Understanding the Four Stages of Piles (Hemorrhoids)
Piles, also known as hemorrhoids or Bawaseer, are one of the most common yet misunderstood conditions affecting the rectum and anus. They occur when veins in this area become swollen and inflamed, often causing pain, itching, and bleeding.
At Thrissur Piles Clinic, led by Dr. Raviram S, a Senior Proctologist in Thrissur, patients receive personalized, evidence-based care for every stage of piles—from early discomfort to advanced cases requiring laser surgery. Understanding which stage of piles you have is the first step toward lasting relief.
The Four Stages of Piles (Babaseer) Explained:
Piles are classified into four grades or stages based on the severity of swelling and prolapse (when hemorrhoids push out of the anus).
Let’s understand them one by one.
Stage 1: Early or Initial Stage of Piles
In this first stage, the hemorrhoids remain inside the rectum. You may not feel any visible lump, but slight bleeding can occur during bowel movements.
Common symptoms:
- Mild bleeding or blood spots after passing stool
- Itching or irritation near the anus
- Feeling of incomplete bowel emptying
How to cure the first stage of piles?
Early piles can be reversed with lifestyle changes:
- Eat a high-fibre diet with fruits, vegetables, and whole grains
- Drink 8–10 glasses of water daily
- Avoid straining or sitting too long in the toilet
- Take short walks daily to improve digestion
Dr. Raviram S recommends simple home-based and preventive care at this stage, avoiding the need for surgery.
Stage 2: Moderate Stage of Piles
Here, the hemorrhoids prolapse (come out) during bowel movements but go back inside on their own. The bleeding may increase, and discomfort becomes more noticeable.
Symptoms:
- Painless bleeding while passing stool
- Mucus discharge or itching
- A small lump was felt during a bowel movement
- Occasional pain or irritation
Treatment for Stage 2 piles:
If lifestyle changes don’t help, minimally invasive treatments are advised:
- Rubber Band Ligation – a small rubber band cuts the blood supply to the hemorrhoids.
- Sclerotherapy – a medicine is injected to shrink piles.
- Infrared Coagulation – heat therapy seals small hemorrhoids.
At Thrissur Piles Clinic, these procedures are done as day-care treatments — no stitches, no hospital stay, and patients return home the same day.
Stage 3: Advanced Stage of Piles
By Stage 3, hemorrhoids become larger and remain outside the anus after passing stool. You need to push them back gently with your hand.
Symptoms:
- Painful swelling around the anus
- Persistent bleeding
- Difficulty sitting or walking
- Feeling of pressure in the rectal area
Recommended treatment:
At this stage, non-surgical options are less effective. The best choice is Laser Piles Treatment — the most modern and painless procedure available in Kerala.
Laser Piles Surgery in Thrissur offers:
- Local or spinal anaesthesia
- 20-minute procedure
- Same-day discharge
- No stitches, minimal bleeding
- Quick recovery (within 7–10 days)
- Very low recurrence rate
Dr. Raviram S, an experienced laser piles surgeon in Thrissur, has successfully treated thousands of patients using FiLaC (Fistula-tract Laser Closure) and LHP (Laser Hemorrhoidoplasty) methods.
Stage 4: Severe Piles (Grade 4 Hemorrhoids)
This is the most serious stage. The hemorrhoids remain permanently prolapsed outside the anus and cannot be pushed back. Pain, swelling, and bleeding are constant.
Stage 4 symptoms:
- Continuous pain and heaviness
- Frequent bleeding
- Large external lumps
- Difficulty sitting or standing
- Risk of infection or thrombosis
Treatment:
Only surgical management gives long-term relief. Laser Piles Surgery in Thrissur or, in rare cases, Open Hemorrhoidectomy may be recommended.
Laser surgery offers:
- Minimal bleeding
- Faster recovery (2–3 weeks)
- Reduced postoperative pain
- High success and low recurrence rates
Recognizing Early Symptoms Across All Stages:
- Bleeding during or after bowel movements
- Itching and burning near the anus
- Pain while sitting or passing stool
- Mucus discharge
- Feeling of incomplete evacuation
If you notice any of these, consult Dr. Raviram S., a piles specialist in Thrissur, at the earliest for timely care.
Why Piles (Bawaseer) Develop?
Several lifestyle and health factors increase the risk of developing piles:
- Chronic constipation or diarrhoea
- Straining during bowel movements
- Low-fibre diet
- Prolonged sitting or standing
- Obesity
- Pregnancy and childbirth
- Heavy lifting
- Ageing (weaker vein walls)
- Family history of piles
Dr. Raviram S emphasises prevention through dietary fibre, hydration, regular activity, and stress management.
Diagnosis — How Doctors Identify the Stage of Piles?
At Thrissur Piles Clinic, diagnosis is simple and painless:
- Physical Examination – visual check of the anal area.
- Digital Rectal Exam (DRE) – gentle finger examination to assess swelling.
- Anoscopy or Proctoscopy – viewing inside the rectum using a small scope.
- Colonoscopy – if required, to rule out other causes of bleeding.
Once the hemorrhoid stage is confirmed, Dr. Raviram S explains the findings and recommends the most suitable treatment plan.
Treatment Options Based on Stage at Thrissur Piles Clinic:
At Thrissur Piles Clinic, treatment depends on the stage and symptoms:
For Stage 1:
- Lifestyle correction and dietary advice
- Sitz baths and topical creams
- Avoiding constipation and straining
For Stage 2:
- Outpatient procedures such as Rubber Band Ligation, Sclerotherapy, or Infrared Coagulation
For Stage 3 & 4:
- Laser Hemorrhoidoplasty (LHP) or FiLaC
- Stapler Hemorrhoidopexy (PPH)
- In rare cases, open hemorrhoidectomy for complex piles
The cost of Piles Surgery in Kerala depends on severity, technology, and hospital facilities. Thrissur Piles Clinic offers transparent pricing, EMI options, and cashless insurance for all major providers.
How to Prevent Piles from Progressing?
Simple daily habits can prevent piles from getting worse:
- Eat a balanced high-fibre diet (fruits, vegetables, oats, brown rice).
Drink 8–10 glasses of water - Avoid sitting for long periods—stand or walk every hour.
- Exercise regularly (walking, swimming, yoga).
- Respond quickly to the urge to pass stool.
- Maintain a healthy weight.
- Avoid lifting heavy weights unnecessarily.
- Manage stress for healthy digestion.
Following these measures after treatment also reduces the risk of recurrence.
Thrissur Piles Clinic — Kerala's Trusted Proctology Centre:
Located in the heart of Thrissur, Thrissur Piles Clinic is a dedicated centre for painless, advanced hemorrhoid and colorectal treatments.
About Dr. Raviram S – Piles Specialist in Kerala:
- MBBS, MS (General Surgery), MCh (Surgical Gastroenterology)
- Over 15 years of experience in colorectal care
- Specialist in Laser Piles, Fissure, Fistula & Pilonidal Sinus Treatments
- Trained in advanced proctology procedures from leading institutes in India
Why Choose Thrissur Piles Clinic?
- Advanced Laser & Endoscopic Equipment
- Experienced and compassionate medical team
- Affordable pricing with EMI & insurance support
- Same-day discharge for most laser procedures
- High success rate (above 90 %)
- Privacy and comfort assured
Thousands of patients from Thrissur, Kochi, and across Kerala have found lasting relief here.
Conclusion — Know Your Stage, Choose the Right Treatment
Understanding the Four Stages of Piles helps you act before complications arise.
- Stage 1–2: Manageable with diet and outpatient procedures.
- Stage 3–4: Require expert laser or surgical care.
With early diagnosis and expert guidance from Dr. Raviram S, piles can be completely cured—without fear or embarrassment.
If you’re experiencing bleeding, itching, or discomfort, don’t delay. Consult Dr. Raviram S. at Thrissur Piles Clinic today to understand your stage and receive customized, painless treatment.
FAQS: About the Four Stages of Piles (Hemorrhoids)
The four stages of piles range from mild internal swelling (Stage 1) to severe, permanently prolapsed hemorrhoids (Stage 4) that often need surgical treatment.
The first stage of piles is when veins inside the rectum swell slightly but do not protrude outside. Symptoms include mild bleeding, itching, and discomfort.
The first stage can often be cured with a high-fibre diet, plenty of water, regular exercise, and avoiding straining during bowel movements.
Early piles are treated through dietary changes, sitz baths, topical creams, and medicines prescribed by a Proctologist in Thrissur, like Dr. Raviram S at Thrissur Piles Clinic.
Yes. Most Stage 1 piles heal without surgery if you maintain good bowel habits, hydration, and follow your doctor’s advice.
Follow a fibre-rich diet, stay hydrated, avoid sitting for long periods, and use prescribed ointments. Early medical advice ensures faster recovery.
In Stage 2, hemorrhoids may protrude during bowel movements but retract automatically afterward. Minimally invasive treatments like rubber band ligation or laser therapy work well.
Stage 3 piles require manual pushing back, while Stage 4 piles remain permanently outside, often causing pain, bleeding, and infection.