often cause:
- Pain or discomfort
- Swelling or lumps around the anus
- Itching and burning sensation
- Sometimes blood clots (thrombosis), which cause severe pain
External piles are easier to see and feel compared to internal piles.
Key Differences Between Internal and External Piles:
Understanding these key differences helps you quickly identify your piles type.
Symptoms That Help You Identify the Type of Piles:
Symptoms of Internal Piles:
- Bright red blood during stool
- A feeling of incomplete bowel movement
- Mucus discharge
- Painless swelling inside the rectum
- Piles coming out (in advanced stages)
Symptoms of External Piles:
- Pain around the anus
- Swelling or a visible lump
- Severe itching or burning
- Painful hard lump (if thrombosed)
- Difficulty sitting or walking comfortably
How to Know If You Have Internal or External Piles – Quick Self-Check Guide?
You can use this simple self-check method:
1. Check for visible lumps
- Yes, there is a visible lump → External piles
- No visible lump → Likely internal piles
2. Check your pain level:
- Bleeding but no pain → Internal piles
- Painful swelling → External piles
3. Identify the type of bleeding:
- Bright red blood on tissue → Internal piles
- Minimal bleeding near a lump → External piles
4. Feel for swelling:
- Swelling outside → External piles
- No swelling outside → Internal piles
If you are still unsure, a quick consultation with a Piles Specialist in Thrissur avoids confusion and ensures proper care.
When Should You See a Proctologist?
You should consult a Proctologist in Thrissur if:
- Bleeding continues for more than a week
- You see a painful hard lump
- Pain prevents sitting or walking comfortably
- Symptoms repeatedly come and go
- Over-the-counter creams are not helping
- You suspect thrombosed piles
- You find mucus in stool or experience itching with bleeding
Early diagnosis prevents complications and helps avoid surgery in many cases.
How Piles Are Diagnosed at Thrissur Piles Clinic?
At Thrissur Piles Clinic, diagnosis is simple and painless.
- Visual Examination: External piles are easily identified by looking at the anal area.
- Digital Rectal Examination: A gentle examination helps detect internal piles and rule out other issues.
- Anoscopy: A small tube with light is used to check the internal piles clearly.
- Proctoscopy: Shows the full rectal area and helps grade internal piles accurately.
Dr. Raviram S. ensures that the entire process is comfortable, quick, and fully explained.
Treatment Options for Internal and External Piles at Thrissur Piles Clinic:
At Thrissur Piles Clinic, Dr. Raviram S offers customised treatment for both internal and external piles based on symptoms, grade, and severity. The goal is to provide quick relief, painless procedures, and long-term results.
Internal Piles Treatment:
Grade 1–2:
- Medicines and lifestyle changes
- Sitz baths
- High-fiber diet
- Office procedures like Rubber Band Ligation or Infrared Coagulation
Grade 2–4:
- Laser Piles Treatment
- Painless
- No stitches
- Same-day discharge
- Fast healing (3–5 days)
Laser piles surgery is highly effective for internal piles with minimal recurrence.
External Piles Treatment:
Mild External Piles:
- Creams and ointments
- Sitz baths
- Cold compresses
Painful Thrombosed External Piles:
- Minor procedure to remove a clot
- Instant pain relief
Persistent External Piles:
- Laser Piles Surgery in Thrissur
- Quick recovery
- Suitable for sensitive skin around anus
Home Remedies vs. Medical Treatment – What Actually Works?
Many people try home remedies first when they notice piles symptoms. These simple steps can reduce discomfort, but it’s important to understand their limits.
Home Remedies:
- Warm sitz baths: Sitting in warm water for 10–15 minutes relaxes the area, reduces itching, and soothes pain.
- Fiber-rich food: Fruits, vegetables, whole grains, and fibre supplements help soften stools and prevent straining.
- Hydration: Drinking 8–10 glasses of water daily keeps stools soft and reduces constipation.
- Coconut oil or aloe vera: These natural options help soothe irritation and reduce itching.
- Avoiding spicy and oily foods: Helps prevent irritation and reduces bowel discomfort.
- Regular physical activity: Walking and light exercise improve digestion and reduce pressure on rectal veins.
These remedies help with mild piles, but they cannot shrink or remove larger piles.
When Medical Treatment is Needed?
- Repeated bleeding during or after bowel movements
- Persistent pain that affects sitting or daily work
- Visible lumps that do not go away
- Prolapsed piles that hang outside the anus
- Thrombosis (blood clot) causing severe pain and swelling
- Symptoms that do not heal even after home remedies
Advanced piles require medical intervention for long-term relief.
Preventing Internal and External Piles:
- Eat high-fiber foods
- Drink enough water daily
- Avoid straining during stool
- Don’t sit on the toilet for long
- Exercise regularly
- Avoid constipation
- Maintain healthy weight
- Limit spicy, junk, and oily foods
Small habits can prevent piles from recurring.
Why Choose Thrissur Piles Clinic for Piles Diagnosis & Treatment?
Thrissur Piles Clinic, led by Dr. Raviram S, is one of Kerala’s most trusted centres for piles treatment.
Why patients prefer us:
- 15+ years of experience in Proctology
- Completed 3,000+ successful piles and sinus surgeries
- Expert in Laser Piles Surgery and minimally invasive procedures
- Accurate and painless diagnosis
- Quick procedures with same-day discharge
- Affordable pricing
- Clean and patient-friendly clinic
- Trusted by patients across Thrissur, Kochi, Palakkad, and Malappuram
Dr. Raviram S explains every detail in simple words, ensuring you feel comfortable and confident throughout the treatment.
Conclusion:
Knowing whether you have internal or external piles helps you choose the right treatment and prevents complications. Internal piles cause painless bleeding, while external piles cause pain, swelling, and visible lumps.
If you are experiencing symptoms like bleeding, itching, pain, or swelling, don’t ignore them. Early diagnosis gives faster and safer relief.
For accurate diagnosis and effective treatment, visit Thrissur Piles Clinic – Kerala’s trusted centre for painless laser piles treatment.
Book your consultation with Dr. Raviram S, the leading Piles Specialist in Thrissur, and get long-lasting relief today.